Gedman's PSA History and membership RENEWAL

Following a few weeks behind Gedman, I had my follow-up for my April, 2013 surgery with Dr. Tewari on Friday, 2/21/2014. Got the call from the office this morning, that my PSA was also 0.00 (yes, as discussed in prior threads, they do now report actual zeros). Wishing the same good news to others!

And, am also happy to report that Dr. Tewari's office at Mount Sinai seems to be running smoothly after the transition from NYP-Cornell.

brooklynguy-

That's great news. Congrats!

-Gedman

bluebird:

Your husband had his surgery 6 months before me and brooklyn. So, at this point, your husband has probably "graduated" to the 6-month PSA test cycle, while brooklyn and I are still on the 3-month cycle (until we surpass 1 year post-surgery).

-Gedman

bluebird-

Interesting. I was a G7, and I thought that I was told every 3 months for the first year, then every 6 months for a few years, and then annually. I have another appointment (my 12-month visit) coming up in 2 months. I guess at that point they will tell me whether my schedule will change.

-Gedman

Congratulations to all you "zeros" out there. Hope your string of good news lasts a lifetime.

How often we get our PSA tests post surgery must vary quite a bit. I was a G7(3+4) and was every 3 months year 1, then 6 months year two, and now as of February 4th, I graduated back to yearly after two years. My surgeon is very conservative and thorough and was very confident that this was good for me since the cancer was low volume on only one side, negative margins, etc. He added if I was uncomfortable with this, I could come in any time to be tested, but his recommendation based on several thousand such surgeries was one year. Right now, that sounds pretty darn good to me.

Tom

I have my PSA tested every 3 months for the first 2 years probably because I am a G7 with positive margins and EPE. My 2 year anniversary is this July. I will expect he will keep me on every 3 months after that also.

Bill from Florida

TECHNICALLY, there is no such thing as a "real" zero. Each and every PSA assay (test) has a known limitation to it's sensitivity, below which readings are not reliable. This reliability threshold varies with the individual assay used, but exists in each.

ACTUAL results, below the reliable sensitivity level of the assay involved, are usually reported as LESS THAN (<) the specific known limitation. In the Standard PSA test, this is usually 0.1 ng/ml, but there is at least one that is 0.2 ng/ml. Hyper-sensitive and Ultra-sensitve PSA assays have sensitivity reliability that can go as low as 0.01 and/or even 0.001 ng/ml (not taking in to account electrical interference=noise) that can sometimes artificially alter such low sensitivity results

This said, the casual term "zero" is often used in the verbal reporting of a result when it is below the stated reliability thresholds, even though, TECHNICALLY, it is not the actual result, which should contain the < icon, BEFORE the numerical designation. The term "Undetectable" is even more often used as a substitute for the actual reading but, obviously the meaning varies with the sensitivity of the result.

There is only one way to get a formal printed "zero" report, and that would be to use an assay material with sensitivity below the amount actually reported. Example: If I would use an assay with sensitivity to 0.001 (to 1/1000th) to OBTAIN my PSA reading, but only REPORTED it to 1/100th it would read 0.00, BUT that would not accurately report the true reading obtained.

As you can see, this gets quite complicated and such broad terms as "undetectable" can mean different things to different individuals. Generally, it refers to "clinically" undetectable, which is WIDELY accepted to be LESS than 0.1 (<0.1 ng/ml), in the routine monitoring of post-surgical patients, although certain exceptions are possible in certain individual advanced cases.

I appreciate this is a lot of explanation for something that is mostly inconsequential to patients who have had successful treatment results, but to those that are interested in the technical determinations and their true meaning and significance, I hope it has been beneficial. A lot of the confusion in addressing the disease is a result of NOT knowing and UNDERSTANDING the subtle differences in communicative terminology. - [email protected] (aka) az4peaks