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Posted 12/16/2016 9:50 PM (GMT 0)
HI

I used to post here under a different handle which I no longer recall. The board was great for me but I managed to move on and put my cancer behind me.

That was before my annual test with Quest Labs. I just had four days from hell thanks to them.

For the last 4 years I had annual PSA tests which came back at <0.1 This year is came back without the < sign.

I hadn't even noticed when the report came in the mail but then my surgeon's nurse called me to tell me. I retested with Lab Corp and the nurse just advised that it came back at <0.1 and that although I might want to test again in 3 months to reconfirm the initial lab error, they feel I am still undetectable.

The nurse told me that over the last year they had several dozen people who experienced what I experienced and that that is why they advise their patients not to use Quest. She said that they believe they have made a corporate decision to eliminate the <sign and that they have done so without notifying their customers.

I'm relieved today but it's been four horrible days. I relived trauma and shock all over again. Just like the first time I'd wake up from naps and sleep and after a second remember all over again that I had cancer. It's been rough on my wife and kids too.

I feel so strongly about what they did to me and potentially many others that I think there should be a disclaimer about them on the top of this page for everyone to see.

I'm not going to bother trying to reach out to them because they would never acknowledge this. ***holes.
Posted 12/16/2016 9:58 PM (GMT 0)
We've heard previous reports of Quest and their errors. That company should be avoided.

Sorry you had to deal with this.

Andrew
Posted 12/16/2016 10:07 PM (GMT 0)
We have had on this forum a number of discussions in past months about this apparent problem at Quest Diagnostics.

Here's a recent one from October 2015:

www.healingwell.com/community/default.aspx?f=35&m=3522633
Posted 12/16/2016 10:44 PM (GMT 0)
Yeah, but <0.1 could be 0.09..how much difference would that make? If you are worried about 2 or 3 decimal places you need to have it done at a lab with that kind of precision.
Posted 12/16/2016 11:35 PM (GMT 0)
Londonguy, as I said in my post in the thread linked to above, by 81gyguy, I had a bad experience with Quest. I think it was my 9 month or maybe 1 year post RALP PSA. After getting all <.02, Quest reported my test at 3.8. You can imagine how off the wall I was for 2 days. I went to my surgeon, they retested, sent the blood to the hospital lab, and it came back at <.02. I contacted Quest and actually got a call from a Senior Director of OncOlogic Testing. They did pay attention and were quite pologetic. But they didn't have n answer. He actually said to me that they retested the same blood, and the tests LL came back undetectable, as well as checked the machine that did the test, and found no problem, and told me they just had no explanation, but tht next time I test, I should email him no he would personally check the result before it goes out.

I haven't tested t Quest since, and would probably at least CONSIDER giving up my erections before allowing them to do my PSA test again.
Posted 12/17/2016 5:21 PM (GMT 0)
I agree with sheepguy; this is a bit of a storm in a teacup.


Please note that I am not saying that Quest does not make errors (see Pratoman's post). Moreover, I agree that Quest should have noted that they changed the way how ('low') PSA data are reported to prevent confusion among patients.

Post Edited (Sr Sailor) : 12/17/2016 11:32:19 AM (GMT-7)

Posted 12/26/2016 3:25 AM (GMT 0)
London Calling me..

Thanks so much for posting Quest's decision to exclude < less than sign. I haven't slept for the past week. I was going to give my Uro a call to discuss salvage radiation. It's 10:30 and this will be my first night sleep in a long time.

Thanks again guys...
Posted 12/26/2016 2:59 PM (GMT 0)
Continual errors is a heckava lot more than a tempest in a teacup

For many of us these results are pretty crucial

I'm amazed someone would minimize such errors

Mel
Posted 12/26/2016 11:58 PM (GMT 0)
Naw...its a tempest in a teapot...tho not surprised...that Joe Btfspik from Al Capps Lil Abner would be Maximus the Worseus of da thread...
Posted 12/27/2016 4:00 PM (GMT 0)
Compiler, If the results at that level are so crucial, then find a lab that reporrts to 3,5, 10 decimal places , whatever you want, but don't rely on the presence or lack of the "<" sign.
Posted 12/27/2016 4:40 PM (GMT 0)
Sheep:

I am not talking about a single error in the 3rd decimal point.

Look at what happened to Prat.

Hey Prat -- what are you worried about? A few points here or there.

Sheep -- there is a significant psychological difference to those hoping for that cure when they lose that "<" symbol. It is BIG.... it is not just that technical 3rd decimal error.

Let me put it another way:

Going from 8.23 to 8.24 is not such a major issue. Losing that "<" sign is, for many.


I forgot: what is your PC situation?

Mel

Post Edited (compiler) : 12/27/2016 9:43:12 AM (GMT-7)

Posted 12/27/2016 8:48 PM (GMT 0)
Hello Mel,
I meant to reply to you earlier but the previous thread gathered speed and my reply would have been lost at the bottom.
It's good to see you are going strong although I am saddened to see your disease has progressed a little and you have had to increase your treatment arsenal. Hope the current HT does the trick. Best of luck for your upcoming retirement and congratulations on your daughter's upcoming wedding. Hope Christmas went well and all the best for the New Year.
All goes well at this end of the earth - I still pull undetectable 9 years after treatment for with a Gleason 8 with 70% involvement. Just goes to show how unpredictable this disease can be.

Back to the OP's concerns. I think many don't appreciate just what the < means ----- it is less than of course but with PCa this means "undetectable" and is related to the sensitivity of the assay you use. If a member's result comes back as <0.03 it means that particular test procedure (assay) can detect the presence of PSA as long as it is above 0.03 ng/dL. If PSA is not detected the level can range from 0 to 0.029. Whenever you see the < symbol it always means any PSA present is below our test limit (whatever that lab's bottom limit is).
If a lab reports consistent <0.01 and then reports 0.01 then something has changed. A previous undetectable PSA is now detectable ----- it may not clinically mean anything given the sensitivity of tests but the result has changed.

Interesting reading here:

www.pctrf.org/pca-commentary-vol-91-2-your-psa-is-undetectable-what-does-that-mean-how-does-an-undetectable-psa-affect-management/
Posted 12/27/2016 9:30 PM (GMT 0)
Billy

You are a year behind

Mel
Posted 12/27/2016 11:08 PM (GMT 0)
Mel,

Diagnosed Feb. 2014. PSA 6.2, 3 of 13 cores positive < 5% involvement Gleason 3 + 3. AS at the moment. 4 month or so PSA s , June 2014 8.5, 7.5, 7.2, August 2016 8.7. Normal PSA
Another increase in Jan and the next step is mp3TMRI..hoping I can find a reasonably local imaging service that I can trust.
Posted 12/27/2016 11:10 PM (GMT 0)
But you don't know what losing the < really eve is.let alone what it means. You know 8.23 to 8.25 is an increase of .02...treat it as you will.
Posted 12/27/2016 11:13 PM (GMT 0)
oops...diagnosed Feb 2015..not 2014
Posted 12/27/2016 11:28 PM (GMT 0)
But put very simply the difference between having a "<" and not having one, is measurable PSA vs no measurable PSA. I dunno, tht seems like a big deal to me.

As far as my situation, the reason I was SO annoyed is that they previously reported my PSA AS <.02, and 3 months later they were reporting it as 3.8. YIKES!!!. They should have known to question it, they should have safeguards in place. I feel they have. Moral obligation. Plus the fact that when I requested they retest the blood sample, they wouldn't do it, unless the DR called them. Until I made a lot of noise.
Look t this, a year and a half ago, and I'm getting all worked up again. smhair

Must be because my 2 year PSA test is coming up. But not at Quest LOL.
Posted 12/27/2016 11:30 PM (GMT 0)
Sheepguy:

The < symbol is the difference between undetectable and detectable.

Let me approach it another way.

Hope you stay on AS, but let's say things go South and you have to get a tx. Say surgery. Your post surgery PSA stays at <xxx for a year. Then the next PSA you lose the <.

I doubt if you will consider that insignificant. It will, in fact, be worrisome. For some, slightly so. Others, quite a bit so.
Or at least it will to most men on this Forum, I think, based on what I've been reading.

Going from 8.23 to 8.25, you are basically unchanged. No problem. I guess there could be an exception: if you started HT with a PSA at 8.23 and your next PSA was 8.25 8 months later you are probably in deep crapola, heading for castrate resistance.

Losing the <, you might well be facing a BCR. There would definitely be more pressure on the next PSA test.

After my surgery, my first PSA was 0.01, without the <. I never had a <. My next PSA was 0.03. That was indeed worrisome and, in fact, correctly so.


Mel

Post Edited (compiler) : 12/27/2016 4:36:28 PM (GMT-7)

Posted 12/27/2016 11:50 PM (GMT 0)
Geez I also posted normal PSA...LOL....for 8.7 I meant normal DRE. smile I do hope to stay on AS..but in any case at my age 68 and the physical requirement of farming/ sheep shearing...surgery is WAY WAY down there.

Prato...I didn't realize < 0.1 meant no detectable PSA..so I guess it really can't mean 0.09 I stand corrected
Posted 12/28/2016 12:11 AM (GMT 0)
Sheep:

That was hypothetical. If you are truly a G3+3, then you are in a very good situation.

If you have to do something due to a rising PSA, then I'm sure you will look at all the txs. and pick which one is best for you in your situation.

I did have to take a few weeks off work with my surgery. Your job sounds far more physically strenuous!

I agree that surgery would not be in the cards for you

Mel
Posted 12/28/2016 12:47 AM (GMT 0)
Double down...pogo styler...don't make me bump my old thread. " do you want to be healed".....it's relevant here....
Posted 12/28/2016 1:02 AM (GMT 0)
Sheep you just don't get it. It is not the math it is the movement. If I lose my < it means PSA is going up which after six years of < only cancer could be happening. So what is the difference between <.1 and .1? It could be a lot. But it will usually mean the end of remission and the start of more treatment.
Posted 12/28/2016 4:52 AM (GMT 0)
JNF you are missing the point remember the tempest in the tpot was in re...to the initial threaders post...not to every body's experience with quest...its not just Quest...its every lab that tests depending on who is doing the paperwork...good lawd... you guys have a knack of faith that moves mole hills into mountains...its quite amazing and a very good reason why forums like this...do more harm than good...unless you are well versed in the meanings and power of words...get a fricken grip...

" it will usually mean the end of remission and the start of more treatment" What hogwash...just throw dem words around...like you really know something...NOT!!! Help Lurkers we need a new clique here on HW...the cadre here...if kept their tounge but lost their ear
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