Still bouncing around with uPSA

Had my semi-annual draw yesterday and still bouncing around. I'm due to see the Uro in a couple of weeks.
2 big changes for me which I'll ask about
1) started Wegovy last May and take 2.4mg per week
2) have started to develop kidney stones from time to time - recently passed 2 after never having them before age 63. All of the below with same lab / draw location.

10/19/2020 <0.014
1/18/2021 <0.014
4/27/2021 <0.014
7/26/2021 0.009
11/16/2021 0.014
3/3/2022 0.018
8/10/2022 0.014
2/17/2023 0.013
8/7/2023 0.017
2/7/2024 0.023

Prior high was .018 Mar 2022 so 23 months ago

GG - These are pretty small numbers so I would not be too quick to extrapolate into any conclusions. Since you don’t have a prostate, I am guessing that passing stones would not cause any PSA variances but again, the measured numbers are very small. No idea on the Wegovy.

Long time before you have an identifiable or treatable problem if that even happens. Some men have a small PSA which levels off at some point so no need to get too excited now, they are just numbers.

Casey59 said...
Congratulations on a very long streak of super low PSAs!! I don’t know more of your history than what is here, but I’m wondering to myself why you are even still getting 2x/yr measurements. These are really low numbers, and years of data. Do you have a reason for getting the ultra sensitive test?? Not from you signature or what you’ve posted here.

Yes, he does: seminal vesicle invasion, extracapsular extension, and a high-risk Decipher score. However, his numbers are still low.

Djin

Small fluctuations close to the detection limit. In my opinion, you do not have any reason to disturb your sleep thinking about what these figures mean. If there is any worrisome trend, it will be shown after new tests, probably in a far away future.

Ok, SVI & EPE, now I get the uPSA (otherwise no). But you’ve got 5 years of fantastic numbers. I’ve worked through stats of enough lists of numbers to look at yours and say the latest (even though it’s highest) is probably part of naturally occuring variation of numbers; not statistically significant change. Many congrats to lengthy, excellent track record!

Moreover, the published data suggest that the only time that men in your situation should react to uPSA findings is in a very specific situation: a uPSA over 0.03 and rising on two subsequent uPSA tests or a rise of 0.05. In situations where uPSA is below 0.03, or where it is above 0.03 but it is stable, there is no cause for concern.

(I see your signature now…it seems that it doesn’t always show up on mobile devices. 🤷‍♂️)


Added later: I think I see now that the full signature only appears when I’m logged in to HW…which explains why it wasn’t there on my first reading of your post. Apparently a “feature” (or is it a bug) of the new HW platform.

Post Edited (Casey59) : 2/10/2024 6:47:13 AM (GMT-8)

GG…I don’t know the accuracy of PSA testing but PSA is expressed in nanograms per milliliter. This is the same as parts per billion…indeed a very small number. I can’t even imagine how many parts are in a billion let alone understand how they can measure it. Best wishes…Terry

For very early salvage radiation the threshold is about .05, and you are less than half of that now. Wait and see. Still, it does not hurt to think about your options should the rise continue.

Follow up appt was this week, overview
1) Doc also said it was a small rise this time and I seem to do small bounces
2) At first, he wanted to do 6 months for next test, I asked for 3 months and he agreed if that is what I wanted. So, I'll get it done in May and see where it stands.
3) Kidney stones - not related to ART in his experience. More due to diet and water consumption. I had been eating more spinach lately which is high in Oxilates (oxilate stone on analysis)

Also did follow up with the Metabolic Dr - I have lost 44 pounds in 9 months so a lot of good progress there. I'm on 2.4mg Wegovy / 1x per week. 18 more pounds to go to get to ideal weight.

BP has improved enough to drop Norvasc script!

Also, put in to retire mid-April so lots going on at the same time but all good!

DjinTonic said...
Keep in mind that with Labcorp's uPSA test, if you repeat the test many times on the same blood draw, you will get results that fall within ±0.002 of your actual value in ideal test condition, and more likely ±0.003 in every-day, real-world settings even before you look at sources of error/variation, like sample prep. Couple that range of values with our PSA levels that fluctuate even when basically steady, and you'll realize that it takes quite a number of data points to establish a reliable trend.

Djin

Thanks for the reminder Djin! I do recall that Biotin can have a small effect on the #'s too and it is in most foods.