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Posted 1/12/2017 2:33 PM (GMT 0)
2 year PSA came back at .02. No "<"

THE NP called it undetectable, I asked her if the result included the <, she said no, but sometimes it fluctuates, (which I know, but still this is disconcerting).
I have my 6 month appointment with the UFO, on Feb 3rd, they will retest at that time.
So this is NOT undetectable.
Posted 1/12/2017 2:51 PM (GMT 0)

Pratoman said...
2 year PSA came back at .02. No "<"

THE NP called it undetectable, I asked her if the result included the <, she said no, but sometimes it fluctuates, (which I know, but still this is disconcerting).
I have my 6 month appointment with the UFO, on Feb 3rd, they will retest at that time.
So this is NOT undetectable.

It sucks, does it not, Bro? Of course still undetectable by the old standards and what most of them still seem to go by. I am coming up on my 3rd year, and we all hope for no increase, but it I lost my < a while back, I forget, maybe a year? And my NP also still calls it undetectable. (EDIT: I just read my own sig to see it is closer to 1.5 years since I lost the lovely <. )

Anyway, sorry for your "loss", but hey, maybe you will get it back? And if you stay at .02 it will never really matter will it? But we all have our fingers crossed to not see any increase, or even the loss of that < sign to start with. Too bad we don't have a switch to turn off any ability to even think about the possibilities of a future significant rise until and if it happens, and deal with it then.
Posted 1/12/2017 3:18 PM (GMT 0)
Oh darn…you’ve been snared.

Why in the world would a surgeon recommend an ultrasensitive PSA test for a patient with clinically favorable-risk case and with favorable surgical pathology…I don’t know. But I see it not infrequently. It is not a “best practice” of the American Urological Association.

The result? PSA anxiety. It is absolutely the bane of ultrasensitive PSA tests. And now you’ve inescapably been snared into it.

Now what? Hand-wringing, and wonder if you should go today, or tomorrow, or again the next day—back to Quest—for yet another follow-up test to get a more-likable result.

You’ve likely experienced the naturally occurring variation which commonly occur at the test limits.
Posted 1/12/2017 3:26 PM (GMT 0)
No be silly...vote for willy... no not dat one...Of course its undetectable...and the switch is always available...thats the problem...nes c'est pas?...as we say in hawaii "chance em" wait a year for your next psa test...reach out for the gold ring...you will not disappear...guarens ballbearens...As len goodmen from DWTStars...yeah I got cancer...its not like Im riddled with it...um riddled..I like that word...I wonder why?? I feel your pain...but feels more like an itch...life's a beach...er that reminds me........ Take care of yourself.... prato everyman...
Posted 1/12/2017 3:39 PM (GMT 0)
Man, that's my least favorite thread title on HW. But you had good pathology, right? I'm thinking this likely the vagaries of the ultra-sensitive test more than anything else. Or even just a typo.
Posted 1/12/2017 3:55 PM (GMT 0)
Prat:

A little bit disturbing, but I doubt if you have a problem.

I honestly don't know the latest about when to start SRT?
Is it at 0.06 or 0.60.

If the latter, then indeed the ultra-sensitive PSA just creates more anxiety. Then again it also gives you more information. But, is it misinformation? Is it a FAKE news story?

You have two big questions that are right now unanswered.

1) Is it just an aberration?
2) If not, what is your PSADT? I suspect it will be a very comforting number!

I will be curious to see some input from TA. I suspect he will say it is probably not a problem but you'll know more after the next PSA

Mel
Posted 1/12/2017 4:10 PM (GMT 0)
Where I live in Europe and use the public health care the only available test has the analytic sensitivity of 0.05. I once asked the lab why we don't use the same sensitivity as you use in the US. The answer from the lab was:
However, we think in Europe that Americans sometimes might focuses smth strange, since we believe that it is of no clinical interest to measure below 0.05
Maybe the lab is right. It seems to cause a lot of unnecessary psychological stress to know these ultra low values that probably is only normal fluctuation.
Other important characteristics of the test we use are repeatability, accuracy and analytical specificity. It is not only about the sensitivity of the test.
Posted 1/12/2017 4:13 PM (GMT 0)
It's measurable. Not detectible. there's a difference. It only makes sense that we do this. But, it's incorrect to do so. (and disquieting as well)

Ultra-sensitives have changed our lingo. It's gotten to a point to where we now use the words "measurable" and "detectible" interchangeably. As if....they're meanings are the same. Everyday usage of these words further encourages this mistake. But...this is medicine (so the rules of sanity no longer apply....excuse the sarcasm).

"Detectible" is .1 Anything less is "undetectable" It's measurable with these machines....but that doesn't change the fact that you still have an "undetectable" amount of PSA in your blood.


Read Halbert's sig. His machine measure down to <.04 His could be doing the same thing ours is, Billy Bob's is, (a lot of ours are) and he doesn't have to worry about it.

Don't assume I'm dismissing your feelings on this Prat. (I'm not and I don't. I felt the same way when I went from .00 to .01).

This is a mind game man. It truly is. Hang in there buddy.
Posted 1/12/2017 4:21 PM (GMT 0)
So it can be found but not measured because there so little of it that it can't be measured but is there? At what level does measurable become detectable? So what has more meaning Measurable or undetectable? If anything less than 0.1 is undetectable..why worry about anything less than that at all.
Posted 1/12/2017 4:34 PM (GMT 0)
wikidiff: Measurable is a synonym of detectable.
As adjectives the difference between measurable and detectable is that measurable is able to be measured while detectable is that which can be detected, noticeable.

As a noun measurable is that which can be measured; a metric.
Posted 1/12/2017 4:35 PM (GMT 0)
and as always, "wait for the retest."

Andrew
Posted 1/12/2017 4:52 PM (GMT 0)

sheepguy said...
At what level does measurable become detectable?

traditionally, .1 has been the standard.

sheepguy said...
So what has more meaning Measurable or undetectable? If anything less than 0.1 is undetectable..why worry about anything less than that at all.

these ultra-sensitive results (below .1).....we may just now be at the beginnings of seeing some trends with them. At least that's my understanding of it all. (I'm learning to not dwell too much on it. If you do....you'll see a bunch of trees instead of a forest).

Post Edited (island time) : 1/12/2017 10:22:24 AM (GMT-7)

Posted 1/12/2017 6:12 PM (GMT 0)
Thanks guys. I know it may be nothing. Won't know until they retest. Even then, they are retesting in 3 weeks, so even if it comes back the same, all i know is its not lab error, doesn't tell me if its a trend. Time will tell.

I said to someone yesterday, i'm not even nervous about this PSA coming up, which makes me nervous. So there is it is. Fullfiller of my own prophecy. Whatever. Even if its a recurrence, with the best of care, i'll probably still live till 80, unless something else gets me.

Still, I'm on edge.
Posted 1/12/2017 6:38 PM (GMT 0)
After rp and srt psa sticks at .2 for 2nd time, what are chances for iit to go down more?
Posted 1/12/2017 8:54 PM (GMT 0)
Disappointing news Prato. But there is nothing in your pathology to justify concern at this time. Hopefully it'll fall or you can ride it out at this level for the duration.
Posted 1/12/2017 9:03 PM (GMT 0)

Pratoman said...
Thanks guys. I know it may be nothing. Won't know until they retest. Even then, they are retesting in 3 weeks, so even if it comes back the same, all i know is its not lab error, doesn't tell me if its a trend. Time will tell.

I said to someone yesterday, i'm not even nervous about this PSA coming up, which makes me nervous. So there is it is. Fullfiller of my own prophecy. Whatever. Even if its a recurrence, with the best of care, i'll probably still live till 80, unless something else gets me.

Still, I'm on edge.

You should be. There is a whole bunch out there that wants to take you out, stuff that has a far greater chance of getting you than some measly G3+4, PSA .02 PC. Keep a sharp watch out for that other stuff that is guaranteed to get us all sooner or later, particularly jealous husbands! ;)
Posted 1/12/2017 9:09 PM (GMT 0)
Prato, I suspect that all is fine. You had a great pathology report with every reason to think that you are cured. I trust and hope that is the case.

Jim
Posted 1/12/2017 9:36 PM (GMT 0)
I had one test just past the two year mark come back at 0.1. I freaked out. The urologist said not to worry, kept me on my testosterone regimen, and re-tested in 6 months. Both tests since then have had the less than sign again.

I'd like to tell you not to worry, but I obviously worried a bit. I was engaged in a fight with a second cancer that distracted me a bit from that result, but I still worried a bit.

I bet your next test has the less than sign again.
Posted 1/12/2017 9:55 PM (GMT 0)
You have more than enough on your plate without that annoying lab report. No, not undetectable, but very low. I hope you can put it out of your mind until the retest in a few weeks.
Posted 1/12/2017 11:56 PM (GMT 0)
TA, I know. I'm not freaked out, just concerned. Not sure why I'm not freaked out, probably because I'm numb from all the crap I've been dealing with since PC DIAGNOSIS. UGH

Also, dude, you couldn't give me something more technical? Your response is the one I was waiting for. And all you've got is "Don't worry"

Lol, just kidding
Posted 1/13/2017 12:02 AM (GMT 0)
Thanks to everyone for all the responses, and reassurance. Like I said, I'm not fair on fire freaked out. But I am concerned. 2 things bother me about my pathology.
1. The grade 4 cells in my G(3+4). I don't know what % of the tumor was grade 4. It wasn't on the path report. But it only takes 1 cell to escape and survive, and then it's no different than the same thing hppen9ng with a G8.
2. THE PRIMARY TUMOR was at the apex, and initial frozen section showed positive margin at that location. Dr got negative margin only flyer he went back in and cut wider.
So I think there IS a chance that something is going on.

Also, if in fact it is bcr, my understanding is that with negative margins I have a low chance that SRT will work.
Posted 1/13/2017 12:36 AM (GMT 0)
All I can give you that's technical is the study that showed that if PSA doesn't reach 0.03, and even if it does, if it's stable, it does not predict recurrence, especially with good pathology. Does that help?

Low detectable PSA after prostatectomy – watch or treat?
Posted 1/13/2017 12:44 AM (GMT 0)

Pratoman said...


Also, if in fact it is bcr, my understanding is that with negative margins I have a low chance that SRT will work.



LOL oh my ... worrying about negative margins are we? My brotha from another motha....

I'm feelin' ya baby !! (takes one to know one lol)
Posted 1/13/2017 12:50 AM (GMT 0)
also...that..."just takes one (cancer cell)..."

I'm not so sold on that....(I've heard it a lot thought) not so sure our bodies are that defenseless....one cancer cell.....we probably all got one somewhere floatin' 'round one place or another

EYE don't know

(I'm hearin' ya BillyBob.....it's what's NOT showin' up on the radar for us kinds of guys)
Posted 1/13/2017 1:16 AM (GMT 0)
Pratoman,
A true PSA level of .019 may deliver a test result of <.02. Likewise a true PSA level of .021 can deliver a test result of .02 ------ a minuscule difference of .002 ---- well within the margin or error of an ultrasensitve test. That is why it is important with ultrasensitve results not to get hung up on one small variation. It is the trend that is important, not the actual result, and that needs to be verified by 3 to 4 readings.

I am a little confused about the 1/16 and the 6/16 results. 0.00? That is not a proper test result ---- if PSA is not detected it should be reported as not being detected at the bottom limit of the assay's ability to detect (which can vary according to the manufacturer). In other words it should, if not detected, be correctly reported as less than something. <.003, <.005, ,<.04, <.03, <.01, which would be that lab's lowest detection limit. It is often the case that a result at three decimal places may be rounded up to two. eg. An actual result of .008 may be reported as <.01 because that is a particular lab's procedure.

Post Edited (BillyMac) : 1/12/2017 6:22:26 PM (GMT-7)

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