My husband Paul had his ultrasensitive test repeated at 3 months, this time with 2 laboratories using different assays.
Lab1 (Prince Alfred) - DMC Immulite
8 weeks: 0.02
3 months: 0.03
Lab 2 (DHM)
3 months: 0.01
The GP, who has a lot of patients with prostectectomies, is used to seeing ongoing consistant <0.01 with most of his patients. He called the pathologist at DHM on his advice on how to interpret the results. The pathologist was straightforward in saying that with his test they almost always see a <0.01 at 3 months in cases where there is a "cure" following a prostetectomy and he recommends a retest in 2 weeks.
This was also the feedback from Prince Alfred when I called them 4 weeks ago. They believe they should also see a <0.01.
So my concerns are the change of 0.02 to 0.03 - I understand that in the best case the numbers could be 0.024 to 0.026, but still I was fully expecting the numbers to trend down. Although Paul's results had negative margins (close at APEX), negative perineural invasion and negative SVI and 3+4 with only 5% of 4 and a low cancer volume of <0.5cc, I am not comfortable with Paul's numbers being so far from ultrasensitive undetectable and I am uncomfortable with the trend up. As are the GP and the pathologist.
I guess we will know more in a few weeks when Paul repeats his tests. I have fading hopes that they will go down - the best I think we can hope for is that they will stay stable at 0.02 or 0.03.
NB: I believe in ultrasensitive tests and I have considered the issue of PSA anxiety, but I would rather know as early as possible if things are not going right.
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.
Post RP PSA, Sep10 – 0.02