Is <0.06 post-surgery really zero?

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Regular Member

Date Joined Aug 2010
Total Posts : 64
   Posted 11/18/2010 8:38 AM (GMT -6)   
We had Tim's 6 week follow-up appointment yesterday and the surgeon informed us that his PSA is zero and no further treatment is necessary. Just PSA tests every three months for the first year. YAY!!!

But when he handed us a copy of the report, it said <0.06 ^1 . I asked if that is really zero and the surgeon told us the number means Tim's PSA is undetectable.

The notation below the result for the ^1 says: Patient samples may contain human heterphilic antibodies that could react with immunoassays to give falsely elevated or depressed results. Basically - results could be falsely high, or could be falsely depressed. Comforting!

It seems I've read lower post-surgery scores here pretty routinely. I mentioned this to the surgeon and he equated forum information to "late night talk shows" where someone knows a friend's sister's mother-in-law's cousin twice removed who was an eye-witness to whatever the hot conspiracy theory of the moment happens to be. At that point I knew it wouldn't do any good to tell him that , "No, these are men who have PCa (or wives posting on their behalf) and have or are currently undergoing treatment."

So, all of you friend's sister's mother-in-law's cousin twice removed smilewinkgrin , I just want to know if you agree that <0.06 really means undetectable.

Post Edited (pipedream) : 11/18/2010 8:06:03 AM (GMT-7)

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4069
   Posted 11/18/2010 8:44 AM (GMT -6)   
Pipedream: from the "Late Night Talk Show" Yes your hubby, Tim is a big zero!" Congrats, that does not get you off the hook you guys have to buy the beer.

Cajun jeff

Veteran Member

Date Joined Jan 2010
Total Posts : 2832
   Posted 11/18/2010 8:46 AM (GMT -6)   
you moved the decimal place pipedream - - if it is <0.06 - then it is undetectable .... your second mention in the last line - <0.60 is not...

- you can edit your text using the pencil link at the right of your posting -

-congrats on the zero club membership ( PSA <0.10 - nothing is an absolute zero)

Age: 55 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB
Sept 23, 2010 -0.05 - again -hoorah !

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2209
   Posted 11/18/2010 9:07 AM (GMT -6)   
Anything that is "<0.1" is zero. ( make sure they say it aloud and repeat it so you hear those important words "LESS THAN"!!!) - Hoorah welcome to the club.

Check that decimal point though. (However they'd hardly be putting Tim on 3month tests if it was 0.6.!!)

The PSA tests have a certain very small discrepancy when it comes to their degree of accuracy, which before surgery doesn't really matter, I mean the difference between 9.621 and 9.622 is frankly irrelevant at that stage.
The accuracy after surgery is more vital and the small margin of error may make you worry. Perhaps it would help if the PSA score included the margin of error, ie a 0.06 was actually reported as with the upper and lower margins of 0.055 and 0.065, or whatever the margin is, rather than to just say "here's a number and there's a margin of error in it" without explaining clearly how big the margin is.


Regular Member

Date Joined Aug 2010
Total Posts : 64
   Posted 11/18/2010 9:08 AM (GMT -6)   
Thanks, corvetteman3! We're tee-totalers but I'll be happy to buy the beer!

tatt2man - Thanks for catching my is indeed <0.06. I fixed it.

Now I feel like I can really celebrate! Hooray!
Husband DX @ 64; 7.5 year survivor colon cancer; father had PCa @ age 65
04/09 - PSA 3.06
10/09 - PSA 1.55
04/10 - PSA 4.26

Biopsy 7/10 Gleason 7; 3+4 & 4+3 - 6 of 10 cores

RRP - 10/1/10; Gleason 3+4; 20%; pT2c; contained, clear margins

Post surgery PSA - 11/10 = <0.06

Forum Moderator

Date Joined Jan 2010
Total Posts : 6854
   Posted 11/18/2010 9:18 AM (GMT -6)   
All other discussions aside, if the lab reports carry the "<" (less than) sign, it means that the level is below what they are able to report.
So "< 0.06" means not enough to hit the bottom limit of their equipment, meaning undetectable. If it had been " 0.06" it would mean that they did measure it at that level. Regardless, for my Uro, anything that reports from his lab as "< 0.1" is undetectable, as he considers less than 0.1 to be unreliable. There would be argument on this site about that position, but lets not go there.
What the bottom limit is depends on the test and the equipment it was run on.
Great news - Tim is now in our (probably mis-named) "Zero Club"!

Regular Member

Date Joined Sep 2010
Total Posts : 38
   Posted 11/18/2010 11:31 AM (GMT -6)   
Wonderful news!! Welcome to the club!! I like my beverage tall and cold please
Age 42 PSA 7.4 4+4 G8
Davinci Sept.8 2010
No incontinence issues but ED issues
1st post surgery PSA <.008

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 11/18/2010 11:51 AM (GMT -6)   

You got a bonafide zero by any standard. Enjoy it, and pay up at the bar, its only fair. Hope you have many years ahead with
numbers like that.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Veteran Member

Date Joined Apr 2008
Total Posts : 813
   Posted 11/18/2010 1:28 PM (GMT -6)   
Face it, your husbands a zero, he's nothing.  Stop trying to hide it.....LOL

Veteran Member

Date Joined Sep 2010
Total Posts : 1160
   Posted 11/18/2010 1:42 PM (GMT -6)   
Some people will say anything to get outta buying the beer! tongue

Congrats on the good news.

Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 11/18/2010 6:14 PM (GMT -6)   
Pint Please !

Veteran Member

Date Joined May 2009
Total Posts : 2691
   Posted 11/18/2010 7:01 PM (GMT -6)   
Now, let me be technical.

The test lower limit for the lab you used is .06. The result could be anywhere from .00 to .059. For a 6 week PSA that is excellent.

If you want a real answer as to zero, find a lab that will test to .01.

My testing lab prints a statement on the results that says greater than .05 is considered abnormal. You will find disagreement on that statement here. Some say the number is higher. Some say anything below .1 is zero. Technically speaking, it should be less than .01.

Congratulations on the results. It is most likely that a 3 month test will be even lower.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

Regular Member

Date Joined Aug 2010
Total Posts : 64
   Posted 11/19/2010 11:09 AM (GMT -6)   
The test was done at the same hospital where all his PSA tests have been done. Prior to this, of course, there was no need to worry about what happened after the decimal as there was always a number in front of it.

If I understand correctly from your explanations (and thank you everyone....for those as well as the congrats extended) that if this lab only measures above 0.06, then Tim could be at 0.01 now, PSA could rise and we wouldn't know anything until it measures beyond 0.06. It sounds like it might be worth looking for a lab with a finer calibration for the next test in February. Anyone know how to find one?

We have very limited choice here - one of two relatively local hospitals and no private labs that I am aware of.

After being shocked at the price ($120 for six 20mg Cialis pills at Wal-Mart no less!), and shocked that our insurance does not differentiate between recreational use of ED drugs and rehabilitation needed due to cancer surgery, I felt we had reason to ask the surgeon about "off-shore" suppliers. He said some of his patients have had a very good experience with Canada - anyone have a recommendation for supplier(s) from Canada and advice about how to do it?

I asked for and got a prescription for 30 5mg Cialis and was able to get free ones with the online coupon. My poor husband - he probably felt like crawling under the exam table listening to (mostly) my conversation with the doctor. All I can say is....It's a dirty job but somebody had to do it! turn

We have always been grateful for our blessings but have rarely had so much to be thankful for right at Thanksgiving. This will be a special one for sure.
Husband DX @ 64; 7.5 year survivor colon cancer; father had PCa @ age 65
04/09 - PSA 3.06
10/09 - PSA 1.55
04/10 - PSA 4.26

Biopsy 7/10 Gleason 7; 3+4 & 4+3 - 6 of 10 cores

RRP - 10/1/10; Gleason 3+4; 20%; pT2c; contained, clear margins

Post surgery PSA - 11/10 = <0.06

Forum Moderator

Date Joined Jan 2010
Total Posts : 6854
   Posted 11/19/2010 11:44 AM (GMT -6)   
I understand the problems with PSA test limits myself. My Uro will only request "standard" tests at my now six-month visits. They are from Bostwick (great lab), but they report (for that test) only to <0.1. The practice does not believe in ultrasensitive, as they "create anxiety".
I went to my GP and got a couple done over the last months. In July, it was <0.01. Great. In October they changed labs, and it was 0.02 (notice - no "<"), and the new lab says they can report to <0.01. Not so great, but still far below what most consider a problem.
So, if it were me, I would take a <0.06 and run with it. I'm chosing to listen to those who counsel that 0.02 may be noise in the test. Looking for more detail may leave you having found too much detail -
Yeah, getting the Cialis paid for in any quantity is a mess. Asked for my refill one day early, and Ins. refused to let them fill it.

Regular Member

Date Joined Jul 2006
Total Posts : 201
   Posted 11/19/2010 12:09 PM (GMT -6)   
Congratulations to you and your husband pipedream.
I leaned something here.  I didn't realize that < meant the PSA was below the lower limit of the tests capability.
I had been <.01, but the last two tests were <.03.  I had thought that was an increase.  But now I'm thinking it's just a lab issue, as in they use to test as low as .01 but now their minimum is .03.  Is that correct?  I've been waiting for .05.
Sorry for the t/j.  Thanks for the clarification 142.

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2457
   Posted 11/19/2010 12:39 PM (GMT -6)   
Anything less than 0.1 is considered a zero, Congratulations.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18 months) undetectable
Latest PSA test (21 months) .005

Forum Moderator

Date Joined Jan 2010
Total Posts : 6854
   Posted 11/19/2010 12:57 PM (GMT -6)   
Could be like my case - the doctor's practice changed labs, and the new lab has different equipment, or your lab may have multiple pieces of equipment with different tolerances.
They "should" provide that information on the lab report in my opinion, but I have seen it listed, and even then inadequate, on one of my reports.
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