Very interesting article.
There are variations in ultra sensitive PSA tests when different assays are used. So my husband had two laboratories test his PSA, one came up with a result of 0.03 and the other with a result of 0.01 for samples taken on a single morning. This is back in early 2011. The two laboratories showed similar fluctuations up and down but from a different base. My concern is that with this article and with only access to a 0.03 result people in our position would have gone to SRT.
What it also does not clearly explain for me is what the right course of action is for favourable pathology post RP. (3+4, T2, clear margins, cancer volume <5%) Paul is five years post RP. We only go to the one laboratory now - the one that originally baselined at 0.01 and Paul's PSA is now 0.02 (and has been for the last two years, although it was back down to 0.01 in February). If it ever goes to 0.03 do we need to consider SRT?
It seems that what is lacking in this approach is an additional digit on the ultra sensitive PSA reading and more clarity and standardisation on assays and calibration of equipment.
Husband's age: 52. Sydney Australia.
Hereditary PC: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69.
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: T1c, 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|Feb11 – 0.03|
Lab 2: Nov 10 - 0.01|Dec10 – 0.01|Feb11 to Mar 13 - 0.01| Aug 13 - 0.02
Post Edited (An38) : 9/12/2015 6:10:45 PM (GMT-6)