I found it disturbing that in 2 seperate lab results from the same lab 1 week apart one was 16.9 and the other was 13.8! One requested by our primary Dr. and the other requested by Onc. Dr.
The last prior result 3 months ago was 14.5. Hubby went thru the Provenge treatment last summer.
Any thoughts?
Our Onc Dr. didn't seem very disturbed about the difference.
It's common when you switch labs. Just pick a lab and stick with it.
She said "same lab"
thanks - I misread that.
I thought this was science? Human error always a factor.
I’m sure theirs a margin of error associated with the test results. One doctor dismissed my variation as the margin of error associated with any laboratory measurement. Another doctor highlighted PSA tests as being very very accurate.
When my first test came back unexpectedly high (pre diagnosis) the urologist made me redo it because “it’s almost certainly a lab error”.
Bumpity bump. Lab result don't make our ride through Apc any easier. No big difference and a couple of points can be caused by any kind of stress, even just taking a bike ride.
PSA varies from day to day, probably even hour to hour. According to what I've read, the extent of the variation in men who had not been diagnosed or treated for cancer has been as high as 35%. I don't know if studies have been done on men with known cancer but I assume that they too have the possibility of some PSA variability.
There are studies showing that some kinds of exercise and sex before a PSA test will elevate the number as will inflammation and/or infection in the prostate tissue. Believe it or not, some researchers have reported variation correlated with temperature and rainfall.
So I think the doctor is probably right in not taking the variation too seriously. It's the longer term trends that we have to worry about.
Google for "psa daily variability" (no quotes) to see lots of articles about this.
Best of luck.
Alan
Just informational as a "sample of one":
...
I am post-RALP but not yet quite to the "going for SRT" mindset yet. Have been closely tracking my uPSA after seeing it become detectable two years ago. Have cycled off and on TRT injections over about six month spans and trying to figure out if I should stay on the TRT or if it is doing me harm. My uPSA has sure seemed to follow my TRT, though that's not IAW "saturation theory", and my uro can't explain it either. Am age 69 and kind of low-T guy, but have always been above the T=250 "saturation level", afaik.
...
Setting aside two "blips" up and down, that have caused even my uro to get a little nervous, below are two runs I have seen in last year. I always use LabCorp, same uPSA test panel, test same time of day, stay similarly hydrated before the blood draw (urine pale yellow), and abstain from biotin (vit B-7) that LabCorp documents as interfering with its test. Also abstain from weight lifting for day before. Have been doing this to try to figure out what is going on with me and if I need to go for SRT. Anyway, just shows how amazingly stable uPSA can be under certain circumstances:
2018/01/12: uPSA = .026
2018/03/05: uPSA = .032
2018/04/04: uPSA = .028
2018/06/15: uPSA = .029
2018/08/22: uPSA = .030
2018/11/02: uPSA = .034
2019/02/04: uPSA = .036
2019/03/04: uPSA = .035
2019/04/01: uPSA = .035
Robert
Robert,
I'm impressed with the effort you've made to keep a consistent approach to your PSA testing. It may be that your approach has overcome the normal variability that many (though not all) men experience. Or maybe not. You did experience a 14% drop in PSA between April and May, 2018.
I take it that you are not on androgen deprivation therapy and your cycles are on/off testosterone therapy with no treatment of any kind in the off cycles, i.e., you are not on BAT (bipolar androgen therapy). So the question of why you are taking T supplements naturally arises. Is it something you are using to prevent cancer recurrence, or are you supplementing T because it makes you feel better in some important way? If the former, do you have a theory about whether it's working? If the latter have you found a significant difference in your life due to the T supplementation?
Alan
It’s interesting how we can view the same data differently. When I look at your numbers I see variability between -18%/+13% over 16 months but only +/- 3% since January.
AlanMeyer and ottawmike, I see what you both are saying in terms of percentage changes. Guess you are right. Maybe not as stable as I thought.
But the way I was thinking about it was this: the uPSA is reported in ng/mL. That is "billionths of a gram" per "thousandths of a liter". So it just seems amazing to get "runs" of monthly tests that vary only in a few thousandths of ng/mL. In light of the "psa variability" talked about above, I would have expected to see more variation up and down around a trend line, even though testing monthly, not daily.
Alan, never on ADT and this is not BAT. Uro that did my RALP in 2012 offers TRT to his patients that test on the lower “normal” range of T, as I did several times, and if they feel better on it, which I do. I have gone off the TRT twice because I suspected it was causing spikes in my uPSA (I did not include the “spikes” in the uPSA history above). Reported this in another thread and found another user “dave2” that has encountered this. Having hit the .03, I am just trying to remove TRT as a confounding variable to see where I really fit on the Koulikov groupings:
pcnrv.blogspot.com/search?q...
Alan, on your question about “significant difference”, well, it’s better being on TRT, but not enough so to overcome my fear about stumbling into an “SRT overtreatment”.
Robert
That actually seems reasonably stable.
There needs to be a trend. Thtee consecutive rises or drops in psa or an upwarrd or downward trend in. the variations. Rocco
It’s a small sample size, but that’s a +/- 10% variation. I was tested frequently for a few months and found the same up and down variability. Over a short period of time, maybe two or three months, before any treatment started my PSA varied +/- 25% from the mean. For the most part they were all at the same lab.
Apparently there is some natural variability in PSA levels. And why wouldn’t there be? That’s not my concern.
I am concerned that all of my doctors seem to discount this and feel it’s sufficient to base their treatment recommendations on single tests spread far apart. Or a trend based a small number of tests (like two tests a few weeks or even months apart).
It seems to me that to understand the behaviour of this disease, you require frequent tests on regular intervals to cancel out the error due to a patient’s natural variability. Looking at my own PSA progression, I am convinced that infrequent testing of PSA can easily hide a trend that’s there and indicate a trend that isn’t really there.
Worse, it can give the wrong impression of how your treatment is faring.
The unconcerned response I’ve received from all of my doctors makes me think I’m crazy for making this point. But I don’t see the fault in my logic. I’d really like to hear what the community here thinks.
Mike
Depends if the one lab technician is into Feng Shui and the other one isn't. Some of the doctors work on averages.... hopefully not mine.... (don't sweat it... it's like love making sometimes you hit a home run and sometime you strike out). Signed: The Strike Out King.
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 04/03/2019 7:55 PM EDT
Taxotere result
Could my psa variations be a result of lab errors ?
PSA Roller Coaster ride!
Dads case, psa climbing on zoladex
