Ultra Sensitive PSA

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T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 6/16/2010 7:56 PM (GMT -6)   
Well,

Got my 9 month PSA and it went from .003 to .005 so I was understandably concerned even though it was still very low. Found out that the testing facility adjusted their protocol to a limit of .005 so I was still at the lowest possible figure they could detect. That was a major relief. I did some further studying of my physicians website and uncovered the following information as well.

They state that if you have an initial PSA after 6 weeks that is =0.01 you have a 99.2% chance of cure even with long term follow up. Conversely, you have a significantly higher risk of BCR if you don't achieve such a low level.

Also, the .005 protocol allows you to observe a rising PSA much sooner and can lead to SRT being much more effective. I guess I'm lucky that my doctor uses the ultra sensitive. It definitely puts me more at ease.

On a side note, got an ambimed inject ease and will try using it tonight. I'm not much for needles but by golly, its for a good cause. If anyone has experience with it let me know. I'm going to jet and get some alcohol swabs. Will check for replies when I get back!

T40
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
4 months no longer using pads. ED using trimix with positive response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.
Post op pathology 3+4 PT2A NOMO
6 wk PSA .004
3 month PSA .003 12-18-09
6 month PSA .003 3-17-10


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 6/17/2010 8:57 AM (GMT -6)   
T40,
I had a PSA test at the 1 year mark that was .004, the next one at almost 15 months was .005 (different lab). I'm wondering if the second lab is similar to yours.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 6/17/2010 10:59 AM (GMT -6)   
Just curious..I know that standard assays are to the tenths (0.1) and usually post surgical start out at the hundredths (0.01)...but down to the thousands (0.001). I dunno but wouldn't the psa fluctuate up and down naturally at that level from things other than prostate cancer or benign prostate tissue? Wouldn't this lower level just add to the post-op psa anxiety as a result?

Would seem to me, that most doctors would dismiss anything in the 0.00X area until it rises significantly to the hundredths or even tenths before beginning to take a closer look at possible recurrence.

Secondly, precision costs...does your insurance cover the additional cost?

BTW congrats on the low psa tests. May you have a lifetime of them
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 Apr 2009     .06
                   9 month Jul  2009     .08
                 12 month Oct 2009     .09 
                 18 month April 2010   .19


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/17/2010 11:25 AM (GMT -6)   
Just my take:

Prior to dx, during the PSA testing years, a reading of x.x is perfectly fine.

After surgery, its important for at least the first year, to have readings of .xx. That way, if recurrance is lifting its ugly head, a trend can be spotted quicker.

If you have RT or seeding as your primary treatment, I am under the impression that post treatment readings of .x are adequate, considering that you still have a prostate in place. Someone please correct me if I am wrong.

For those that show no signs of recurrance after a suitable time, the reading of <.1 is good to get use to, cuts down on PSA anxiety.

For the life of me, can't understand why anyone would need a reading to .xxx. Any movement in the 3rd position out, would be absurd to track or follow, and I can't see how it could be useful to anyone, including a doctor.


David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 6/17/2010 3:29 PM (GMT -6)   
David:
 
You are correct.
 
.003/.004--it's all very good. No need to worry about that kind of movement.
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 6/17/2010 3:30 PM (GMT -6)   
Wow. Three decimal places!
I am so jealous...
J

T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 6/18/2010 12:09 AM (GMT -6)   
precision doesn't seem to cost at this point. The psa test was like $159 and after insurance it came out to $14 and change.

On a side note, the inject ease worked perfectly. Self injections now no big deal. Sure did make a big deal out of it for myself so when I actually did it felt like a moron because it was so easy.
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
4 months no longer using pads. ED using trimix with positive response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.
Post op pathology 3+4 PT2A NOMO
6 wk PSA .004
3 month PSA .003 12-18-09
6 month PSA .003 3-17-10


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 6/18/2010 3:10 AM (GMT -6)   
T40
Yep, I hear you. The auto-injector makes it easy. I even put a little solarcaine on the spot before injecting.
Enjoy,
Jeff

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 6/18/2010 11:32 AM (GMT -6)   
Jeff, do you mean to say that you are injecting the needle thru a layer of solarcaine, hence introducing a non-sterile field, or the solarcaine first, then the alcohol swab to seralize it?
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 6/18/2010 11:42 AM (GMT -6)   
James,
I'm glad you pointed that out. I was actually injecting through the solarcaine. It has not been a problem but I will not do that any more. I'll do it like a man.
Jeff

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 6/18/2010 1:08 PM (GMT -6)   
I understand that there are some super sensitive PSA tests out there.. so they break down to a finer number. But even on this board I see talk of post op psa from .003, to perhaps .05 as being acceptable (or palatable, I guess),,, yet I see urologists out there saying "A value of 0.2 or 0.1ng/ml would be considered essentially zero": http://www.drcatalona.com/qa/faq_post-op.asp . Ironically, as I write this, my urologist office calls and says I am 0.1 - and says THAT IS GREAT News. He says the urologist considers that "machine noise" and it is the most common result they get after doing RP. So I see 1.0 and folks saying sorry, and I get 1.0 and they tell me Congrats.??

p.s. Had my path meeting yesterday, some of my prostate was Gleason "5".. wow. It was 75% involved. Urologist brought it before the "GU Tumor Board".. group of experts at Boston University Hospital, hey tells me (and writes). He said he was REALLY surprised it was as aggressives as it was.. tells me in March the biopsy indicated 25% involvement, and by May 17 it was 75% involved..

So that's my good news bad news good news bad news story for this hour. Thanks.r
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain!


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 6/18/2010 5:51 PM (GMT -6)   
Hey BobCape,
I'm a little confused by your post. Is your PSA 0.1 or 1.0? There is a huge difference between the two.
I'm a stickler for getting an accurate PSA test when it matters. It matters in your case. You need to make sure the "Diagnostic" box is checked rather than the "Screening" box. Call around the labs in your area and find one that has the capability. If customers (us) don't ask or demand it, there is no incentive for them to upgrade. The costs are virtually identical.
Do it. Tell your Doc you feel it is important. You'll be helping both yourself and the next guy.

Jeff A two decimal point guy
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 3+4=7, 3+3=6. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. There must be another issue. Uro mtg 4/23.
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 15 Short sphincter
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05, 4/14 9 months - 0.04 and <0.01 with ECLIA.


BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 6/19/2010 8:05 AM (GMT -6)   
Hi Worried (more than a few of us could have chosen that name).... You are correct, I stated it wrong at the end... I am 0.1. YES, HUGE difference I know! but that kinda goes to my point. I was called and told by my dr's nurse it was "0.1".. I had her repeat it. My urologist's assistant calls me and he confirmed it was "0.1". He said that was the lowest low reading they get, so he felt it was good news. He said they do the test there at BMC. I said "so you dont use the highly sensitive machine".. he didn't know. That troubles me a touch, though I am comfortable this is a capable dr and institution, and they handle a substantial # of PC cases. But one would hope they knew that important variable (I'm sure my urologist knows, but his key assistants should as well, if they are going to deliver the reults to the patient, which I may mention to them as feedback).

I just had the RP on May 17, on June 17 he did the PSA during same meeting as pathology results.. and I think we agree that RT is my next move.. and I meet with them on Tue. BUT TO MY INITIAL POINT RE THE PSA... I hear some say that 0.1 is good, and other are speak like it's too bad you got 0.1.. THIS dr states that he considers 0.1 to be ZERO: http://www.drcatalona.com/qa/faq_post-op.asp HE SAYS "Therefore, we consider any PSA value less than 0.2 as being negligible".

So I dont know what to think... Apples & Oranges? The machine that reads "0.1" likely does not have the capacity to read "0.03".. so it give A reading?
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain!


Sharp18
Regular Member


Date Joined Mar 2010
Total Posts : 78
   Posted 6/19/2010 12:24 PM (GMT -6)   
Hi BobeCape,

Is your PSA result came as "<0.1" or just "0.1"? The first reading would indicate that equipment PSA sensitivity is 0.1 and your actual PSA may be from 0.001 to 0.1. The second reading would indicate that your PSA is 0.1.

Sharp

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 6/19/2010 12:43 PM (GMT -6)   
Hey Bob,
My big problem with the single decimal machine is this. Imagine you have a progression every two months of .06, .08, .10, 0.12, 0.14 and maybe even 0.16. All of those values would be reported as 0.1 You be sitting fat, dumb, and happy for more than a year and then bam! you get a 0.2 that they might or might not consider noise. Do you really want to wait that many months before maybe thinking about doing something else? I am sure the Uro would not if it was for himself or a family member. If you have to go to a place without 2 decimal capability then a "<0.1" is a great score. A "0.1" is only great for someone on the other side of the prostate.
It is 2010. Time to find a place that does two decimals. It matters. (Or are you still driving a car with a carburetor?)

Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 3+4=7, 3+3=6. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. There must be another issue. Uro mtg 4/23.
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 15 Short sphincter
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05, 4/14 9 months - 0.04 and <0.01 with ECLIA.


BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 6/19/2010 12:44 PM (GMT -6)   
Hi Sharp... No < Less Than Sign. Ya, I had anticipated that as a possibility, so when i spoke with The Uro assistant I ask him exactly that. He said "no, it's 0.1, which is the lowest grade that they assign"... I will have to inquire further, I can't believe that they've done 1,000+ of these Robot Assisted Rps. yet can only measure PSA to the 10th.. that wouldn't make sense.

It would mean, they basically have two counts - 0.1, and then 0.2 which means recurrance..? As if the TRUE more accurate/precise count (say going from 0.1 to 0.19) is irrelevant.

If the lowest grade they assign to ANY PSA result is "0.1" - Think it's possible they CANT calibrate below 0.1 - Simply unable to use the "<" sign?
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain!


BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 6/19/2010 1:02 PM (GMT -6)   
I found a Topic on this site "just what is undectable psa after surgery?":

in 2008 TimG wrote:
"The standard PSA has a lower detection limit of 0.1 ng/mL, so anything below that is reported as less than 0.1 (<0.1). Ultra-sensitive tests go lower and usually report to the nearest hundredth rather than the nearest tenth, for example, 0.02. The detectable limit is lower as well.

Having written that, I opted to go with the standard PSA test for two reasons (1) I don't plan to consider any salvage radiation unless the PSA is above 0.1 and (2) there is so much noise in the ultra-low test results below 0.1 I don't want to experience undue anxiety by seeing a report that shows a rising PSA, say 0.02 to 0.04 that may in fact be simply test variation and insignificant."

*I'll have to think a little more on the points he makes before deciding howm I personally feel about this.
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain!


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 6/19/2010 1:29 PM (GMT -6)   
Bob,
In that same thread you probably saw my rant on the subject. I want to know - not hide it under the rug of a crude scale. Do you accept a scale at home that is only calibrated in 10 pound increments? Why not? You won't do anything about it until your clothes don't fit or your wife complains.
If the difference between a 0.02 and a 0.03 bothers you then just round to the nearest decimal and pretend. You should have the option.
I'm not sure where you live but it is time to start making some phone calls. I called two labs and asked about the equipment and its capability. They were both very knowledgeable. I do not accept an order with the "Screening" box checked. You've already been screened. Time to move on to "Diagnostic".

Jeff (0.01 and happy)

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 6/19/2010 2:07 PM (GMT -6)   
Jeff. I plan to start making some phone calls. Because I have heard and do believe that there is a "noise" factor, i'm not sure I would want to go through .002 to .003, but I ABSOLUTELY believe that 0.02 and 0.06, for example, could not be attributed to "noise", hence DOES matter. I assure you Jeff, my reasoning for trying to uinderstand the variables involved here were not measured by "do I want to know, or do I want to hide it under the rug"... My concern was that if the machine(s) vary and cannot consistantly calibrate to the .000, then I dont want to be held captive to the variance of .002 and .003.

Back to my original concenr, when MY uro, who is head of urology at this well know local institution, gives me a result of 0.1, and then I see others (I use this example: http://www.drcatalona.com/qa/faq_post-op.asp ) ALSO saying that "0.1" is considered by THEM EACH to be ZERO, yet THEN I see folks on here saying "wow, too bad you got a 0.1" - then something is wrong.

Trained urologists saying 0.1 is effectively zero, then untrained patients saying it's a bad grade. So, I welve to find out. I WILL ASK MORE QUESTIONS.. I WILL demand better answers. But it seems that - There is some inconsistancies in what trianed doctors are saying VS what some here are sayin, and ALSO between capabilities of the machines. I'm not ready to suggest there is some great consiracy here.

I MAY find out that the assistant I spoke with simply didn't know enough to gove me the correct reading, with the "<", or MAYBE, my result was 0.100 exact, or maybe the initial PSA is OK being at 0.1 due to "noise" and gets more detailed thereafter. I understand there could be natural psa found in the body even after the prostate is removed, so that needs to be accounted for. Some here (and elsewhere) suggest that it is the pace (velocity) of the increase that is most important, and mnot the inital post op psa number.

I dont know, but i'm planning to learn. 3 months ago I didn't know what a prostate was.. now I know more than I care too.. with more than I can image left to be learned.

MY PRAYERS WITH ALL OF YOU, AND HAPPY FATHERS DAY TO EACH OF YOU, AND/ OR YOUR FATHERS, AND SONS!
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain!


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 6/19/2010 3:43 PM (GMT -6)   
Bob,

A year ago, I didn't know what a prostate was either. Well, I did know a little - It was somethng old farts had trouble with when they were peeing. When I found out my PSA was 17.8 I thought that was good. I am in perfect health and everything works great. DoH!

You're going after the problem the right way. Knowledge is power.
You made my day.

Happy Father's Day to all of you, too.

Jeff

fogball
Regular Member


Date Joined Mar 2006
Total Posts : 31
   Posted 6/19/2010 11:30 PM (GMT -6)   
I dunno, mebe this will kick the ball a little closer to the goal --

http://prostatecancerinfolink.net/diagnosis/psa-testing/different-psa-
tests/

fogball

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 6/20/2010 9:17 PM (GMT -6)   
Bob,
I suggested to my GP doctor to do the ultra sensitive at my annual physical and was glad to see it was .004. Before that, my uro was only reporting it was <0.1. Since then, I asked my uro to do the ultra sensitive test. The lab that the my uro uses is different and it came back as .005. I'm not worried yet about the slight increase in 3 months since it might just be noise level or lab differences. my next test is not till October (6 months), I'm hoping for a good result.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 6/20/2010 10:32 PM (GMT -6)   
Thanks to all. Ed, that is right the the point of one of the problems... one machine gave you a .004, and another machine came back at .005... and you're "not worried yet about the slight increase"... But that number is soooooooo fine, that it is likely THE EXACT SAME RESULT... No Increase Whatsover, simmply two different machine that are calibrated to round off differently or something. Not worried yet indicates the time will come where that specific .001 difference will cause you some worry..

Stiil, I get back to my uro, having done 1,000+ of these, telling me that 0.1 is great and it's the lowest they grade. Just doesn't make sense. But i'll get to the bottom of it.

Happy Fathers day to all.. I will say a prayer for all of use tonight who deal with this issue through no fault of our own.
First ever PSA test Jan 2010 @ 51 years old. 4.0.
Digital exam in March 2010 showed 1 side hard, other soft.
Biopsy, positive in 3 of 12.
Davinci @ Boston Medical Center, May 17, 2010.
Was suggested prior to it was likely contained.
June 1 advised 3+-4 was really 4+3 per pathology. Pos margins.
Catheter removed June 1.. 1 pad/day, doing ok. ED, but not in rush.
Sore as heck down there, but doing much walking with my wife.
To meet with my Uri (1st meeting since) June 17 - 1 mo point, to discuss.
BMC already has me setup to meet with radiology.
Felling a little better each day. Cant tell if my expectancy just went from 10-15 down to 5-7, the information out there appears to be all over the place. I WILL NOT radiate my insides to the point of being a veg for the sake of a few years. QOL is primary to me. Selfish I guess. I pray for all of you as I do for myself, but must remember that i've had a pretty good 50+ years, and know others who have lost their children to disease.. so I dont have the nerve to complain!

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