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Rolling dice every three months

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Posted 5/10/2013 3:41 AM (GMT 0)
I am not really a big fan of rolling dice every three months.

Should I be asking for the ultra-sensitive test. I would like to know very quickly if it is starting to increase. The reason I say that is because my pathology didn't look all that good.
Posted 5/10/2013 3:48 AM (GMT 0)
I hear you, it's hard. I've graduated to yearly tests in my third year and it's a lot easier (right up to the month of testing of course). But seriously, it does get easier with each test.
Posted 5/10/2013 4:10 AM (GMT 0)
I don't like that either. Somethings you don't like, you just got to do.

I am not a big fan of the ultra-sensitive test but likely something you should ask the doc about. I'd only switch if you were going to take any action before the PSA became detectable with your current test. Some docs won't start new treatments until you get to .1 or .2. Others do it sooner.

Hang in there - it gets better,
Andrew
Posted 5/10/2013 4:21 AM (GMT 0)
Hi NavyChief,

I would ask for an ultrasensitive test if I were you, because there was extraprostatic extension and there is an advantage to receiving radiation therapy before your PSA reaches .2.

(btw, I think you meant the date of your post-surgery PSA as 2/19/2013 in your signature)
Posted 5/10/2013 2:57 PM (GMT 0)
I've had a great recovery achieving the trifecta of being cancer free, total urinary control, and sexual function, but those darn PSA tests still put my gut in knot.  I think it is because it is a 3/6/or 12 month constant reminder of what we have been through and after you have been given a cancer diagnosis once, I know I will never feel completely safe and secure again.  The good news is that it does get better with each passing good report.  I used to worry weeks before each test--now it is pretty much down to the day or two before.  I do like that affirmation of being cancer free that the test does give you though.

Best wishes,

Tom

Posted 5/10/2013 5:48 PM (GMT 0)
I agree with Allen.

With adverse pathology findings after your surgury, I think it's better to be proactive with the testing so you can watch for any kind of a trend.

If salvage radiation is needed, the sooner you do it the more you increase your odds of success.

Posted 5/10/2013 6:04 PM (GMT 0)
I had always gone ultra-sensitive. You get a 3 month or more jump on deciding your next course of treatment. When my PSA came back it went from .07 to .28 to .50 a 5 month period. If I hadn't done ultra sensitive, I wouldn't have know about the recurrence until I was at .28 and moving quickly.
Posted 5/10/2013 7:28 PM (GMT 0)
Navy,

I am not a big fan of ultra sensitive PSA tests, from observing here at hw for nearly 5 years, seems to create more anxiety for many. I think there are men that get tested way too often. In some cases, it is justified, in others, feel like men are just being too OCD about it.

Even in my case, with failed surgery and failed radiation, my doctor only wants it checked at the most, twice a year. He said he doesn't see the point of checking it more often, as its not going to change his approach with me. Mine was last checked in December, and it had climbed to 40.x.

Personally, I have never experienced PSA anxiety. From my first reading post surgery late in 2008 to present, its just a number, I never get worked up ahead of time, it is what it is, so why fret and worry, life is too short for non-productive worrying in my opinion.

david
Posted 5/10/2013 9:33 PM (GMT 0)
I don't like the ultra sensitive either. SOme of you know what happened to me my year in Rome.

In NYC they would simply tell me ZERO.

Then I went to Rome, Italy and they told me over the phone less that 0.02. Nobody had ever used this method with me before so I actually thought it was increasing until the HW folks told me to go downstairs and have another Caipirinha.

Then on my next Roman PSA test 6 months later the nurse forget a zero and told me 0.2. That's when for about 15 min I relived the worst moment of my life until I got on the phone with the lab.

I think the test itself and the process is already enough of a nervous ride, i'd rather just get the call from my surgeon's nurse saying "you're good, it's zero, see you in a year"
Posted 5/10/2013 11:05 PM (GMT 0)
I'd ask for it. The only labs that don't think it is necessary are the ones still using 5 year old or greater machines and don't have the capability. It is 2013. Take the two digit test. If you want a one digit answer you can round the numbers yourself.
We did a study here comparing costs for a one digit vs. a 2 digit test and the results were virtually identical. In one case a 2 digit test was less expensive than a 1 digit!

Don't let anyone kid you. Every year the equipment gets more selective and precise. The lab I go to uses the Roche Cobas 601 ECLIA unit. It is very precise and has a resolution of 0.003. That means it will report out numbers like 0.003, 0.006, 0.009, etc. The lab rounds the answer to the nearest 0.01. Some labs report out the three digits. (I believe BillyMac's lab does that and there are others.)

Call around and ask. Labs won't get better unless the customer ask for it.

Of course some guys think it is ok to roll the dice with the odd numbers blocked off. I say let them play that way if they like.
Jeff
Posted 5/11/2013 4:05 AM (GMT 0)
My husband has had both traditional and ultrasensitve psa tests. Our Oncol. recommends traditional. We are trusting him and doing what he recommends.
That's what we believe and are sticking to it.

BOOGEE
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