What's psa numbers for "Non-detectable"?

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Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 6/3/2009 2:11 PM (GMT -6)   
I recently had a psa reading of .07.  Is that still undetectable or is it considered a significant elevation into the detectable area?
 
Gene214
PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Post-Surgery psa  -- .011
Removal of stricture 6-07, incontinence continues
01-15-08 psa -- .05
AUS, IPP implanted 07-16-08
AUS, IPP activated on 08-18-08.  They both work!
10-20-08 went back to surgeon for a follow-up.  Both devices work well.
10-20-08 psa -- .05
05-15-09 psa -- .07
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/3/2009 2:16 PM (GMT -6)   
It depends on your doctor.

<0.1 is undetectable for mine. He said he would never take action with anything fluctuating below that number regardless of the Assay used.

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


dsmc
Regular Member


Date Joined Jul 2008
Total Posts : 149
   Posted 6/3/2009 2:33 PM (GMT -6)   
My Doc says the same as Tony's. My assay goes down to 0.04 and I asked him shy he did not use the ultra sensitive test and he told me that it was an ultra sensitive assay and that the 3 decimal place test would just cause undue worry and that if it did not hit 0.1 nothing would be done anyway. I am the nervous type anyway so I think he is correct. Just keep an eye on it. Good luck and God bless.

David
Age 53
Pre-op PSA 4.3
Surgery Feb. 17 2005
Post-op Path : Gleason 3+3=6
Right pelvic lymph nodes: negative for metastatic carcinoma
Left pelvic lymph nodes: negative for metastatic carcinoma
extent: right lobe 40% left lobe 10%
capsular penetration: Absent
Seminal vesicles and vasa differentia: Uninvolved
Prostate: 26 grams
Post-op PSA's <0.04 for 3 years
Feb. 08: 0.07, March 08: 0.08, June 08: 0.09 and Sept. 08: 0.1
IGRT scheduled.....November 17th....
FINISHED 01/14/09 YEA!
05/14/09
1st PSA after Salvage RT <0.04..... Another YEA!


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/3/2009 2:39 PM (GMT -6)   
The newer "ultrasensitive" tests show 2nd decimal for PSA. Older ones only go to one decimal. So, technically, 0.07 is not undetectable. BUT, whether this is meaningful is a different question. Docs usually don't look at anything below 0.1 and don't consider it a recurrence for anything below 0.2.

Previous 5 biopsies over 4 years negative

PSA going from 3.8 to 28

Father died from PCa @ 78 - normal PSA and DRE

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)

1/8/2008

33.90

1/11/2008

29.50

1/31/2008

38.20

2/21/2008

32.00

3/13/2008

26.20

4/3/2008

26.60

4/24/2008

20.60

followed by RRP at Duke (Dr. Moul) on 6/16/2008

Gleason downgraded 4+3=7, T2c N0MX, one small positive margin

PSA undetectable for 8 months, then

2/6/2009

0.10

4/26/2009

0.17

5/22/2009

0.20


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 6/3/2009 2:41 PM (GMT -6)   
 
Here is another example of how this dreaded disease can vary from patient to patient. If you look at my signature you can see that my Uro watched my PSA numbers very closely and when it reached 0.08 after about 20 month post open RRP, he along with my Onc and of cause myself, decided to take further action. When radiation started, it had reached 0.1. By most standards a PSA of 0.1 is considered very low, but if I were you, I would watch my PSA VERY closely and take action as soon as it is clear that I had a recurrence. It is my understanding that the earlier radiation is started, the better the chance for a positive out come.
Wishing you all the best in the years to come.
 
Magaboo

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA on the 26 Jan., 09, =0.05. PSA tests now every 6 month


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 6/3/2009 4:27 PM (GMT -6)   
Hi Gene....the .07 is detectable...but only in trace amounts. Like the others...don't be concerned unless it goes over the .1 mark. Salvage radiation is important to begin treatment when the PSA is low...somewhere before .5 from what I have read. So watch the velocity...if it is going up, determine the velocity and then you can sort of calculate how many months before it reaches that .5 mark. Gives you some time without additional treatment if that is the route you want to take...otherwise if it reaches the .1 and you are anxious, talk to your doc about beginning treatments right away.

It's almost like when first diagnosed with low grade cancer...do you go the watchful waiting or treatment route. With biochemical recurrance, the same holds true...wait until it reaches a point determined by you and your doc...or proceed with treatment when you feel it is best for you.

Honestly, there isn't a wrong choice when dealing with recurrance. Just don't let the PSA go over 1.0 before making your decision, cause you will most likely lose the chance of a successful cure at that point.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month April 2009 .06


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 6/3/2009 5:32 PM (GMT -6)   
I was also 0.07 at my last test, and my uro said to expect my next test to be higher. It's a fine line -- the body produces small amounts of PSA normally even without a prostate. So you don't want to rush into unnecessary extra treatment -- especially in view of the side effects.
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
ED:
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 6/3/2009 6:34 PM (GMT -6)   
Greetings, Gene.  My doc says anything under .1 and in fact he doesn't show anything other than less than .1.  I wouldn't be too concerned about it.  David
Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


CaPCa
Regular Member


Date Joined Aug 2007
Total Posts : 118
   Posted 6/3/2009 9:46 PM (GMT -6)   
I agree with what others have said. I also think that your post-surgery pathology should also enter into the equation. Your Gleason is 6 - this is good. Do you have negative margins and possibly no capsular penetration? If so, your odds of a recurrence are extremely low. This might argue for a less-than-ultrasensitive test, something that I am contemplating to reduce anxiety. In this situation, if you were to get an elevation above the 0.1 mark, your PSA velocity would most likely be low (due to the Gleason) and you would have time to make plans for salvage therapy. On the other hand, if your pathology was poor, this could argue for more aggressive watching for an early recurrence with the ultrasensitive test. This is just my opinion.
 
-Rob
Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel
              Difficult surgery due to prostate inflammation.
              Both nerve bundles spared.
              Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
              Final pathology: neg margins, no capsular penetration,
              Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07  First usable erection with Cialis
11/22/07  Thanksgiving - Bye-bye, pads
01/17/08  First post-surgery PSA result: < 0.008 ng/ml
03/17/08  Erection quality mostly back to pre-surgery levels with Cialis;
              have not tried without meds yet.
04/23/08  Second post-surgery PSA result: < 0.008 ng/ml
07/30/08  Third PSA: 0.01 ng/ml
11/04/08  One year PSA: 0.01
              Still taking 10mg Cialis every other day - enjoying the results
              too much to stop yet.
02/07/09  Taking 5mg Cialis every other day - having too much fun to try
              to stop for now.
03/23/09  PSA: 0.02
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/4/2009 7:28 AM (GMT -6)   
According to the medical literature, detectable amounts of PSA can be produced by what are sometimes called "minor sex glands" Cowper’s glands, the glands of Littre, and possibly the glands of Morgagni. I have not found any literature about how this might complicate measuring PSA in cases of PCa, but as we get to more refined tests it will be something that needs more study.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 6/4/2009 7:51 AM (GMT -6)   
Your sample could probably be sent to two different laboratories resulting in results which are different, I think we've seen discussion of this before.  So, having the samples analyzed using similar protocol in the same laboratory is important - for people who want to carefully track/plot the results over time to see if the cancer has returned.  My Urologist doesn't report results more sensitive - below 0.0 because, he's told me, it's insignificant and slight rises can be brought on by a variety of factors.  I suspect he carefully considers the results which I don't see, and that's what I want him to do.  Sometimes we can get caught-up in the smallest details which in the larger scheme of things are probably not significant, and even get ourselves worked-up, upset, etc.  I've chosen the path of letting my doctors sweat the small stuff, and I expect them to talk to me when there's a concern.  I have faith in the people I've chosen to advise/care for me.

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0

 


Bernardo
New Member


Date Joined Jun 2009
Total Posts : 2
   Posted 6/4/2009 3:53 PM (GMT -6)   
Current age 72. Prostate removed Sep. 2004. PSA before operation 4.1. Cancer found only after biopsy. Gleason 7. Clean PSA post surg. 0.0. No problem until fall of 2008. PSA .28. Just got new PSA back: .72. They did not find any cancer outside of prostate but now my PSA is no longer 0.0. But, no other signs. Literature seems to say if PSA after (I guess even many years) rises to .20 to .30, you got problems. Urologist I am seeing believes in wait and see. One of my problems is that there seems to be different PSA markers for a given problem. Any suggestions or comments? (I am beginning to doubt my urologist :(......)

I asked these questions on another topic but wanted to also enter it here. I hope this is OK with the group. Barney
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