HealingWell
Search Close Search
☰

Trying to understand two different PSA scores

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/12/2023 12:52 AM (GMT 0)
I am a Veteran that is seen in community care at UT Southwestern. I had High Dosage Brachytherapy and EBT back in May 2020. I also receive semi-annual checkups being over 65 at VA and at my last recent checkup my PSA was .02 there. My last PSA in August at UT Southwestern was 0.13. I realize they're not on the same sensitivity scale but my PSA score before at VA was .01 and my previous PSA at UT Southwestern was 0.07. It is very confusing so can someone tell me the differences - if any- between the two? My next PSA at UT Southwestern is next month.

Post Edited (WayneTX) : 10/11/2023 4:55:20 PM (GMT-8)

Posted 10/12/2023 1:57 PM (GMT 0)
Wayne, I'm not sure I completely understand you are asking. It seems that your PSA ( when?) at the VA was .02? But, in August at UT Southwestern it was 0.13? So, you are concerned about the increase over 3 months?

But you also write: " I realize they're not on the same sensitivity scale but my PSA score before(when?) at VA was .01 and my previous(when?) PSA at UT Southwestern was 0.07. ". So were these at nearly the same time, leading to you to wonder why one was 7 times higher than the other?

I think it would be best to simply compare a PSA tested at one institution against a PSA tested at the same institution. There could be differences in machines and their calibration. Also, were there any " < " signs associated with any of these tests? In that case, one machine might just be telling you that the PSA is less than – for example – .07 meaning their machine will not measure any lower than that. (At my docs office the current cut off is less than .05, but it used to be < .01) if it is then measured on another machine calibrated to a lower cut off number, then the PSA might show as – for example – .02 rather than the less than < .07. So, best to compare PSA run at one institution against PSA at another institution, or things might get confusing.

On the other hand, if the PSA has risen – even if analyzed at 2 different institutions – from .02 to .07 ( no "<" signs on either), or .13, in just a few months, this deserves watching. Your best bet is to get another test as soon as possible- or within a few months at most- at the same place that gave you the higher number. And see if it is now giving you a significantly higher number compared to the 0.13. Then you will have a better idea of what is going on. If that is inconvenient, then get another PSA drawn at the place that gave you the lower number, and see if that has also increased or not. But best to compare results from one machine against the same machine.

Regardless, do not ignore that 0.13. That is getting high enough to be paid attention to, as well as the steady increases apparently involved. So get another test to see if that has increased or possibly even going back down a bit.

Post Edited (BillyBob@388) : 10/12/2023 6:13:02 AM (GMT-8)

Posted 10/12/2023 3:34 PM (GMT 0)
Wayne, obviously the readings are coming up higher at Southwestern.

It is inevitable that it gets confusing when different labs are involved. I would try to stick with one lab, for consistency, unless there is a reason you are doing both.
Posted 10/12/2023 4:30 PM (GMT 0)
Wayne - IMHO, radiation patients should not monitor with ultra-sensitive testing, just the standard < 0.10 testing. There is too much variation with a smoldering prostate that means little and PSA bounces are common in early years. Add multiple labs to this creates confusion x 2. If you have a problem, your PSA will have to get in the single digits before worrying about anything.
Posted 10/12/2023 6:57 PM (GMT 0)
Wayne,
Ignore VA, go with UT Southwestern

That one is going up, monitor that one.
Also keep track of time between tests.
If it keeps going up, then figure out your PSADT (PSA doubling time)
If the PSADT is anything under one year.
You need to talk to your Oncologist.
Posted 10/12/2023 11:04 PM (GMT 0)
Wayne........thanks....I trust UT Southwestern more by far at every level.........
Mumbo...when you say single digits does that mean 1.0, 2.0, etc. ?
BillyBob,,,,,you're right I was not very clear on dates. I'm going to just stick with UT Southwestern and 0.13 was a jump from .07 so I need to track that one........my next consult and PSA at UT Southwestern is on Nov. 27. I always get a PSA with my checkup at VA and that's why I know it went from .01 to 0.2 over past six months as I read the results online and the UT Southwestern increase was over a four month period as they have me on 4-month evaluation schedule. Just a bit concerned that both went up so asking some questions. I am Gleason 9, Stage 3 High Risk so the concern is there seeing both go up. My PCP at VA did not say a word about the .02.
alephull......thanks for that info......I will see my Oncologist next month and I will get better answers based off that PSA test.
Posted 10/13/2023 12:20 AM (GMT 0)
Wayne - Yes, the definition of RT failure is typically defined as the lowest PSA value after treatment (nadir) + 2 (not 2.1 or 1.9). Therefore, one has to get to much higher values than 0.13 before any RO would start to get concerned.

The propensity for PSA swings (bounce) years after radiation treatment can make it a roller coaster ride if one watches the numbers too closely without perspective. Doubling time with small numbers over short time intervals can be misleading as well so all must be kept in context.

Now, we all are fixated on PSA but it is a much better tool for surgery patients than RT patients. Does not make it any less real when you are the one getting the results and trying to make sense of them though.
Posted 10/13/2023 12:51 AM (GMT 0)
thank you Mumbo for that explanation. My lowest PSA number after brachytherapy and EBRT in May 2020 was 0.07, 0.05 is the lowest number as I understand. It has bounced around a little since but has not exceeded 0.13. It settled at 0.05 for five straight PSAs at 6 mos. apart. What freaked me a bit was the PSA test taken at my VA checkup on Sept. 28 that went from .01 to .02 over 6 months. Not sure what that means either, but PCP never said anything about it at consult.

Post Edited (WayneTX) : 10/12/2023 5:21:32 PM (GMT-8)

✚ New Topic ✚ Reply