PSA TESTING - .03 OR .01

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Charlierobert
Regular Member


Date Joined May 2009
Total Posts : 24
   Posted 8/23/2009 8:48 AM (GMT -6)   
I just had my second PSA test since my surgery.  From posts here and from other research, including talking on the phone with major clinics and university medical centers, I found out that the larger facilities all have equipment that measures PSA to the <.01 level.  My doctor's respond was the the Americian Urology Assoc uses .03 as the standard.  After some difficult discussion he agreed to send the sample to Mayo for the ultra sensitive testing.  Am I just being a pain in the neck?  It seems to me that the earilest warning of movement of the reading would be found if the <.01 moved upward. 
 
but then I have handled this entire life-changing episode very well.  I am still in the "anger" mode and can not seem to move into the "acceptance" mode.  I surely agree with many of the posts that indicate that doctors are not up front with us before the operation.  I am not sure I would have had the surgery at this time if I had known the after effects, both physically and emotionally.  Maybe could ahve waited a couple years and enjoyed life a bit more.
 
Anyhow...enough of my vending.  Is .01 vs .03 testing enough to make a stink aobut it?
70 year old male
PSA of 5.1
3/9/09 robotic surgery
non nerve sparing surgery
5/5/09 PSA Non detectable
5/24/09 slowly regaining bladder control. 
6/8/09 graduated to thinner liners at night and most of the day.  Pads when doing physical work, or going out of house for short trips.
 8/18/09 PSA Non detectable at <.03


Charlierobert
Regular Member


Date Joined May 2009
Total Posts : 24
   Posted 8/23/2009 8:50 AM (GMT -6)   
Oops, I meant I have not handled this well.
70 year old male
PSA of 5.1
3/9/09 robotic surgery
non nerve sparing surgery
5/5/09 PSA Non detectable
5/24/09 slowly regaining bladder control. 
6/8/09 graduated to thinner liners at night and most of the day.  Pads when doing physical work, or going out of house for short trips.
 8/18/09 PSA Non detectable at <.03


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 8/23/2009 9:25 AM (GMT -6)   

You can kind of look at PSA test results like currency. aka fuzzy math.

You started off with a 5.1 which is 510 pennies.

Now you're down to either One or Three Pennies. (not much difference)

 


Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 8/23/2009 9:39 AM (GMT -6)   
Charlie, welcome here, glad to have you. If you are still venting anger about your situation, taking it out on the difference and validity between a PSA of .01 and .03 is a terrible waste of your resources and efforts. The real standard is that after your surgery, is that your PSa should always be <.10. When you get into sensitive and ultra sensitive PSA testing, there is too much plus or minus going on all the time. Testing difference, who did the test that day, minute differences in you from day to day, even the tolerance within the testing procedure. Now is you were .01, 3 months later .05, 3 months later .08, etc. That might be a genuine upward trend.

You are a 70 year old man, you went through the surgery, you either are dry or almost dry, and you had two statisitcal zeros in a while, I would say you have a lot to rejoice with.

Everyone is different, but you should have long been over the anger part. There is no one or nothing to be angry at. You didn't do anything to make the prostate cancer happen. God didn't single you out for punishment if you are a religious man. Definitely a case of it rains on the just and unjust a like.

In my area just this weekend, a 23 year old boy was killed on his motorcycle. Not his fault, wore a helmet, car ran a red light and nailed him dead. Just 23, that is something to be angry about. He's dead and will never get to live his life.

What will help, stick around us, watch and learn from those that really have the PC hard, the advanced men with advanced cases, and see what some of the others deal with day to day. Contribute a little of your time. The best way to help yourself with this misplaced anger is to help someone else.

Not fussing at you, my new friend, just want you to accept what was put in your life. Trust me, brother, none of us want to deal with this, the treatments, the side effects.

Its time to enjoy the things you like to do, and can still do.

David in South Carolina
 Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, 8/14 met with Rad Oncl, still talking option, 8/18 - had laser scope surgery to clear blockage, now on Catheter #7
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/23/2009 10:58 AM (GMT -6)   
Charlie,
Don't sweat the small changes in PSA, you are doing quite well. The surgery is water under the bridge and there is nothing you can do about it now, so it does no good to play "what ifs"; it will drive you crazy.
Surgery is tough on older patients and anyone older than 65 should think twice about having it if other options are available.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 8/23/2009 4:14 PM (GMT -6)   
I agree with the others do not allow yourself to get caught up in the differences in PSA testing at this point. Looks like the surgery was a success. Settle down and enjoy the blessings of life. I do thank you for posting because I believe getting our feelings out is vital to dealing with this life altering disease.
Peace be with you
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11

PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 8/23/2009 5:37 PM (GMT -6)   
Charlie,
This is my understanding of the PSA tests at the ultra sensitive level. First generation test equipment (late 80's) could detect PSA below 1 down to a level of about 0.3. Anything below this was declared undetectable (reported as <0.3) although the actual PSA could be from absolute 0 to 0.29. Development of the testing apparatus during the mid 90's led to 2nd generation equipment which could test to a level of .03. Anything below this was the new undetectable (reported as <0.03) ( the actual PSA could be absolute 0 to .029). Further development in the start of 2000's resulted in Gen 3 equipment which could now detect PSA down to a level of 0.003 which became the new undetectable (reported as <0.003) (the actual PSA could be absolute 0 to .003). Because of the infinitesimal numbers involved in the Gen 3 results where results from testing on the same sample could vary slightly, when PSA is not detected (i.e. somewhere below 0.003) it is usually reported as <0.01 undetectable. If your are receiving a result of <0.03 then it would be my assumption that the test was carried out on Gen 2 equipment although many labs rather than give the actual number that resulted from the test simply report a result as <0.1 undetectable.
Information on the testing here under
"what is an ultrasensitive PSA assay"
www.prostate-cancer.org/education/preclin/McDermed_Using_PSA_Intelligently2.html
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01

Post Edited (BillyMac) : 8/23/2009 4:41:57 PM (GMT-6)


Charlierobert
Regular Member


Date Joined May 2009
Total Posts : 24
   Posted 8/25/2009 11:57 AM (GMT -6)   
Thanks for all the comments and info.  I appreciate the time all of you have taken to respond to my ventings.  I am going to take a break from the site, and try to get back to work.  Maybe my mind set will improve if I can concentrate on my work.  Thanks ago.
70 year old male
PSA of 5.1
3/9/09 robotic surgery
non nerve sparing surgery
5/5/09 PSA Non detectable
5/24/09 slowly regaining bladder control. 
6/8/09 graduated to thinner liners at night and most of the day.  Pads when doing physical work, or going out of house for short trips.
 8/18/09 PSA Non detectable at <.03

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