Posted 12/3/2010 9:02 PM (GMT -6)
I know all the arguments about ultrasensitive PSA. I do realize that .1 is still a low amount of PSA. If I had a PSA of 5, then whether it is 5.01, or 5.05, makes little or no difference.
I would argue that the difference between <.01 and .02 is significant. Not that it means we should worry, or that we rush in for radiation, or HT, but it is a doubling, or tripling of the PSA in our system. If we go along for 2 years at <.01, then a .02 is something to take note of. A retest in 3 months would be in order in my opinion.
Understand, I am talking as a G9 patient. I am particularly attuned to rises in PSA. I also don't buy the PSA sources from other parts of the body, unless it is left over prostate tissue. Margin of error in today's lab world is not really a consideration. These machines are continually calibrated and checked against a standard. I would be amazed if a lab test could be off more than .001.
It is important of course to make sure that we compare lab tests of the same type, and even better to try and use the same lab.
I have been utilizing the Roche Modular E170 PSA electrochemicalluminecent immunoassay. I have had consistent results every 3 months. In the written test results which I obtain from the medical records office of the hospital, it says the following :
After radical prostatectomy, the reference interval is less than .05 ng/mL if there is no residual disease. In healthy males without prostatctectomy, the reference interval is 4.00 ng/mL. The lower limit of detection is 0.01 ng/mL.
This statement is printed by the testing laboratory. I trust this more than a urologist deciding that .2 is number.
So, if they feel that .0499 is the limit for not having residual disease, then I rationalize that .02 or .03 are significant. Call me crazy, call me paranoid, but I find it hard to argue with numbers.
I just can't accept that anything less than .1 is a zero. I like the warning signs of a .01, .02, or a .05, long before I get the .1 number.
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