PSA, Total vs PSA, Ultrasensitive

[richlisad]

After RP last August, my PSA, Total checks were all <0.01, until a test by my local Urologist ~5 weeks ago that was a PSA, Ultrasensitive test that came back just under 0.7 - that is what landed me here talking to you all. That sent me back to OHSU in Portland to the people who treated me, and they did a PSA, Total test that came back <0.01. Just to be sure we had the same test run back at our local hospital, and that PSA, Total result was <0.03. My question is what is the difference between the 2? My Dr at OHSU thinks there must have been a mistake made with the test that came back 0.7, but with them being different tests (Total vs Ultrasensitive), I want to make sure I really am off the hook, even if it is only for now.

[NPfisherman]

Maybe the lab meant to enter .007 or lower... 0007 and screwed up....You've had 2 tests since that which were at undetectable--I'd bet on lab error...

Fish

[Tall_Allen]

Lab mistakes do happen.

[Ralph1966]

My last PSA was 0.06 ng/mL but the MO included a free PSA test also which was < 0.02 ng/mL. What does this free PSA refers too?

1 month ago PSA was 0.05 ng/mL but this last test (March) was sent by my MO.

Do they use it to know more details about the progression of this disease after treatment (surgey/radiation)?

[richlisad]

Agree a mistake was made, and not complaining about the results. Thanks for the input about consistency on my end for testing.

[Hidden]

You are doing real good. Two comments IMO (I have had 88 tests): For 14 years always tested for PSA, fPSA, and T plus a host of other tests in the same lab. Never an ultrasensative test. In the opinion of my research medical oncologist, most Physicians do not know how to how the ultrasensative test and as a result they usually serve to cause worry in the patient. You will always have minute fluctuations in PSA not associated with the prostate from assorted activities.

<0.1 is the standard cutoff for undetectable. With a rise above, one should immediately have another test. A second rise generates concern and three subsequent rises are indicative of failure. And it an excellent indicator of systemic treatment. It is so important to use the same lab for consistency. In my case, the lab is onsite.

0.7 could be an anomaly with different labs; however subsequent testing is needed before concern becomes an escalation in treatment.

I wish you the best in kicking the bastard. May your life be filled with undetectables, i.e, <0.1.

Gourd Dancer

[elvismlv123]

As I undestand it different labs may use different kits to evaluate PSA. Years ago ultra sensitive tests didnt exist. Iam not sure that even castrate range is zero and it has an amount of T associated with it. When numbers are this low what are we opining about?

Are we testing the test or the cells producing PSA?

I think the .005 readings are nice but have no meaning as they can rise and make us worry

needlessly.

[elvismlv123]

Since you did RP they must do I think 3 successive tests months apart to see if there is a failure of the RP. They are guaging what the next option might be..Often they irradiate the prostate bed to treat any residual they missed.

[j-o-h-n]

Scientific method.

Actually these labs place various numbers in a hat then they reach in and pull out a number (reduces costs). *

Ok now you pick out of a hat and tell us your age? location? treatment location? and doctor's name(s). All info voluntary, but it helps us help you and helps us too.

If you respond please do so in a future post (not here and not to me). Thank you.

*p.s. That's how I picked out my second wife.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/21/2019 3:37 PM DST

[richlisad]

I posted most of this in my intro post a bit ago.

Rich - 54 - Olympia, WA

I was diagnosed in early 2018 (PSA - 4.1, 3x4=7)

RP performed by Dr Amling at OHSU (Oregon Health & Science University in Portland, OR) in August of 2018.

Seeing Hilary Shreves for follow-ups

First 2 PSA results following surgery were <0.01

The 3rd post-op test came back at 0.7 in mid-March at the lab in a local hospital

April 15 PSA was <0.01 - back at OHSU