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Need advise on interpreting latest ultra-sensitive PSA result

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Posted 7/30/2008 11:16 PM (GMT 0)
I just got my 9-month post-surgery result back, and the total PSA is "0.01". The last two tests came back as "< 0.008". The same lab was used, and I believe the same assay was used as well. I know from my previous research that the assay results are not terribly accurate at their limit of detection, which is 0.008 for this particular assay. I sure wished that it came back as "< 0.008" again. Should I be concerned, or is this most likely "background noise"? Thanks

CaPCA

Posted 7/30/2008 11:32 PM (GMT 0)
My doctors told me that most labs use <.01 as the standard for no measurable level of PSA. So I was very pleased to go from 14.6 to <.01 on my first post op test (the ultra sensitive test). One can never be absolutely certain they are cancer free based on any blood test. But I believe the odds should be vey much in your favor.
Posted 8/1/2008 12:52 AM (GMT 0)
Hello CaPCA,
The hyper sensitive and ultrasensitive tests are just as their name implies. It is my understanding that the sample is run through the testing equipment 3 times and an average taken as at such extremely low levels there are slight variations each run. Your initial reading of less than .008 is essentially 0. Your following reading of .01 is only 0.002 higher which is infinitesimal and completely meaningless ............... don't at this stage worry yourself and believe it is increasing. There are a couple of other organs in the body capable of producing minute quantities of PSA (I don't understand why it would be designated Prostate Specific Antigen in this case though ............... I suppose it must be chemically identical and thus registers on the equipment despite being from a different source). Congratulations on the great news, go with the flow and "Keep on keeping on"
Bill
Posted 8/1/2008 4:42 AM (GMT 0)
Thanks for the words of encouragement. I think I let myself get too optimistic with my initial two readings and rapid recovery in other areas. I would like to get this prostate cancer behind me as quick as possible. However, I have to be realistic - even if had another "<0.008" reading, I would not be "out of the woods".

Posted 8/1/2008 2:34 PM (GMT 0)
My thoughts are, until you have two consecutive rising PSA's, that any small rise is background noise. My father's PSA scale goes down to <.02, therefore, you are still undetectable according to his. I know it is scary to see any movement in an upward direction, but stay positive and we will hope and pray that the next PSA is <.008.
Posted 8/1/2008 7:19 PM (GMT 0)
there are some papers out there that define biochemical recurrence with an ultrasensitive test as three consecutive rising values, regardless of absolute level. Others, like Dr. Patrick Walsh, dismiss anything below 0.1 as being insignificant. After surgery, I had originally requested the "standard" PSA test in hopes of avoiding such anxiety, especially since my final pathology was very good. Evidently, my urologist's office either doesn't offer the standard test or misinterpreted my request. I think it's too late to switch to the standard test now so as to avoid inconsistencies.

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