Funny Thing Happened at the Blood Lab...

Stopped by the lab after work and handed the phlebotomist my script from the doctor. As she's studying it with a puzzled look on her face, I told her that my doctor wanted the post prostatectomy PSA test, not the standard PSA test. She said yes, but the code for the standard PSA test is what is on the script. Then I pointed out to her that in the comments section at the bottom of the form, they had typed in "post prostatectomy PSA" because they did not know, nor could they find, the proper code. So, I'm getting my blood drawn, trying to think about other things but I noticed it was taking longer than normal. She finally finishes and much to my surprise, she is holding two vials. I asked why she took two vials and her reply was that the way the doctors office wrote the script indicates that the doctor wanted both tests, standard and post prostatectomy PSA. I don't know if they use different assay methods for the two tests, but it will sure be interesting to see if the two results are in agreement.

I thought the same thing when the doc could have checked off the regular PSA and free PSA test - how the numbers would vary from pre-op results - keep us informed on what happens.

BRONSON

Worried Guy said...
Hey Taurus.
about 4 months ago we checked the prices of screening PSA (one decimal ) and the Diagnositic PSA (2 decimal) and found the prices to be virtually identical. In fact, in one area the 2 decimal test was LESS!

I am part of a study comparing two different assay methods for the diagnostic PSA test - the 2006 protocols vs the new 2010 protocols. You might be in a study, too. That's how diagnostic tools improve. 20 years ago they were reading PSA to NO decimal places and 200 years ago they read it by counting the number of fat leaches.
That's progress. 10 years from now we will be getting results to 3 decimals.

My signature has my numbers and protocol comparisons. The latest and greatest is ECLIA.
See if you can get your hands on the reports.

Good luck. May you have <0.02 That's no bull.
Jeff

Hey Jeff,
results are already reported to 3 decimals. The ultrasensitive test in fact delivers a result to 3 decimal places (down to its detectable limit of 0.003ng/mL) but as the result is somewhat variable at this level it is usually reported as <0.01

www.phoenix5.org/Basics/PSAundetectable.html

(a) Standard test -----------1 decimal place
(b) Hypersensitve test------2 decimal places
(c) Ultrasensitive test-------3 decimal places

Post Edited (BillyMac) : 9/16/2010 6:57:20 PM (GMT-6)

Jeff,
I am located in Sydney where the cost is fully covered under our universal health scheme. The cost here that is charged for the test (no matter the sensitivity a few years ago was $20-00. I believe it has risen about 10-15% since then.

www.sswahs.nsw.gov.au/sswps/default_hb.htm

Bill

Post Edited (BillyMac) : 9/16/2010 9:21:36 PM (GMT-6)

I am glad I always had post-op PSA tests with two decimal places... In my opinion, it allowed me to see a pattern and jump on SRT at the most opportune time for success based on my post-op pathology.

With single decimal PSA, it would be mathematically possible to have an actual rise in PSA going from 0.06, 0.08, 0.10, 0.12, 0.14 all reported as 0.1 in a single decimal test

In my opinion, you would have lost some valuable information about a potential BCR and the most timely, effective, and appropiate treatment strategy for it.

PCa is a true beast and I will always look for the best and most reasonable testing methods to keep my eye on it...

Best to all, pasayten