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ultrasensitive psa anxiety

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Posted 10/4/2010 3:12 PM (GMT 0)
I have read numerous threads on ultrasensitive psa anxiety.  My anxiety seems to be never-ending.  I know all the ups and downs of ultrasensitive testing.  I just cannot seem to find significant number of men who are going through my Dad's situation, and all turns out ok.  Here are my Dad's stats:

Bilateral Robotic Surgery:  2/08

Gleason=7  (3(90%) +4 (10%)) (tumor involving 2-5% of prostate)

pT2cNxMX

post op PSA <.01 until 10/09  10/09=.01, 12/09=.01, 2/10=.01, 5/10=.02

His psa was very low at his diagnosis .6 (on proscar, so 1.2 adjusted), which is worrisome as well.

His oncologist (very well respected nationally) says it appears to be remaining prostate cancer. His surgeon says not so!  Who has the best data on these ultrasensitive tests?  His next psa is next week and it could go either way.  It is driving me crazy.  If only I could know how many men this happens to, without biochemical recurrence! 

I would love to just "Laugh Again"

Posted 10/4/2010 5:57 PM (GMT 0)

It happens a lot.

This article explains what you ar experiencing as well or better than I can (go to the link, then scroll down to the yellow section at the bottom titled, "The Downside of Ultra-Sensitive Tests"):  http://www.phoenix5.org/Basics/psaPostSurgery.html.  The article says:

''From day to day, the results could vary -- it could be 0.03, or maybe even 0.05'' -- and these ''analytical'' variations may not mean a thing. ''It's important that we don't assume anything or take action on a very low level of PSA.

Did he have positive surgical margins (PSM) or extraoprostaic extension (EPE) or seminal vesicle involvement (SVI)?  If no to these, then recurrence is highly unlikely.  If yes to any of these there is a greater chance, but one would still not say that recurrence is "likely."

PSA anxiety is the downside to the ultra-sensitive PSA test...for which only time will resolve the anxiety.

Hope that this helps


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