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Post SRT PSA test - Regular or Ultra Sensitive?

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Posted 11/30/2018 10:31 AM (GMT 0)
I am winding down my SRT (have 3 of 35 treatments left) after 2.5 years post RALP.

In 3 months my RO is recommending a regular PSA test rather than an ultra sensitive. My RO believes that a low detectable ultra sensitive would be hard to interpret and could lead to unnecessary treatment and anxiety.

My pre-SRT PSA at the RO Cancer center (all Lab Core) were: 0.0 (regular May '18), 0.05 (ultra sensitive May '18), 0.06 (ultra sensitive Sep '18)

My ultra sensitive PSA for the 2 years post-RALP at my Urologist (Quest Diagnostics) at 3&6 mo intervals were: <0.02, .02, .02, .03, .03, .09 (Apr '18, the big jump led me to see RO)

I want to follow my RO's advice and pull a 0.0 regular. My Uro is going to want an ultra sensitive to see the results on the original lab equipment. Anyone have any thoughts on ultra sensitive vs regular PSA test?
Posted 11/30/2018 1:07 PM (GMT 0)
I see both doctors' points of view. But I'd want a regular as well.

To my mind, there's no point in sitting there watching for miniscule amounts of PSA. You'll know with either test. I want to see zero's. But I'm speaking in abstraction. I've not had SRT.

People who know more about his will teach me something as well.

Congratulations on finishing up....
Posted 11/30/2018 1:14 PM (GMT 0)
At this point you've already done the SRT. So why bother with ultra sensitive? It's not like you can go do the SRT again. You've already shot that bullet. The next thing would be more ADT.
Posted 11/30/2018 2:03 PM (GMT 0)
I agree that at this point in your treatment the only thing an ultra sensitive test will provide is potential anxiety. Why bother with it?
Posted 11/30/2018 2:54 PM (GMT 0)
Regular. The extra digits don't do anything for you at this point.

The regular test will give you all the data you need to determine if more treatment is needed. Since the next step would be ADT, and that wouldn't begin at very low levels, the ultra sensitive doesn't make a lot of sense.

However, it's just numbers, and you don't need to act on all the digits your present with.

So for me the answer would be: Whatever.

Andrew
Posted 11/30/2018 4:44 PM (GMT 0)
If there was any "unnecessary treatment and anxiety", that horse has already escaped the barn.

A regular assay is all you need, but if you don't tend to alarm yourself with heightened anxiety, the uPSA is OK.

It's you, not your docs or us, who know which one works best. Good luck!
Posted 11/30/2018 4:59 PM (GMT 0)
I'm a fan of the ultra-sensitive test post surgery, but agree that post SRT it could cause unnecessary anxiety, and the results aren't actionable in any case. I'm in the same boat, and am not considering additional scans or HT until my PSA reaches some new level. I'm not quite sure what that level will be for me, but it doesn't need the uPSA test to measure it.

Best wishes for many years of non-detectable PSA!
Posted 11/30/2018 5:55 PM (GMT 0)
I’m getting uPSA post-SRT because I like to worry unnecessarily. Watch for my post about a year from now in which I do a virtual DNR when my uPSA rises from <0.02 to like 0.031.
Posted 11/30/2018 6:08 PM (GMT 0)
I am in no hurry to start ADT. I am not going to do anything until my PSA starts going up by tenths fairly quickly.
Posted 11/30/2018 6:24 PM (GMT 0)

Saipan Paradise said...
I’m getting uPSA post-SRT because I like to worry unnecessarily......

You are in good company around here, Richard ;-)

Don't you already have a DNR on file?
Posted 11/30/2018 6:38 PM (GMT 0)

Saipan Paradise said...
I’m getting uPSA post-SRT because I like to worry unnecessarily. Watch for my post about a year from now in which I do a virtual DNR when my uPSA rises from <0.02 to like 0.031.

LOL Just so we know we're on the same page!
Posted Yesterday 12:00 AM (GMT 0)
I think it all depends on what is the actionable number. I would think, with SRT under your belt, and the next step (hopefully not necessary) being lifetime ADT, you could wait until 1.0, even 2.0 or 3.0. Depending on velocity. But I’m not sure. If it’s 1.0 though, no point in doing uPSA, unless you have an unhealthy need to know.
I’ll be at that point soon, but my RO, at MSKCC, always uses a test that measures down to .05. I guess that’s like, semi ultra sensitive or something
Posted Yesterday 4:15 AM (GMT 0)
Been there. And I'd have been very unhappy to have had anything other than two decimals. Maybe just me, but wanting to see and track the data doesn't mean undue anxiety - only information - what's around the corner, what's behind my back, what's to left and right when entering a room. Not knowing would make me anxious.
Jim
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