Anyone understand this?

Hi all,

I had a radical prostate removal in 2009 at Guy's in London.
The following 3 years all PSA tests were done at the hospital and were >0.03.
Then I was discharged to my GP and the PSA test were done local but only to the <.1 measurement.
That changed this year when the local lab now declared they could do the ultra low PSA measurements and my ultra low tests came back at 0.04, 0.03, 0.09 and 0.08. (The last was a retest)
At this point I got a referral back to Guy's and spoke with the oncologist yesterday.
She ordered a PSA test as the first step and it came back as <0.03.
Can anybody explain the discrepancy in these results?

Thanks,
Mike

It shows that the psa moves around a lot based on a lot of things particular to your metrics. It is also the reason that most in the medical field regard a bcr as anywhere fro .2 to .4. The best part is your latest psa. Get a retest again and it will be like my grandmother used to say. Look hard enough and long enough and you will find anything...Its all there waiting... thats my nickel!

Maybe this European guideline is not entirely wrong.
PSA values ​​≤ 0.09 mg / l is not uncommon for residual benign prostate tissue. These values ​​should be listed as < 0.1 in the response from the laboratory, because the clinical benefit of knowing these low values ​​is insignificant and is not deemed to outweigh the concerns that it may cause to enter different values ​​for the patient.

spotty, this is a topic of nearly endless discussion in this forum. There seems to be significant variability in the low level PSA testing across multiple labs. For me, there just isn't enough stability of values to make it a terribly useful test.

Yes, 0.09 is 3X 0.03. How much of that is due to the variations in test methods, calibration quality, etc is unknown...I'd suspect a lot of it is. I keep looking for a reference document that shows the cross-laboratory QA/QC profile for the low range PSA test, and google has not been my friend in this case. If I find it, I'll share it here.

I wouldn't sweat it. I would suggest that false LOW readings are much less common that false HIGH ones. That means, trust the low numbers, not the high ones. that is, however, just my opinion.

Hi Bob,
Pathology below.

PSA 5.5 june 09
robotic prostatectomy nov 7
prostate weight 45gm path report gleason 3+4 = 7
clear margins.