8 years post surgery PSA result question

Hi All

I have been following this forum off and on since my husband's diagnosis 8 years ago. He had surgery in August 2014 and his PSA tests have all been <0.01 since then..

He had his 8 year test today and the test range was 0.00 - 4.0 and his result was <0.0 and was flagged as low by the health system reporting system- as it is below the reporting range. It appears to have been done on a different Siemens machine - the Atellica rather than the Vista - for what that's worth.

I don't understand the result. I wish it was the way I was used to reading it - the basic <0.01. I asked him to get re-tested hoping for a more understandable readout, but he refuses. The doctor's office sent back it was undetectable with a new order for next year and they said that is not usually how they see these results, but were unconcerned.


Any thoughts?

By the way, so glad to see that Halbert and Pratoman (I hope I have your user names correct) are still on the forum doing well. You both were getting treatment around the same time as my husband. There are other names I recognize as well that I am glad to see are still doing well.

Thanks..

Hi lovif. First, it's very important to make sure you've got the decimal point in the right position and are reporting all the zeros accurately. Many men are followed after surgery with the "standard" PSA test also used for men who still have their prostates. This test can detect only down to 0.1, so if one's PSA is anything lower, it is reported as <0.1, which is undetectable for that test, and is generally understood as "undetectable" in general.

If your husband's previous results in the past have been <0.01, it means he was followed by an ultrasensitive PSA test (uPSA). In this case his particular uPSA test can detect down to 0.01, so if his PSA is lower, the result is reported as <0.01.

Frankly no PSA test should ever report <0.0, because no test commercial test can detect a true zero (and obviously less than zero is meaningless). If you do see <0.0 it looks like a transcription error that someone made. PERHAPS you husband was tested with the regular PSA test and not the uPSA test, in which case the result should have been reported as <0.1, as mentioned above. That result doesn't tell you much, since the uPSA test measured ten times lower previously.

The Reference Range of 0-4 is usually given for all PSA tests because that is roughly the range for "normal" PSA in most men. It is NOT the range that the test can measure! HOWEVER, if the reference range is reported as 0.00 to 4.00, it would appear that this was an ultrasensitive test (because of the two decimal places). This doesn't jive with the result of <0.0 you were given with only one decimal place.

I would call the office and ask for clarification. The best way to see results is to see the actual lab report, when available. Transcription errors occur when lab results are copied from the lab results into other patient portals or patient records.

In any case, your husband is still "undetectable." My best guess is that the test given was, in fact, his "usual" ultrasensitive PSA, and the <0.0 should be <0.01 because <0.0 isn't a true lab result. I think the final 1 was left off in error.

IMO he doesn't need another test, but rather should find out the correct result of the one he had. I'd ask the office to please double check against the result the lab reported. I think it will be prove to be <0.01 (or possibly <0.1).

Hope that helps, and congrats on the undetectable, in either case

Djin