Variations in post-surgical PSA

I posted something about this, albeit in a slightly different vein some weeks ago, but after three post-surgical PSA's (following RRP 12/07) of <0.01 I had the latest come in AT 0.01, which true to the stories of ultra-sensitive test anxiety, has had me a bit anxious. My doc wanted to simply test routinely for my next regularly scheduled appointment in six months. After considerable brow furrowing he "compromised" and gave me a lab form for three months (late March). The more I thought about it, the more steamed I got, and decided to take matters into my own hands, since I am of course the one ultimately responsible for my own treatment. I called my GP and had him write a lab request (same lab I always use) and had blood drawn today. I'll either be relieved if it comes back at <0.01 (and have a better February and March) or see "the truth" and begin preparing for what may be the next step of this fiasco.

Now that I'm off my soapbox has anyone else had their "ultra-sensitive PSA readings fluctuate, and how much?

I just got another PSA done this week because the < was not there in December, my 2 year PSA in December came back 0.04 instead of the others which have come in at <0.04, not a lab error as computer prints out results during the testing, so naturally with my pre-op findings I was worried that it might be going up. The one that came back today had <0.04.

Jetlagged,
Here are a couple of links discussing ultrasensitive PSA testing including the YANA input
www.yananow.net/UltraPSA.htm
www.phoenix5.org/Basics/PSAundetectable.html

I worry as well for each test. At the 6 month reading the doctor said undetectable. I asked for the exact amount. He said it was as low as the machine would go (<.04). At the 9 month mark doctor said undetectable and I didn't ask what the reading was since it was as low as the machine would go.

Let us know what the results are. However, I don't think you have a bad attitude. I think you have a need to be exact!

I like the mavericky idea on finding out things we need to know as patients, whom cares the most about ones own outcome??? I got mavericky a few times in the 2nd opinions arena and fired a few docs, one of them 1-2 days before radiations were to start and totally glad I did (hind sight now). I noticed she also was no longer at that facility 1- year later (hhmmm), and she was untruthful to my questions (2 of them)....she looked good however so if it were the flu she would have made a sale.

Did a psa test thing (mavericky) just recently, but I am not a post surgery patient, but just to see if Psa numbers would be about the same...got two psa tests on the same day and only about 1-2 hours apart, the results: .61 at the first one (Abbott) assay and .50 at the second different lab (I would have thought they would even be closer as I am patient on DES drug therapy and just would not guess that fluctuations would be that much when under drug useage, without drugs yeah psa's fluctuate alot every hour and day). I did not do any activity or work, just from one hosptial to my onco-docs clinic location. Atleast with a third psa from this first lab, psa dropped to .36 more recently, this is why psa history and velocity etc., is what we need to look at. It is different for a post surgery patient and post radiation patient or cryo etc.

While there are no doubt more sites to surf on the subject, I thought why not go to the likely best resource.

There are several remarks about "other" sources of PSA, I was wondering if anybody has read exactly what those sources are, as I can't seem to find any information about it.

Also, I have seen remarks that nobody would nuke me until it hits 0.1, but is there an acceleration towards that number that would inspire them to act prior to that point. My doc said that the "survivor rates" if it's nuked by 0.1 (assuming that it didn't start rising before the first year) are 90%. Is he just pulling numbers out of his posterior, or is there actual data?

I'm starting to wish I stuck with the 0.1 threshold tests.

Hmmm...everything I read is the magic number should be .2 before beginning SRT. However if the doubling is less than 6 months it might be done sooner. I only know of one individual that had SRT at .11 Even if the PSA rises to .1 it can hold there and never rise after that. That is why most oncologist want to wait for the .2 mark before beginning any definitive salvage treatment plan. From what I read, SRT has the best outcome for cure if started before it reaches .5 and anything after 1.2 SRT usually isn't going to cure the disease.

Les, your post right above, is along the lines of what my dr told me yesterday, and I tend to believe him as well.