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My ultrasensitive PSA test journey ends

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Posted 6/23/2009 4:18 AM (GMT 0)
As I have posted before, I have been strongly considering a switch to the "standard" PSA test. I was fortunate enough to have an excellent pathology, but this ultrasensitive test has caused me mild anxiety that never really leaves my conscious. I found a new urologist that agrees with me and uses the test with a "<0.1" sensitivity. Some may accuse me of shopping for the result I am hoping for, and while basically true, I have yet to hear a cogent explanation as to the benefit of the ultrasensitive test for those with a very low chance of recurrence after surgery. Had I had a poorer pathology report or was monitoring an already elevated level, I would probably go for the ultrasensitive test. For now, I am happy with my decision and am going to celebrate with a nice glass of red.

CaPCa

Posted 6/23/2009 12:43 PM (GMT 0)
CaPCa...good news and I agree with the decision to stop the ultra-low tests in your case. Just goes to show you that dealing with cancer not only has to do with the disease, but the mental and emotional aspects as well. Too often men ignore the issues concerning their emotional well being and treat just the disease. I commend you for taking those measures to deal with this disease objectively.

Best wishes
Posted 6/23/2009 1:05 PM (GMT 0)
I agree with you completely, I am overcoming a strong bout of PSA anixety right now as I write, it can be real mental and emotional torture, a sword over your head all the time.
Posted 6/23/2009 1:37 PM (GMT 0)

Gentlemen:

I concur with you all that there is some anxiety brought on by the PSA test. But, I have just had a follow up visit with my uro and my PSA was .36. (This is one year after the start of lupron therapy and nine months post IMRT.) Both my uro and oncologist are pleased with the current measurement and have told be not to get excited about the number. Apparently anything below a 1.00 and stable, emphasis on stable, is a good result. (I know that PSA after surgery should  be at non detect levels but the stability of the reading should also be taken in to account.)

Best of luck to all.

Don

Posted 6/23/2009 1:48 PM (GMT 0)
Not to be flip but on a more humoristic side I call this PSA testing journey "P.I.S.S."  PSA/Interval/Stress/Syndrome. 

I have had both tests performed from different labs.  All good results mind you, but each having their own little personalities. I have decided to try and have the same type of test from the same lab, done.  This way it reduces the little differences that seem to abound with PSA testing.

All the best,

Frank

Posted 6/23/2009 3:45 PM (GMT 0)
I had the same post op pathology as you.  I had surgery by Dr. Partin at Johns Hopkins.  They do not use the ultra sensitive test.  In fact if your first post-op comes back undetectable, they put people like us on yearly testing only.  We have a zero percent chance of dying from PCa in then next 15 years.  Even if we have reccurrence. 
Posted 6/24/2009 4:38 AM (GMT 0)
OK, I've had this on-going debate myself.  To do the Ultra-sensitive test or not. 

My regular physician's lab does the ultra-sensitive.  I've had it done several times.  My surgeon, Dr. Catalona in Chicago, does the standard and was one of the PSA pioneers.  He says the ultra-sensitive test is too "noisy" to be reliable.  Yet there are studies that show that ulta-sensitive tests can detect recurrence sooner and therefore increase the effectiveness of early intervention of radiation.  Yet no one recommends radiation until your PSA is over .1 anyway, so not sure I get that.

 All the PSA pioneers seem to be in synch that the standard test is still the one to follow...Partin, Walsh, Catalona.  I say, if the ultra-sensitive test causes too much stress, stick with the standard test. 

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