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PSA levels of 0.02 questions

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Posted 9/27/2013 3:35 AM (GMT 0)
My husband had radical prostate surgery about 3 1/2 years ago. Several months later he completed 3 months of radiation treatment. After this, his PSA levels were less than 0.001.  At his last test, the levels were 0.02.  He is sure his cancer has returned, though his doctor has told him he does not need to see him for a year. 

He will have another PSA test in Jan '14.  Everything I've read indicates that 0.02 is in the "zero" range and that, unless there are other symptoms or there is a doubling at the next test, this level is most unlikely to indicate a return of the cancer. 

Information from this forum would be much appreciated as we live in a very rural area and there are no support groups nearby. 

Posted 9/27/2013 3:44 AM (GMT 0)
Are you sure the prior levels were <0.001? That would seem very unusual. The most sensitive tests are typically reported down to 0.01. 0.02 could just be from a different lab / equipment and someone may have forgot to mention a less than sign.

In any event, 0.02 is still a long way from indicating recurrence, which is typically defined as multiple readings of 0.2 and increasing.

There can be benign sources of low levels of PSA after prostatectomy.
Posted 9/27/2013 4:01 AM (GMT 0)
For my uro, there is only <0.1. Multiple decimals don't count in his scheme. Ultra-sensitive readings can change on such small differences that they are more anxiety-generators than anything else, as he sees it.
Posted 9/27/2013 4:14 AM (GMT 0)
There is no reason for worry or concern. His reading of .02 is about as good as you can get accurately, and a long way from any thought of recurrence. Many men could only wish they had a reading that good. I have both failed surgery and failed radiation and my last PSA was 60.x, and I am not worried, so I couldn't imagine having any bad thoughts regarding a reading of .02 after 3 1/2 years. He's doing great.

David
Posted 9/27/2013 4:51 AM (GMT 0)
Welcome to HW. That's a great result.

I'd say party time!

Like the others said, until you're talking .1 you've not nothing to worry about and everything to celebrate.

Andrew
Posted 9/27/2013 12:16 PM (GMT 0)
Yes .02 is great. My hubby has been that for several years. Cheers
Posted 9/28/2013 3:35 AM (GMT 0)
We are in the same boat with your husband and mine, he is now also a 0.02 after being a 0.01 since his surgery three years ago.

It is very likely that this is just noise. Lana who just posted has had her husband in this range for about 6years. There is every reason to think that we are in the same boat.

Regards,
An
Posted 9/28/2013 3:27 PM (GMT 0)
My uro has told me in the past that he doesn't trust the accuracy of any measurement below 0.03. My own experience has been that my readings have been 0.00 for three years since my salvage radiation. But this isn't exactly true. There was one reading of 0.01, but the next test and all subsequent tests have been 0.00, so I've chalked that one up the kind of inaccuracy at those levels that my uro mentioned.

For a patient like your husband who has had both surgery and adjuvant or salvage radiation, test of only <0.1 would be too coarse a measurement, in my opinion. Given that he has had his prostate removed and his prostate bed irradiated, a consistent rise (I mean more than a single measurement at the .02 level) could be a cause of concern. My uro has told me that he would consider repeated measurements at 0.05 or greater a sign that the PCa is once again active, somewhere.

If I understand correctly, you say his doctor doesn't need to see him for a year (you didn't say when his last PSA test or doctor visit was was), but that he has another PSA test coming up in January. So I assume his doctor has ordered an interim test between actual doctor appointments. If so, this sounds like a reasonable plan to me. Here's hoping that the next test shows that the .02 reading was just noise.

Jim
Posted 9/28/2013 8:58 PM (GMT 0)
Thank you, thank you, thank you and THANK YOU!!!!

I can barely express how much peace of mind you have brought to us and, especially, to my husband.  I didn't realize the level of tension and fear and, frankly, terror that this last test had generated in his mind.  He is not a person who looks on the "dark" side of things but this cancer has been a real test of his courage and his positive outlook. 

When his last test was higher, he immediately assumed it was terrible news and a confirmation of the return of his cancer.  I don't know if his doctor didn't do a good job of explaining or if my husband's anxiety prevented him from hearing, possibly it was a combination of both....

Hearing from all of you who responded has helped so much to alleviate his fears.  He now understands that he is, in fact, very lucky.  When I read him the messages you sent, he cried.  He hugged me and cried on my shoulder.  The burden he has been carrying these last several weeks has been so heavy and I am glad that he can put it aside.  There is no guarantee that the cancer will not return but, for now, we are blessed.  One of you wrote that his test score of 0.02 was a cause for celebration.  Yes it is and we will celebrate!  We have 15 folks coming down next weekend.  I think they will see the return of their Dad, brother, and friend.  What a wonderful gift you have all given to us.  My husband asked me to tell you that he hopes that one day he will have the opportunity to help someone as much as you have helped him.

Please know that you will be in our thoughts and prayers forever.....

Posted 10/1/2013 8:40 PM (GMT 0)
Dear Bararalbb,

Just wanted to thank you for your lovely message. It is so good to know that we could provide some reassurance and comfort to your worried hubby and yourself.

I hope you have had that celebration by now!  Eventually, bit by bit, you will both learn to live with this uncertainty. We found the first 3 years the most stressful in terms of results and monitoring. I can feel your sense of massive relief, and hope your weekend with the 15 friends is a joyful one. Make sure you keep in touch and post any other worries or concerns again if you need to. Someone will always respond, and the burden is lifted a little by sharing and gaining information. Most of us wives here would have truly gone mad long ago without the help and support of many people here. Keep in touch. Take care and kind regards, Lana

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