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Post Op PSA, I'm confused

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Posted 9/23/2011 6:16 PM (GMT 0)
Hi guys,

I had my regular doctor's appt. the other day and had routine blood work.  I asked the general practioner to also run the PSA thinking I would save myself an extra stick in the arm (and bill) from the Uro Doc. next month.  Well, the blood test went to Lab Corp for analysis.  It came back as "Less than .1"  I called Lab Corp and requested results in hundreds and not tenths.  You would have thought I had a third eye from the way they answered me.  "Sir we don't go below .1 on our test".  My last PSA was 0.04 from the Uro.  Oh well, I'll have to wait until next month to get an accurate reading. 

I was curious if anybody else had this issue. 

Posted 9/23/2011 7:21 PM (GMT 0)
Different labs do things differently. Not much you can do...
Posted 9/23/2011 7:24 PM (GMT 0)
I know in Dr. Walsh's book he recommends against readings to the hundredths. Apparently what happens is that someone will have a reading of perhaps 0.04 and the next time it might be 0.06 and they will start panicking because they believe their PSA is rising. However, those readings would basically be so close that they would be considered identical.
Posted 9/23/2011 7:30 PM (GMT 0)
Is it possible they have two tests on their price list, one using the older machines that is only accurate to tenths, and only reports as such -- but costs less and -- and another, for the ultrasensitive tests, that reports to hundredths, and costs more?

I ran into one lab that called out the two tests separately on the lab requisition slip. They used the .x test for medicare routine screening and the .xx test for everything else.

If you look at Labcorp's test menu you'll see the following for PSA:


Found: 13 Tests
Test Number Test Name
010322 Prostate-specific Antigen (PSA), Serum
480772 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex
480947 Prostate-specific Antigen (PSA), Free:Total Ratio
140731 Prostate-specific Antigen (PSA), Ultrasensitive
140674 Prostate-specific Antigen (PSA), Complexed
480145 Prostate-specific Antigen (PSA), Serum (Serial Monitor)
480780 Prostate-specific Antigen (PSA), Free:Total Ratio (Serial Monitor)
480640 Prostate-specific Antigen (PSA), Free:Total Ratio Reflex (Serial Monitor)
140723 Prostate-specific Antigen (PSA), Ultrasensitive (Serial Monitor)

I suspect the basic test was specified and performed, and you wanted 140731 or 140723. Your GP probably didn't spec the test you intended.

Post Edited (proscapt) : 9/23/2011 1:34:47 PM (GMT-6)

Posted 9/24/2011 4:34 AM (GMT 0)
GP's seldom order the ultra-sensitive test..The results produced by the standard test are all they need..Many U-docs and R-docs feel the same way, but some feel the ultra-sensitive test offers benefits to post-treatment patients..
Posted 9/24/2011 11:25 AM (GMT 0)
viperguy -
- you are in the Zero Club - ENJOY ! ( PSA <0.10 - there is no such thing as an absolute zero)
Bronson
Posted 9/24/2011 12:10 PM (GMT 0)
Wow!  I didn't know there were so many PSA test.  Thanks for explanation.  Tatt2, your words are encouraging.   I hope I'm in the ZERO club.  Will know come Oct 5th.  Wish me luck. 

My recovery continues.  I wear a precautionary small pad for daytime leakage but rarely leak.  Night time leakage is bad.  I suppose when relaxed the old bladder just empties. 

ED is still an issue.  I'm going to give it a full year before going to the injections.  The daily Cialis may be helping a little.   

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