With ultra sensitive PSA of <.02 three months after RP can I believe that I will be placed on a schedule to be retested at intervals or will the medical oncologist want me to start further treatment when I go to appointment on 3/10/2023?
Thanks for your thoughts!
Our cases are very alike. You had EPE, I had SVI.
In a nutshell:
1) Monthly PSA counts to get a reliable PSADT (time series of 6 samples at minimum).
2) Do nothing while PSA is less than 0.1.
3) If/when you breach 0.1 avoid BLIND irradiation. PSMA scan first!
That's undetectable- no reason to have further treatment
Thanks Allen!
Bravo! That’s what I’m hoping!
If I understand current guidelines, the first year after your surgery the "standard of care" is every three months. If the results are undetectable, then your medical team may test every six months and if the results remain undetectable, then somewhere around the three to five year point, test annually.
You of course, may not be comfortable with those and ask your medical team for a different testing timeline, Justfor_ lays out one example.
Those timelines are based on the standard PSA test which measures to a single decimal point, not the ultrasensitive PSA tests. As TA says, anything less than .2 on the standard test is considered undetectable and requires no action by you and your medical team. Using the standard test, your results would be reported as <.1, undetectable.
There is a lot of discussion about USPSA, what it means, in terms of actionable results. I am not sure the medical community has come to a consensus and agreement. Here's one example, again, it is the agreed upon answer that say the NCCN guidelines are, probably not - prostatecancerinfolink.net/...
Single results are generally not a call for a decision. You want multiple clinical data points over time, even then, those data points are but one subset of clinical data you and your medical team may want to collect in making any treatment decisions - imaging is one, other labs, biopsies, your health data indicataing any changes - increased frequency of urination, muscle and joint pins that are new or unexplained...
Kevin
Your <0.02 reading puts you in a very good category. Assuming you are not on any ADT. Or taking any drugs or supplements that might halve your PSA reading.
Now you determine if that will be permanent or your PSA rises, and if so how fast it rises.
LabCorp has two ultrasensitive PSA tests that will go to <.006
The two ultrasensitive tests are both the same test except one gives you graphs of all your ultrasensitive tests with them. No need to pay more for the graph version. With monitoring and WithOut monitoring is what they call them. Get the WO monitoring one.
At this point your just monitoring your PSA increases for multiple (three) consecutive increases that indicate you still have residual PC.
If you see those increases, (hopefully you won't and continue on with your normal life) you should eventually determine when to look at your next treatment, likely radiation treatments.
At this time in medicine.
Two schools of thought, one is radiation before PSA rises beyond 0.2. And the other newer thought due to improved scanning technology is to determine where the PC is found first, the radiation to those areas.
Do not use the term undetectable as it has no consistent meaning. Doctors and the medical industry should stop using that term, and create new terms recognizing that new technology will continue to improve what we can detect.
If you stand on the shore at water level and look out with a telescope and can't see a ship in the distance does that mean there is no ship?
If you then go up on a hundred foot building/cliff and see a ship, is there still no ship because you didn't see it below. Oh course not, you just found a better method to determine if there was a ship over the horizon.
The ultrasensitive tests let you know to the best of today's technology if there is a ship coming.
Thanks for your thoughts and a great analogy!
It sure could be that you are cured from pc for good! Don’t predict it’s return ,just keep moving past this! A guy next to me in the gym had an RP 25 yrs ago . He’s still clear . Be healthy !
During m6 first yrs with pc I fought also to get the 3 digit testing done . It just drove anxiety in minor flucuations . Now Psa< .1 is AOK with me …. Dont sweat it ! Good luck!
Thanks for your positive outlook!
your PSA doubling time is more important than PSA level. Your response is fantastic at this point. I would not do any additional treatments with your PSA level. I would avoid hormones and radiation. Take a look at this article on doubling time. That’s what you watch for.
Three months after RP to test PSA?
1st PSA after RP
Creeping PSA after RP
Ultra-sensitive PSA Readings and Green Tea
