PSA Results after Surgery-Worried

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sween76
Regular Member


Date Joined Feb 2007
Total Posts : 60
   Posted 2/27/2008 8:21 AM (GMT -7)   
I am turning to this great group because I know you can help relieve my anxiety.
 
I keep reading from comments about a PSA of "zero" and this makes me worried.
 
My PSA results: .02 after 6 weeks;  .01 after 6 months;  .03 after 1 year.
 
I understand the concept of "ultra sensitive" and intellectually I should not be worried about these results since they are probably all in the range of statistical error. However, I do not like the trend and quite frankly, I am very worried.
 
I will not see my surgeon for another 8 days and so I am turning to this Group for help.
 
Sometimes I just curse the concept of ultra sensitive technology, but I recognize that technology (DaVinci) created a better surgery.
 
Should I be worried or am I just projecting and creating my own anxiety?
 
Thanks in advance for your help.
 
Ed

Age: 64
PSA 2.62, Negative DRE
Biopsy: Gleason 3,3  Stage T1c
Prostate 71 grams 
Biopsy: Cancer 5% in one of twelve modules
DaVinci April 16, 2007, Cathter Removed Day 8
Tumor Confined To Prostate,  Gleason 3,3
Surgical Margins and Seminal Vesicles Are Negative for Tumor
Playing Golf: Week 5
PSA:  Week 6 .02:  6 Month: .01:  1 Year .03


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 2/27/2008 8:31 AM (GMT -7)   
Ed,

I am glad that my surgeon does not give me numbers just tells me that it is undetectable. My primary doctor has given me my blood test that he has done and my PSA on those have been .002 and .003. Your post op path report indicates the tumor was confined to the prostate so you should relax and not worry about the numbers. Make sure you let your surgeon know that you are feeling stressed with the numbers and I am sure he will explain them to you.

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 


sween76
Regular Member


Date Joined Feb 2007
Total Posts : 60
   Posted 2/27/2008 8:48 AM (GMT -7)   
Tamu:

Thanks for the quick reply.

Question: Is your PSA .002 and .003 OR 0.02 and 0.03? I have never heard of a PSA to three decimal points!!!

I recognize that the statistical undetectable threshold is probably .05 or less but I am still very anxious.

Ed
Age: 64
PSA 2.62, Negative DRE
Biopsy: Gleason 3,3  Stage T1c
Prostate 71 grams 
Biopsy: Cancer 5% in one of twelve modules
DaVinci April 16, 2007, Cathter Removed Day 8
Tumor Confined To Prostate,  Gleason 3,3
Surgical Margins and Seminal Vesicles Are Negative for Tumor
Playing Golf: Week 5
PSA:  Week 6 .02:  6 Month: .01:  1 Year .03


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2248
   Posted 2/27/2008 8:54 AM (GMT -7)   
sween76 said...
 
My PSA results: .02 after 6 weeks;  .01 after 6 months;  .03 after 1 year.
 
Sometimes I just curse the concept of ultra sensitive technology, but I recognize that technology (DaVinci) created a better surgery.
 
Should I be worried or am I just projecting and creating my own anxiety?
 
Thanks in advance for your help.
 
Ed

 

I understand your anxiety, Ed.  In PSA testing, and sometimes in the PSA lingo we use on the forum, it can be confusing to see numbers other than zero on your test results. It would be more accurate for us to write "undetectable" or less than 0.1 rather than "zero", but "zero" understandably sounds much more definitive.
Most urologists use the 0.1 ng/mL cutoff below which the PSA is considered negative.  The ultrasensitive PSA test, as you know, measures to the neareset hundredth of a nanogram (0.01), so you may see results of 0.02 and 0.03 as in your case. 
For the standard PSA, which measures to the nearest tenth of a nanogram (0.1), the lowest detectable value is 0.1 ng/mL, so anything below this, including your test values, cannot be measured.
I personally chose to have the standard PSA test for my followup testing, because it still measures accurately enough to catch any cancer recurrence, but eliminates the "noise" of values below 0.1 that can be measured, but that are insignificant.
I sleep better not knowing any numbers other than <0.1 ng/mL for my followup PSAs.
Take care and hang in there...Tim


Age 59  PSA velocity quadrupled in 1 yr (0.6 to 2.6) 
1 of 12 biopsies positive (5%) 
Open surgery June 2006 
Cancer confined to one small area Gleason 5 
PSA's non-detectable

Post Edited (TimG) : 2/27/2008 8:57:22 AM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 2/27/2008 11:48 AM (GMT -7)   
Hi Sween76,
I am with Tamu and TimG. While there may be some usable value to anything under 0.1, my oncologist doesn't like to worry his patients. The adrenal gland can emit some PSA that is measurable with the ultrasensitive test, and it has no bearing on the disease progression. I call <0.1 a big zero. And will gladly take it. And I have peace of mind. There is a call to beware if in one test it's 0.01 then 0.05, then again at 0.09 in consecutive tests. But you are still considered below the standard in all three. And additional treatment would not begin until you went to 0.1 in most cases after three tests. (my case may be the exception). I wouldn't let it bother you. Good luck, don't sweat it. Stay Positive!

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 2/27/2008 3:50 PM (GMT -7)   
I sweat out each of my PSA tests so am very glad my doc just tells me I'm a "big fat zero" each time. I don't worry about the small stuff that I can't control so I don't even know if my test is regular or ultra-sensitive. When my PSA went up to 7.1 and my family doc sent me for a biopsy he told me "I'll tell you when to start worrying." Good advice...

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
"Patience is essential, attitude is everything."
 


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 2/27/2008 3:54 PM (GMT -7)   

You have been given good advice.  The only reason I am even commenting is that I had an appointment with my doctor yesterday.  I voiced some concern because my psa was tested at a different lab the last two times (90 days apart) and showed an increase from >.002 to < .02.  It had already been explained that had to do with how the different labs reported results.

My doctor said quite firmly that labs should stop playing with the numbers and indicate to the patient/doctor if it was  or was not dectectable.  He said mine was not detectable and  he would see me in six months, only to continue work with my ED.

He also prescribed bi-mix for me.  This is another story that I will talk about later.


 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8 , no extra extension or invasion
No continence problems
PSA results 90 day (-.01) 6 months (-.01) 9 months (+.02)
PSA one year (+.02)
Using Caverject/viagra for continuing ED problems (one year)
 
 
 
 
 
 
 
 
 

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