Hi ~ Opie,
Our welcome letter will follow but I wanted this posting to be under eglman's...
Quote from Opie’s posting above:
3 months PSA:<.01
15 months :.06 (new software)
18 months: .07
We were advised that the low level PSA could be due to :
1. PSA is naturally occurring in the body
2.Could be from benign prostate cells left behind
3. Prostate cells beyond the surgical margins.
Are there any other explanations for the low level PSA? Any ideas on the probabilities of the above three scenarios?
I found the answers for 1,2,3 in the books listed below. In reference to low level PSA… as long as it’s undetectable… that’s what we are looking for. The fluctuation stated above in the excerpt gives credence to this scenario. And that’s the rule we will be following as we move forward in “Our Journey” after RRP.
I had a hard time trying to understand the PSA results when reading some post… So ~ I had Buddy sit down with me to give me a visual!!! This is a personal view on the PSA information… The information I provide below is specific to “Our Journey ~ RRP” and our lab.
I hope this helps you to understand a little more about your results.
Our lab uses <0.1 as their scale. So when we got our 1st and 2nd call from the nurse she stated that our PSA was <0.1 undetectable which ='s a Woo~Hoo!!
Many labs classify anything <0.1 (10 pennies) as undetectable
Here’s a question that we would get answered by inquiring of the lab or your urologist.
What results do I have to be within to still be in the “undetectable” range with your testing procedure?
Based on the lab results I’ve received (2 different programs used) are they classified as being undetectable?
Here’s a scale that helped me to understand our scale with having Retropubic Radical Prostatectomy:
(green is in the undetectable range for our lab)
<0.01 (no pennies)
0.01 = 1 penny
0.06 = 6 pennies
0.07 = 7 pennies
0.09 = 9 pennies
0.1 = 10 pennies
At this point we would start monitoring.
0.11 = 11 pennies
0.12 = 12 pennies
0.20 = 20 pennies
0.50 = 50 pennies
1.6 = 160 pennies
2.0 = 200 pennies
2.5 = 250 pennies
* Excerpt: PSA Anxiety… The Downside of Ultra-Sensitive Tests
You’ve had the radical prostatectomy, but deep down, you’re terrified that it didn’t work. So here you are, a grown man, living in fear of a simple blood test, scared to death that the PSA—an enzyme made only by prostate cells, but all of your prostate cells are supposed to be gone—will come back. Six months ago, the number was 0.01. This time, it was 0.02.
You have PSA anxiety. You are not alone
This is the bane of the hypersensitive PSA test: Sometimes, there is such a thing as too much information. Daniel W. Chan, Ph.D., is professor of pathology, oncology, urology, and radiology, and director of Clinical Chemistry at Johns Hopkins. He is also an internationally recognized authority on biochemical tumor markers such as PSA, and on immunoassay tests such as the PSA test. This is some of what he has to say on the subject of PSA anxiety:
The only thing that really matters, he says, is, “At what PSA levels does the concentration indicate that the patient has had a recurrence of cancer?” For Chan, and the scientists and physicians at Hopkins, the number to take seriously is 0.2 nanogram/milliliter. (20 pennies my italics) “That’s something we call biochemical recurrence. But even this doesn’t mean that a man has symptoms yet. People need to understand that it might take months or even years before there is any clinical, physical evidence.”
On a technical level, in the laboratory, Chan trusts the sensitivity of assays down to 0.1, or slightly less that that. “You cannot reliably detect such a small amount as 0.01,” he explains. “From day to day, the results could vary—it could be 0.03, or maybe even 0.05”—and these “analytical” variations may not mean a thing. “It’s important that we don’t assume anything or take action on a very low level of PSA. In routine practice, because of these analytical variations from day to day, if it’s less than 0.1, we assume it’s the same as
nondetectable, or zero.”
*Dr. Walsh’s Guide to Surviving Prostate Cancer (2001)
Chapter 10 How Successful is Treatment?
Within this chapter there are many questions answered.
What Should I Do if My PSA Comes Back after Surgery?
Cancer Control after Radiation Therapy
What Happens if PSA Comes Back Again, or If I have Distant Metastases?
Dr. Peter Scardino’s Prostate Book (2006)
Chapter 20 Rising PSA after Surgery or Radiation Therapy
Read this chapter to learn:
Why do some prostate cancers recur?
Does a rising PSA always mean cancer?
What can be done about a rising PSA after surgery or radiation?
Our thoughts are with you both…as you continue to move forward in your journey. It sounds like you’ve got a great support group!! Thanks for allowing us to walk with you.
In Friendship ~ Lee & Buddy
mama bluebird - Lee & Buddy… from North Carolina
v We invite you to visit our personal thread: Click Here: “Our Journey” ~ Sharing is Caring
April 3, 2006 53 on surgery day
RRP / Radical Retropubic Prostatectomy
PSA 4.6 Gleason 3+3=6 T2a Confined to Prostate
4th PSA 2-13-2008 (23 months) Less than 0.1 Non-Detectable :)
Post Edited (bluebird) : 3/4/2008 7:31:43 PM (GMT-7)