Ultra-sensitive PSA test redux

As you can see by my signature, I was blessed with a very good post-RRP pathology: Gleason 6, 5% gland involvement, no capsular penetration and negative margins. My first post-op PSA was "<0.008" which is, of course, considered "undetectable". Statistically, I have something like a 1% chance of recurrence over the next ten years. Even with a great outcome and pathology, I still fight PSA anxiety and it is just part of my personality to worry about such things. I had originally requested from my urologist's nurse that I be given the "standard" PSA test, but alas, my request was either ignored or misunderstood and I received the ultra-sensitive variety. To be consistent, I have stuck with the ultra-sensitive test through the same office and from the same lab for the last three tests. The first two came back at "<0.008" and the last one was "0.01" which is still extremely low.

I am considering, in no small part due to a suggestion from my wife and counselor, that I try switching to the standard PSA test from now on. After all, that is what I had originally wanted. This would hopefully allow me to avoid seeing the background noise so common with these tests. I have read that the ultra-sensitive tests may give an earlier indication of a recurrence, however it seems that nobody would recommend adjuvant therapy unless the level were to reach 0.1 anyway. Therefore, it seems to me now that it has no real value in my case.

Has anyone else made a similar decision? I don't want to short-change myself and risk letting this disease get an upper hand, yet I know that emotionally I would benefit from not seeing the ultra-sensitive test noise. One thought I had was to switch to the standard test, yet test at 6-month intervals instead of the yearly intervals normally recommended at a year out from surgery. Your thoughts and advice would be appreciated.

Sounds like a good plan to me.

Thanks to everyone for their opinions  - I really appreciate the advice. I have also read about three consecutive readings in the ultra-sensitive range as a possible trigger for adjuvant therapy. This may be useful for someone who has had a positive margin or a high Gleason grade, but I question usefulness at very low levels, near the sensitivity of the assay, with a Gleason of 6. Suppose I were to see a sequence of PSA levels <0.008, 0.01, 0.02, and 0.04 - would any oncologist recommend adjuvant therapy in my case? Probably not, but seeing that sequence would drive me nuts. I failed to mention that my PSA velocity prior to surgery was relatively low: < 0.4/yr. Also, I have had an excellent outcome on the ED front and would hate to irradiate the nerves unless absolutely necessary.  You can tell which way I am leaning, but I would love to hear more opinions on this. I don't want unnecessary adjuvant therapy or emotional distress, yet I don't want to bet my life on filtering out information, either.

I personally want only a standard PSA test done, because below 0.1 is considered undetectable.  So that's what my urologist has had done for each of my post-prostatectomy PSAs. 

I'm in the same boat as you, with a low probability of recurrence. I am  thankful for a good primary care doc who sent me to a urologist when my PSA velocity increased fourfold over a year's time, despite the absolute number being in the normal range.

If I had a doc who waited until the PSA value was above normal or opted to ignore it because he couldn't feel anything on the DRE, it could have been an entirely different outcome.