A bit of flucuation normal in Post-op PSA?

Hi Serenity, - There is no way to know, with certainty, until more PSA results have been recorded. BUT, It is quite possible, in fact likely, that the readings you cite are reflecting the same results. They likely reflect the use of 2 different assays (tests) with different levels of sensitivity or reporting methods. At such low levels of reporting, they may well have had the "less than" icon (<) preceding the numerical numbers quoted. I would suggest that you obtain printed copies of your results both now and in the future. In verbal reporting the "less than" (ie; <0.01 or <.01) indicator is not always quoted, since those reporting know the significance, or lack there of, in such INDIVIDUAL readings and often don't stop to recognize that the less-informed patient may not. In general, here is how it works!

For years, the Clinical Standard for "undetectable PSA" in routine monitoring situations following surgery has been LESS THAN 0.1 ng/ml, which is usually depicted as < 0.1 on Laboratory Reports. Although there are RARE individual situations where this may not be the standard used by an individual Physician, it remains the most widely accepted definition of "undetectable PSA', BY FAR. So, in nearly every case of ROUTINE monitoring following surgery this still remains the criteria for the use of the term, "undetectable" in reference to post-treatment PSA. The figures you cite in your Posts are all below this Standard, if the decimal points are accurately reflected.

Obviously, accuracy of the decimal point placement is critically important in judging PSA significance in the post-treatment monitoring, as is the understanding of the metric system in use. The 0.1 ng/ml threshold, referred to above, represents 1/10th of a BILLIONTH of a Gram of PSA found in 1 milliliter of blood. The finding of 0.01 ng/l is 1/100th and 0.001 is 1/1000th of a BILLIONTH of a gram, so these are "minute" (my-noot) amounts of PSA that are present.

Again, anything below 0.1 ng/ml (<0.1) is therefore considered clinically undetectable in routine monitoring of low and/or moderate risk, post-treatment results. Both .002 and .01 are WELL under that threshold.

The < icon ALWAYS identifies the term "LESS THAN" and reflects the fact that any PSA present, IF ANY, is BELOW the known reliability of the assays (the test's) known sensitivity and so is reported thusly.

As long as PSA results remain below the 0.1 ng/ml level, you usually need not initiate any aggressive secondary treatment, in low or moderate risk patients. I hope this helps your understanding. - [email protected] (aka) az4peaks
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Hi Serenity- also, make sure your Hubby is well hydrated each time he takes a PSA test, this will bring a more accurate reading.....

When dehydrated, the PSA number goes up, and when hydrated well, it goes down. So being well hydrated will bring more consistent, accurate results.

When you are dealing with such a sensitive test with very small numbers.....this will certainly help.

Cheers,

Curt

Serenity, you should have serenity right know. Tell your hubby to chill, he's been thru a lot, revel in your success, rather than concentrating on nano grams of useless doubt. The anxiety will get better in time. is hubby a 3+4 or 4+3 gl 7 ? edit There are a lot of Recurrence values out there, best to go with the Cancer society or even MSK hospital. my view any way

The post op pathology trumps the biopsy. 3+4, another good sign. PNI is considered clinicaly diagnostic,post biopsy. Post op, arguably , not so. To keep the thread from being hi jacked. Any comments on my PNI state meant should be posted as new thread. I for various reasons will not start that thread. It is a thread that should be discussed with the top guns on this site. There is sooo much misinformation on this topic. Peace to you Serenity


EDIT EDIT post biopsy , Post Op

Serenity,

I do not think you have anything to worry about, both those readings are about as close to "zero" as you can get, and of course you know you will never see a true zero (.00 or .000). These numbers are well in the range of test tolerances and chatter.

I for one, would be thrilled with them.

As far as the PNI, depends whom you talk to. With my surgeon, he down played it, yet my Radiation Oncologist and my Oncologist put a lot of potential stock in it.

In my case, it didn't matter, as my surgery failed within 9 months, and later, Salvage Radiation failed within months.

Same can be said about positive margins, for some men, recurrence never happens, and for others, myself included, it meant quick failure. Just varies so much patient to patient.

david in sc

This is why many doctors do not advise using the ultra sensitive PSA tests, for the very reason that it can cause needless worry and anxiety.

My original post surgery PSA at 90 days, was .05, and my surgeon said I was probably headed for trouble, and in my case I was, in another 90 days it doubled, and the rest was history. There are other doctors that feel that .05 is the point to begin to think about recurrence in its early stages, though that alone is no guarantee that it will happen. Just worth keeping a closer eye on if it reaches that level, especially if there are other consistent rises along the way.

Hope your husband does very well ahead.

David