Post-Treatment PSA Testing

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Tim G
Veteran Member

Date Joined Jul 2006
Total Posts : 2332
   Posted 2/15/2008 1:21 PM (GMT -6)   
There are two PSA tests that are most often used to track for residual cancer after prostate cancer treatment.
The first is the standard PSA test, approved by the FDA in 1994 and sensitive to 0.1 ng/mL.  Anything below 0.1 ng/mL is considered undetectable.  
The second is the ultrasensitive PSA test.  This test is sensitive to 0.01 ng/mL and is considered by some prostate cancer experts to be better at picking up any significant rise in PSA following prostate cancer treatment. 
There is controversy about which PSA test to use in tracking prostate cancer patients after treatment. Some urologists believe that anything below 0.1 ng/mL is insignificant so use only the standard PSA test.  They say that the ultrasensitive test, with PSA lower limit of 0.01 ng/mL gives too much emphasis to what is essentially 'noise' or test variability,say,the difference between 0.01 and 0.03 ng/mL 
When you see individual PSA test results reported on the forum, those   with values one number to the right of the decimal point have had the standard PSA test; those with two numbers to the right of the decimal have had the ultrasensitive PSA test.
Example: 0.1 ng/mL vs. 0.01 ng/mL

Age 59 PSA 2.6 PSA velocity quadrupled in 1 yr 
1 of 12 biopsies positive (5%) 
Open surgery June 2006 
Cancer confined to one small area Gleason 5 
PSA's non-detectable

Regular Member

Date Joined Dec 2007
Total Posts : 56
   Posted 2/15/2008 1:54 PM (GMT -6)   
Thanks for the explanation, Tim. I had my blood drawn Tuesday for my first post-op test, and while waiting I noticed on the form it specifically said a different version of the test was being used. I'm not sure if that means it's the ultra-sensitive version but now I'll know enough to ask. I'll post the results in my thread when I get them...

Regular Member

Date Joined Apr 2007
Total Posts : 101
   Posted 2/15/2008 4:51 PM (GMT -6)   
Hi Tim, I appreciate the explanation about the two different types of psa tests. DesertGal had a post about her hubbys psa and had shown it as 0.1 and indicated that their doc said that was undetectable.....I added to her post and asked her to double check that score as I had always understood that below .05 was undetectable. She replied and indicated that the lab where the test was done couldn't check any lower than 0.1 and they considered that to be undetectable.....I hope she didn't take any offense as I was only wanting her to make sure she was getting the right information....jwb.
age: 62
PSA 4.57 - Positive DRE
Biopsy 3-19-07 - Gleason 4+4=8
Negative bone scan 3-20-07
DaVinci 4-24-07
Catheter out 5-01-07
post op pathology:
positive margin left side of prostate
left seminal vesicle involved (both removed)
No lymph node involvement
New gleason score 9
T3B....radiation consult on 5-9-07.
June 5, 2007 1st psa post surgery 0.62
June 27, 2007 second psa post surgery 0.59
June 27, 2007 started Lupron injection (24 mos)
September 6, 2007 scheduled to be marked and prepped for radiation therapy.
Start IMRT therapy on September 13, 2007.
September 26,2007 psa test .08
Finished IMRT therapy October 31!!!
January 17, 2008 psa test .05...

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