PSA Staying the same ?

[redbank]

Hey all, I've been told by my Oncologist that my PSA is considered Undetectable @ 0.05 is this true?

[Tall_Allen]

If you detected it and it was not "<0.05" then, by definition, it was not "undetectable." The important question is whether you should do anything about it.

[redbank in reply to Tall_Allen]

still doing Lupron and casodex

[Tall_Allen in reply to redbank]

If you are on hormone therapy, there is no reason to have an ultrasensitive PSA test. It only creates anxiety. A conventional PSA test where the lowest value is 0.1 tells you everything you have to know. On that you would be undetectable.

[NurseRatched in reply to Tall_Allen]

I politely beg to differ: I believe it depends on how long the patient has been in remission. My husband enjoyed 9 years with only qtrly. Lupron & Zometa (Gleason 8 & about 24 bone mets at diagnosis) - it was his unexplainable new pains in 2017 & subsequent scans that made the onc aware that hubs is loaded with new bone mets and no longer produces PSA.

[Tall_Allen in reply to NurseRatched]

What we are discussing is NOT whether PSA should be used at all, but what kind of PSA test should be used. ALL tests should only be given if they can potentially make a difference in treatment decisions.

[Fairwind]

Yes, 0.05 is generally considered undetectable..Some want to see <0.03 on the report but the difference is meaningless, well within the normal drift of the machine used to analyze the blood sample.The ultra sensitive test that provides these readings tens to drift a little and can cause a lot of PSA anxiety...On the standard test, your reading would have been <0.0 , undetectable..

[Hidden]

Hallelujah ! You’re doing great... enjoy the holidays and forget about the Psa ...

[Litlerny]

You're doing great! Kudos!!

[EdBar]

It’s all about the < before the number in regards to it being undetectable. Some labs like Quest don’t provide the ultra sensitive PSA test, Labcorp does. If your number has a < in front then it’s undetectable.

I still get an ultra sensitive PSA test monthly just as Dr. Myers ordered. It doesn’t make me anxious, I want to know as soon as my PCa awakens from its dormancy so I can plan my next move.

Ed

[stangoldberg]

I think your oncologist and some of the answers to your question are conflating two different issues. The first is what is meaning of "undetectable?" Yes, anything less than 0 is detectable, but may not be statistically significant in the context of disease progression.

The second is what is the importance of a static number (e.g., <.05). For 15 years my PSA has fluctuated from <.01 to 1.4. While there is little statistical difference between .01, .03, and .05, if each reading is taken sequentially apart at 3 month periods, the data would indicate an upward trend in disease progression. My oncologist and I arbitrarily chose .6 as the PSA reading at which we would resume Lupron injections. "Artibrary" since neither of us were aware of any research that gave an objective waypoint to resume the injections. I understand the 15 years ago, it was an accepted practice to wait until tumors developed in bone before beginning or resuming ADT (ugh!)

As long as your PSA trends down with Lupron or other ADT protocols cancer remains under control. Remember, once prostate cancer goes beyond the surgical margins of a prostatectomy or is in the lymph nodes, the research indicates that it's not curable--only manageable.

I find it unfathomable why oncologists don't emphasize the importance of trends rather than absolute numbers when they inform or counsel patients living with prostate cancer. You might be interested in an article I wrote that can be found by doing an internet search for "Living with cancer: don't call us survivors - Stan Goldberg" Hope this helps.

[j-o-h-n]

I make sure when I have a psa test that they test it in a completely dark room and the technician is wearing dark sunglasses. Hence it's always undetectable.

Good luck, Good Health and Good Humor.

j-o-h-n Saturday 12/01/2018 12:13 PM EST