Worried Guy said...
The lab request sheet my doc uses to order the PSA test has 2 boxes: Diagnostic and Screening
Diagnostic is for 2 digit resolution
Screening is single digit.
Let's make the Diagnostic normal range go up to 0.20
and keep the Screening at 4.0.
If someone is over those values that will flag it for their docs and trigger a discussion. Easy!
Except it would be like moving a mountain.
That might not work for guys after RT. My RO orders "Diagnostic" PSA readings but since I still have a prostate, and it hasn't been that long since treatment, my current reading will be well beyond 0.20, but a reading of 0.50 or even 1.0 would be nothing to be concerned about
at this point. We still want/need the 2-digit precision, though.
Your point makes sense, but we would need to fine-tune the ranges or allow another check-box for RT patients.
Now, as a recovering consultant, I will warn you. . . "Beware the creeping scope."
Age 68 at Dx
PSA history: 2000-2012 0.9-1.2; 06/2012 started T replacement
2013-2015 3.0-3.3 (new normal); 11/2015 4.6; 05/2016 5.7
Biopsy: 12-core biopsy 07/2016; 3 cores G3+3, 5% or less; 1 core 3+4, 15%; 1 core HGPIN; 2% of gland involved. Summary G3+4.
CyberKnife SBRT with Dr. Hirsch; start 11/15/16, finish 11/23