3rd Generation Ultra-Sensitive PSA tests

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Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 6/6/2011 6:55 AM (GMT -6)   
I received the results this morning of my last PSA tests and am a bit confused. The number was 0.0003, which I was told is as low as the readings can go for this test. This is obviously a good thing, but I was previously under the impression that readings from the 3rd generation PSA test were made to three decimal points. My previous four tests at this facility had been to three decimal points, but on asking the nurse assured me that the lab number was correct.

Has anyone else received test results on a PSA test to four decimal points?

Sancarlos
Age 66, PCa diagnosed 2009 age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative

Treatment: brachytherapy (103 palladium), 100 gy (11/2009) + IMRT, 45 gy (3/2010) + ADT3 (Lupron + Casodex+Avodart)

PSA: 7/2009
At time of diagnosis -- 11.9
10/2009 -- 5.0
12/2009 -- 0.56
5/2010 -- 0.15
8/9/2010 -- 0.06
11/2010 -- 0.013
2/25/2011-- 0.005
5/27/2011-- 0.0003

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5828
   Posted 6/6/2011 7:47 AM (GMT -6)   
I bet you are right and he/she is wrong, though doubt you will hear that from her/him. Those are fantastic numbers, specially with volume and gleason. You won't be dieing from PCA! Betcha
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 6/6/2011 9:09 AM (GMT -6)   
Actually, I think Dr. Scholz's office mentioned they have the latest and greatest PSA tests and it is 4 decimal places..
 
I'm not impressed as I think 2 places are enough, as a practical matter
 
Mel

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/6/2011 9:15 AM (GMT -6)   
what's the point? many doctors already feel that .xx testing is too much anxiety for patients, so why go out to .xxxxx? then we will have people calculating doubling times based on a .0001 rise or something silly like that
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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 6/6/2011 12:06 PM (GMT -6)   
Well, turns out that the nurse assistant did give me an incorrect number, with one more Zero than necessary. I asked to have the result confirmed with the oncologist and she got back to me with the information the real number is 0.003, not 0.0003!!

As to whether there is any clinical value in the ultra sensitive 3rd generation PSA tests I will have to leave that to the medical community and other experts on this forum!! Regardless of whether the test is done to one, two or three decimal points I am going to have a lot of anxiety about it.

Sancarlos

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/6/2011 12:08 PM (GMT -6)   
the .xxx reading sounds more realistic for sure.
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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 6/6/2011 12:36 PM (GMT -6)   
Wow. Then my test must be a FOURTH Generation PSA test. I could swear she said 4 decimal places. Maybe she meant the dec. point plus 3.
 
Either way, big deal. .XX is fine with me.
 
Mel

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 264
   Posted 6/8/2011 4:28 AM (GMT -6)   
Is there a clinical name for this "ultra sensitive" psa test? When I asked about it last time they looked at me like I didn't know what I was talking about.
location: Batavia, IL
dx age 57 2/2010 PSA 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA
Oct 3.97
Dec 2.78
Mar 2.42

BobCape
Regular Member


Date Joined Jun 2010
Total Posts : 416
   Posted 6/8/2011 5:42 AM (GMT -6)   
It makes me sick how casual these nurses and assistants can be regarding psa results. I have gotten incorrect readings, dicimal point errors, several times now. I go for my 4 mo post SRT PSA results in 1 hour.

I stopped calling ahead to get the number because I could not count on it. I have explained to them that THAT result is as important to me as it would be to a woman calling to see if her breast cancer had returned.

The folks i'm talking about are staff of urologists and oncologists. It seems to me that they should be trained to realize the HUGE implication of the decimal points and what it means to the patient.

Or, they shouldn't be allowed to even discuss the result at all. This isn't some rare disease. And it is NOT "cancer light".

Good thoughts to all.

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 6/8/2011 5:38 PM (GMT -6)   
my my this is a bit much. I think this will create worry when there is nothing to worry about. Let's see if a PSA goes from .00003 to .00007 will people think they have a rising PSA?
Keep it simple and love life.

peace and love
Dale
I was 45 at diagnosis with PSA of 16.3
http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's. Scheduled to have a radical on July 11th, 2007, surgery was aborted when it was discovered it had spread to the lymph nodes.
I was on Lupron, Casodex, and Avodart for two years with my last shot March 2009.
My Oncology hospital is The Cancer Treatment Center of America in Zion IL
PSA July of 2007 was 16.4
PSA May of 2008 was.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11
PSA Jan 15th 2010 is .13
PSA April 16th of 2010 is .16
PSA July 22nd of 2010 is .71
PSA Sept of 2010 is .71
cancer in 4 of 6 cores
92%
80%
37%
28%

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/8/2011 5:51 PM (GMT -6)   
Fulltlt,
That is the clinical name ------ "Ultrasensitive PSA". Some do not have the necessary equipment (although it has been generally available for more than ten years) and some do not report the result at the ultrasensitive level even when they do have it. i.e. they may get a result of 0.006 say, but simply report it as <0.01 (less than 0.01) or even "<0.1" (less than 0.1). The lowest detection limit of the ultrasensitive test is 0.003 which means that even the most sensitive test reporting the exact result will register nothing if the blood level is less than 0.003. Ask them straight up what equipment they use.

Bobscape,
I agree with you. I can not understand that simple inability for anyone in that position dealing with those types of reports all the time not having a basic understanding of the meaning and importance of the numbers.

Bill

Post Edited (BillyMac) : 6/8/2011 5:54:33 PM (GMT-6)


maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 784
   Posted 6/8/2011 6:24 PM (GMT -6)   
I am confused as to why after nearly 4 years of normal PSA tests, My Uro has ordered an ultrasensitive test for my next one in July, any idea why? He is away at the moment.

Mal.
age 67 PSA 5.8 DRE firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept 07 Totally dry
PSA 23rd Oct.0.5
Started SRT on 5th Dec.
Finished 24 Feb 08
PSA from 30th April 08, until now range- 0.5 to 0.7

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 264
   Posted 6/8/2011 8:17 PM (GMT -6)   
BobCape said...
It makes me sick how casual these nurses and assistants can be regarding psa results. I have gotten incorrect readings, dicimal point errors, several times now. I go for my 4 mo post SRT PSA results in 1 hour.

I stopped calling ahead to get the number because I could not count on it. I have explained to them that THAT result is as important to me as it would be to a woman calling to see if her breast cancer had returned.

The folks i'm talking about are staff of urologists and oncologists. It seems to me that they should be trained to realize the HUGE implication of the decimal points and what it means to the patient.

Or, they shouldn't be allowed to even discuss the result at all. This isn't some rare disease. And it is NOT "cancer light".

Good thoughts to all.


Bob,

When I get my PSA test done I go at lunch time and have my blood drawn.
The hospital out-patient center is right near where I work.
Then I swing by after work and get the computer printout with the test results on it.
Not much chance for any errors that way.
location: Batavia, IL
dx age 57 2/2010 PSA 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA
Oct 3.97
Dec 2.78
Mar 2.42

fulltlt
Regular Member


Date Joined Nov 2010
Total Posts : 264
   Posted 6/8/2011 8:20 PM (GMT -6)   
BillyMac said...
Fulltlt,
That is the clinical name ------ "Ultrasensitive PSA". Some do not have the necessary equipment (although it has been generally available for more than ten years) and some do not report the result at the ultrasensitive level even when they do have it. i.e. they may get a result of 0.006 say, but simply report it as <0.01 (less than 0.01) or even "<0.1" (less than 0.1). The lowest detection limit of the ultrasensitive test is 0.003 which means that even the most sensitive test reporting the exact result will register nothing if the blood level is less than 0.003. Ask them straight up what equipment they use.

Bobscape,
I agree with you. I can not understand that simple inability for anyone in that position dealing with those types of reports all the time not having a basic understanding of the meaning and importance of the numbers.

Bill


Bill,

My problem is I never ever see or talk to the people that do the testing.
I see the nurse who draws the blood sample. She knows absolutely nothing about what tests will be run or how they work.
When I pick up the results I am dealing with a clerk who also knows absolutely nothing about what the results mean let alone how they were obtained.
location: Batavia, IL
dx age 57 2/2010 PSA 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA
Oct 3.97
Dec 2.78
Mar 2.42

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/8/2011 10:45 PM (GMT -6)   
Sorry Fulltlt, I must be slipping.
I see now that you have had RT. Looking at your PSA results they must be running your PSA test on equipment that delivers a result at the ultrasensitive level for you are receiving your results to 2 places i.e your last one was 2.42. If it were not so, your report would simply read 2.4.
Bill
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