Benign Tissue, PSA and me

Got my latest 2 psa tests, again from different labs, and they are as confusing as usual, although still holding and not increasing. The Radiation Onc.'s theory that some percentage of post-RP men will have benign tissue remaining that will continue to produce small amounts of psa as the blood supply regrows and starts feeding it still appears to be confirmed, so far. If the 2 labs could ever get the same result at the same time, I would be more satisfied with it, but at least it isn't climbing, so far, and I'll take that for a good sign, until a bad sign comes along....

The benign tissue theory continues to make sense.

08/00 3.9
08/01 4.8
11/01 4.1
01/03 3.9
01/04 4.1
01/05 4.2
01/06 5.2
06/06 4.2
04/07 7.6
06/07 6.7
open RRP

Family Doc. ----- Urologist
10/07 .04 ----- 10/07 .04
04/08 .008 ---- 02/08 .04
10/08 .02 ----- 06/08 .04
05/09 .03 ----- 12/08 .04
10/09 .04 ----- 06/09 .04
04/10 .06 ----- 03/10 .06
08/10 .09 ----- 09/10 .09
12/10 .09 ----- 02/11 .08
05/11 .08 ----- 06/11 .12
10/11 .14 ----- 10/11 .08
01/12 .10 ----- 02/12 .15

James,
I mentioned in my post on my PSA that the lab I used had changed fro using the Immulite 2000 to the Roche 8000. The report carried a disclaimer that results from the from the new equipment should not be used as a monitoring comparison to the old readings. I guess this means that two labs are not going to get the same results on the same samples except by chance. It sure seems to be bouncing up and down so you might be right with the benign tissue scenario. Always look on the bright side (Monty Python was it?)
Bill

Second tests are like second opinions... Which one do you trust when the results are different?

Do you get a "third" and then average the results?

I suppose I should have mentioned that I am using the Family Doctors lab results, since they have been running it from 2000, and the Uro's just started 3 tests ago, so I don't put much faith in them--yet.

Ralph, I am sure that there's been one or more different labs involved over the years. The reason why I just consider the FP lab is the other has only 3 data points since they began doing theirs in house at the Uro's and there's too much variation for me. if you compare the test results backward from there on the Uro list, this was the an outside lab which I had used since I got my first post RP test, so they were pretty consistent with the FP side. The docs both want to run their own tests and I need them about every 3 months, so it works good for me. As variable as they are, they still are holding within a 'range' of high and low, and until one or the other shoots up above the .15, then they still average out, especially if you only take it to the first number, as so many here suggest for post-RP guys. Having 2 sets does imply that I never know which is right and which isn't, if they diverge much, but having 2 is still of value when doing a close monitoring program such as I am. I continue to check every 3 months and am aware of the doubling, but it seems to have leveled off- for now, at least, and hopefully for good- so I am still in a watch closely and wait mode.

All of my PSA tests are from Bostwick.   It is the only lab my Uro will use for PSA and biopsies.   Since my Uro is testing, my GP does not.

I have read that the surgical definition of success is PSA <.2 over a 10 year period.    This is the benchmark a local seed specialist usesto compare his results with surgery.    ASTRO and other organizations use slightly different definitions, but I believe the <.2 is the most stringent.   I understand that there is always a probability of some prostate tissue left from surgery, so one could expect a low constant PSA .   Same for radiation.   Some cells survive and will function giving off PSA.

Thus it is not just the PSA score, per se, but also the detection of an increase that would signal cancer rather than confirming just a small amount of benign tissue.   I do agree that everything should be done to isolate the increase and not have the "noise" of insuffecient validity and reliability from the testing protocol that could exist using different labs or different methods at the same lab.