Lab PSA undetacable standards

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

twotall
Regular Member


Date Joined Nov 2009
Total Posts : 38
   Posted 2/11/2011 10:27 PM (GMT -6)   
I had posted a while back about my forth psa test that moved from the "norm" of <.04 to .064. I know that this falls in the range of undeteable on some tests but was still worried. I had the chance to visit with a friend a couple of days ago that also has prostate cancer. He had his latest psa test a few days before our meeting over coffee. I explained my latest results to him at which point he showed me the results of his test. His psa had come back at <.064, the exact same number as mine. He explained that his doctor told him that a bunch of his patients had suddenly had their test numbers go up. The doctor called the lab and was told that they had installed new standards ( I have no idea what they would change) and that was the cause of the different results.


At first I was happy to hear a reason for the increase but am now wondering why a lab would use such a level for an undeteable reading. In the time that I have been visiting this forum I have seen lots of <.1 and <.04 listed as a standard for undeteable but not <.064. Does this sound strange to anyone but me? I am planning on calling the lab and hear first hand what they have to say. Keep in mind that I have been very nervous concerning psa numbers since the urologist told me that there was a good chance that the cancer had already spread before surgery.



Bob

Post Edited By Moderator (TC-LasVegas) : 2/11/2011 9:37:36 PM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/11/2011 10:35 PM (GMT -6)   
Bob,
You can also look around for other labs (making sure they are on your insurance's list if applicable) and just have the doctor write the request up. This may help verify if the "new standards" are the cause of your PSA increase.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/17/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6945
   Posted 2/12/2011 7:00 PM (GMT -6)   
My Uro does not believe in ultrasensitive, so no discussion there.
 
My GP was getting consistent <0.01 from his lab, but then changed to another one for all their work - that one gives me a 0.02.
 
Variables include the machine and the type of test, probably other things on the lab side as well. Then we have the many variables of how and why PSA is created.
 
I suspect they did not change to a different "standard" in a sense of a nationally accepted medical definition, but a new test or hardware upgrade/change. They may have had issues with the test - who knows, reliability? and have accepted a higher undectectable floor in exchange for stability, reliability, cost, time?
 
If you are now being tested on a system that detects down to 0.064 from a test that detected down to 0.04, your PSA may not have changed at all. <0.04 is also <0.064.
 
Be happy with undetectable. Mine isn't.

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 2/12/2011 7:53 PM (GMT -6)   
Bob,
The last 4 tests I had came back as follow:
.004 at my GP's lab
.005 at My Uro's lab
.005 at My Uro's lab
<.008 at my GP's lab
I still haven't been able to find out why the "<" sign in the last score.
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, 21 months) undetectable
Latest PSA test (2 years) <.008 ?

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1148
   Posted 2/12/2011 10:15 PM (GMT -6)   
Even those labs that define PSA <0.01 as their undetectable have a wide range of PSAs from samples taken within an hour of each other. My husbands PSA level was 0.01 from one lab and 0.03 with another. Both are well respected assays calibrated to the same WHO standard. There are people on this site (and outside this site that I know of) who have received <0.01 from each lab.
 
0.01 is a little scary and 0.03 is a lot more scary. The difference is not small. It's intruiging to know why there is so much difference between labs. However all we are trying to do by using to labs is tracking the trend while also verifying that whatever trend exists that both labs see the same trend.
 
Regards,
An
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 main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/12/2011 10:36 PM (GMT -6)   
I don't get you on this one, An. How could a reading of .01 possibly be scary? If you are thinking or hoping for an exact .00, its never going to happen. .01 would be considered so great by anyone's standard, so what am I missing here?

David
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

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 2/12/2011 10:58 PM (GMT -6)   
0.01 would be scary if you were expecting less :-)

I agree with David that 0.01 is a really great result. The 0.03 from the other lab is of more concern, but at this still early stage, you can't read too much into the difference.

Ultra-sensitive tests do lead to PSA anxiety, which is why some don't like them. However if your PSA ever rises to a point where further treatment is needed, those ultra-sensitive results will show the trend earlier, even if they do jump up and down a bit.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4/12 cores
Non-nerve-sparing RRP 7 March 2008 age 63
Organ confined, neg margins. Gleason downgrade 4+4=8
Fully continent
Bimix worked well; now using just VED
PSA undetectable at first but now 0.4, doubling time 7 months
No radiation but ADT coming unless I can slow down the rise...

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 2/12/2011 11:33 PM (GMT -6)   
The above is why I like the <0.04 that my lab does, it's low enough to give early warning if anything pops, high enough to filter out the "noise" If I had been a G-6 with negative margins I'd be happy with <0.1 tests.

I've never heard of a test that has a lower limit of <0.064, everything I've seen posted are <0.1, <0.04 and the ultra sensitive <0.001. Any way you count it I'm happy to hear it was a change in test not a rise for you Bob.

Dave in Durango CO
07-06 PSA 2.5
01-08 PSA 5.5
09-09 PSA 6.5
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5
03-01-10 Age 55 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson
03-16-10 Path' G-8 (4+4+5) Bilateral involving 21% of left lobe, 3% of right lobe, SVI, Focal positive margin, pT3b NO MX

All PSA as of 1-25-11 <0.04

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1148
   Posted 2/13/2011 12:53 AM (GMT -6)   
David, you are right the 0.01 is not scary.
If we had consistant readings of 0.01 I would be pretty happy. It's the other lab that throws some concern into the mix. The 0.03 is a little scary especially as it has risen a little from 0.02. Of course this could be explained by round-off and daily variation.

I am still amazed at the difference between the two labs.

I hope and believe that the results will stay flat at the levels they are now. Negative margins, negative everything, no SVI, no EPE, no PNI, small volume cancer, <2% of the prostate. Paul will be doing the next test later this week. Results in the first week of March - we are going on our annual summer beach holiday up north for a week in the last week of this month with close friends - we will do our best to forget the upcoming test results.

Fingers crossed,
An
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 main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01

Post Edited (An38) : 2/13/2011 12:18:23 AM (GMT-7)


twotall
Regular Member


Date Joined Nov 2009
Total Posts : 38
   Posted 2/13/2011 1:24 AM (GMT -6)   

Thanks for your input on the different lab results.  I plan on stopping by the lab sometime next week to get information straight from the horses mouth so to speak.  My wife tells me that she figured out early in our marriage that she didn't have to spend time worrying, I do enough for both of us.  As others have said it is a catch 22 on the ultra sensitive verus the <.1 tests.  Would like to catch things early if the numbers are heading in the wrong direction but the changing numbers in the ultra sensitive tests can cause lots of stress. As one of my coworkers told me "it is what it is".  I am working real hard to get the right mind set and enjoy family, friends and each day that we have.  I appreaciate your voices of experince and thanks for listening.

Bob

New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, June 17, 2018 5:51 PM (GMT -6)
There are a total of 2,972,619 posts in 325,999 threads.
View Active Threads


Who's Online
This forum has 160831 registered members. Please welcome our newest member, Superifffic.
392 Guest(s), 13 Registered Member(s) are currently online.  Details
goshawk, Solaris719, masonbor, Redhead53, readingmom, Gear, summer16, isitlyme, opugirl, Girlie, Sherrine, Lightlife, Redwhite&blue