7 months after Salvage Radiation

Just received my 2nd PSA result of < 0.1 after salvage radiation. I finished radiation on 8/15/16 and had an ultra sensitive PSA test in December of 2016 that was 0.06 from a high of 0.182 prior to radiation. I live 40 miles away from my radiologist so I get all my PSA tests done at a local LabCorp facility. As many of you know if you have your Dr. request the PSA test insurance will cover the costs of all the quarterly PSA tests. At least my insurance company does. So I had the resident dr. assisting my radiologist write a prescription for the following PSA test. Well by mistake he wrote a prescription for a standard PSA test which was faxed to LabCorp. When I went in to get my PSA test at LabCorp I never thought to confirm I was to get an ultra sensitive PSA test. I received the result and saw it was a standard test with the <0.1 result. I guess the moral of the story is make sure you check with the labs doing your testing that you are getting the right test. I am not planning on doing anything different until I get a test result over 0.1 anyways. See my profile if you want to know more about my PCA history. Not sure how long this low PSA will last but enjoying everyday like its my last.

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  • Good point. I have very similar history as you although diagnosed quite a bit older than you at 66 years old. I agree, those of us who have had an RP and high Gleason need to follow the ultra sensitive tests. Amazing how much we need to be our own advocates and stay on top of things that our doctors are getting paid to do, like writing orders for labs. Not to be critical of docs - many of whom are kind of stressed in the Pca treatment field. But more a reminder to guys to be educated and alert and ask questions. Thanks for the heads up.

    Pkafka

  • Go on and treat every day like it's your first with thousands more to come. We'll all be with you.

  • Interesting thing about the ultra sensitive PSA tests is that a lot of hospitals do not use them. For example, MD Anderson and (my hospital), Henry Ford just go to one decimal point. Henry Ford stated that there was no advantage to take it out to two let alone three decimal points. They stated that there will be no change in treatment until it is at least =0.1. In my mind it is more about cost. In any case, I am still <0.1.

  • Great news. Hoping for many more <0.1.

  • My recent PSA was undetectable but I was still under the influence of eligard so nothing to crow about. My next test in May is going to be a nail biter. I was gleason 8 before HIFU.

  • Salvage radiation poses an interesting quandary. The lower your PSA at the outset, the more likely it is that the salvage will work. But there's a danger the other way that a very low PSA reading might not be a real recurrence, which is why many docs will not recommend salvage radiation if the PSA is less than 0.2 and some not until 0.4, or until two or more successive PSA tests each show a rise compared to the previous one.

    My suspicion is that, when the original studies were done, the 0.2 number was based on a standard, not an ultrasensitive PSA test. If so, the number 0.2 really means something like >= 0.15 and <0.25. In that case 0.182 is within the >=0.2 recommendation and the salvage was about as early as one should hope for.

    I hope it zaps the hell out of the cancer.

    Good luck.

    Alan

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