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First post surgery PSA .04?

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Posted 3/29/2022 4:26 PM (GMT 0)
<.04 is first PSA after surgery 35 days ago. I am pretty sure this is good and considered undetectable. However, in my reading, it appears there are studies that say <.03 is a big marker for predicting recurrence in the future. Can anyone shed more color on this topic of initial PSA a and indicator of need for followup radiation and recurrence? I was 3+4, clear margins, vesicles, and lymphs but I was EPE.
Posted 3/29/2022 4:57 PM (GMT 0)
0.04 just may be the lowest resolution of your particular ultra PSA test. Your reading is below what your test can determine. As of the moment, you're doing well.
Posted 3/29/2022 5:06 PM (GMT 0)
Anytime your PSA comes back with a less than sign, you are undetectable.
Posted 3/29/2022 5:09 PM (GMT 0)
Rich,

A couple things:

Generally, the 6 weeks post surgery PSA is considered a 'trending' indicator. You PSA may still be dropping from it's level before surgery. The definitive value is 12 weeks (3 months).

0.04 is good. What you're looking for in the perfect world is a "<" in front of the reading. This is really important: you want a reading that is below the detectable range of the test. Some tests have a low limit of 0.1, or 0.04, or 0.006. The key to undetectable is the presence of the less than symbol.

How are you doing otherwise on recovery? How is your continence? Have you tested whether you have ED or not?
Posted 3/29/2022 5:34 PM (GMT 0)
Great clarification Halbert. Congrats on your Non-Detect since 20215! Have 1st post surgery Urologist appt tomorrow so I am hoping to get answers to more questions I've dreamed up since my post surgical pathology report mainly regarding statistical likelihood of PCR in the future and what the significance of my EPE will be in that regard since margins were clear. At 35 days, strong urine stream but still up 1 or 2 times at night but dry in the morning as I have control. Full control over my urination except standing or sitting(squirt) LOL during the day. Continuing with Cialis 5mg daily as before surgery and bombing 4 once a week. No response yet but have had 2 non erection orgasms( who knew that was even possible?) Most importantly, my wife is supportive and patient so minimal mind issues to deal with. Age 62. New hobby is kegels.
Posted 3/29/2022 6:00 PM (GMT 0)
Once you are below the lower limit of detection ("undetectable") for a given test--indicated by having the < sign--you can't know just how much lower you are. You would need a test with a lower limit of detection to get any more information. Generally speaking, you are fine if you remain undetectable with any PSA test.

There have been studies that looked at the predictive value of knowing the post-op nadir (lowest value) of your PSA. A nadir below 0.030 is good; below 0.010 better as far as predicting risk of BCR (the return to a PSA of 0.2 and rising). Note that it may (or may not) take time to reach one's lowest PSA after a RP (e.g., mine occurred at 7 months). Other stats: studies found that a PSA below 0.03 at 2 years post op is very good, and that 2/3 of the men who encounter BCR do so within the first 2 years post op.

The only reasons I know of to seek out a more sensitive ultrasensitive test are (1) you currently have a < sign, your RP was recent, and you are are curious about your nadir or (2) you are high risk for recurrence and are contemplating adjuvant or very early salvage therapy and knowing your PSA (or rate of PSA rise) to a better degree of precision might help you with decision-making.

Djin
Posted 4/24/2022 10:02 PM (GMT 0)
Update, incontinence is gone. No pads. 2 months. One down, one to go(ed).
Posted 4/24/2022 10:46 PM (GMT 0)
Wow; you are REALLY doing well!
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