Post surgery PSA levels

I'm roughly one year out from radical prostatectomy (January 20, 2009 - I was able to hear the inaugural speech before going to the hospital). I've had three post-surgery ultrasensitive PSA tests, four months apart, with the first about seven weeks post-surgery. The first two reported less than 0.01 - essentially zero. The third reported 0.01 - implying some level of prostate cell activity.

I know that tests are variable, and that two points do not make a trend. Should I be concerned about this change in test results? I'll be seeing my regular doc soon, and may be seeing the surgeon (his office is currently dithering on whether they called me for an appointment or not, and, since their retail cost is $950/visit, I don't want to push to meet if it's not necessary), and sure plan to ask about this.

Bill,

You say that all 3 of you Ultrasensitive PSA results are 0.01, they all seem perfect

Did you mean the last one to be 0.03 ? If so that is such a tiny variation that it could very well be the lab

Bill,
You look to be doing well, and I know that team at UCSF to be an excellent group. I considered them when I was choosing surgery. As long as things are working well, you probably won't need to see the surgeon again. I know that after my surgery at the City of Hope 3 years ago, I have not seen my surgeon in person since I checked out of the hospital. No need to. I am under the care of an oncologist now and he runs all the tests close to my home in Las Vegas.

Good luck and good healing!

Tony

Bill,
Your surgeon is right. The test equipment no matter how sensitive cannot give a zero reading. I would assume from the result that the equipment delivers an ultrasensitive result. The lowest this can show is 0.003. Strictly if undetectable this will give a result as <0.003 undetectable. But results at this three decimal point level can have a quite wide variation (running the same test again on the same sample is liable to deliver a different result) so many labs will simply report it as <0.1 undetectable. The difference between <0.01 and 0.01 could be as little as .001 (your earlier reading could have been 0.009) so it is meaningless. Make sure you always get them done at the same lab as the equipment needs to be calibrated and this in itself can lead to small variations from one lab to another. Realistically all your surgeon will say is "you've healed up nicely, your PSA is great, that's $950-00, here's a receipt, goodbye". All I do is have my PSA test ordered by my GP and have the results faxed to my surgeon's office as well simply for their records. Looks like our age, stats and results are pretty similar. Congratulations on another zero,
Bill