I have been undetectable for 3.25 years and today it came back at 0.02. My bio is up to date.
We ran the test at the exact same lab as always and in 2 days I am flying back to my Sarasota home from Milwaukee and was wondering which lab is recommended for 2 digit accuracy? I know Labcorp only does 1 digit and does Quest do 2 digit automatically or does it need to be requested specifically?
Also, another question and maybe my anxiety is getting the best of me too quickly but if my PSA test in 2 weeks comes back at same number and not undetectable, which hormone therapy is recommended? Just looking for input at Lupron or which ADT do people typically take and why?
I realize an open ended question but this forum which I read daily is extremely valuable and TONS of good information and VERY, VERY knowledgeable warriors here!
Written by
Peppertree602
To view profiles and participate in discussions please or .
I am needing my Post 6 months radiation and post 5 months Orgovyx status blood test to show my PSA and Testosterone readings. My last reading was while on hormones and was PSA .05 and T 2.75 (these readings were taken while I was still taking Orgovyx.) I now just want to know my status post Hormone tratment. Is it necessary that I have to pick between Lab Corp and Quest and do I need to get an "Ultrasensitive PSA with Serial monitoring"?I just want my cardy to get my PSA and T and free T and lipids , etc.etc. is all the rest necessary right now.. Is it that much of a difference?
You don't need an ultrasensitive test post-radiation. Get the tests from the same lab.
Labcorp has more than one PSA test. Test - 140731 - Prostate-specific Antigen (PSA) Blood Test, Ultrasensitive, from Labcorp reads as low as <0.006. Congrats on an undetectable PSA.
Labcorp has two Ultrasenitive PSA tests, they both measure to <0.006 as stated above.
It actually the same test, the only difference between the two ultra sensitive tests is one gives your results in a graph form and costs more.
Ultrasenitive PSA W/serial monitoring
Ultrasenitive PSA WO/serial monitoring
Get the Ultrasenitive PSA WO/serial monitoring, it costs less. The WO stands for with out.
The lab technicians sometimes aren't familiar with the ultra sensitive codes for the test but the description will help make sure you get the one you want.
Similar case here. If memory serves, 80% G4, 15% G5, 5% G3, left SVI, N0/20, R0. Color saliva test didn't spot any mutations. Yet, my post RP PSA was 0.02 and it lasted only for 6 months. Two and a half years later at 0.17 I started taking an adaptive dosage of Bicalutamide + Tamoxifen. Now, 22 months out, half a 50 mg tablet every 5 days keeps my PSA, deliberately, just over the limit of detectability. My main difference from you, is my total lack of even the slightest signs of anxiety. I take monthly PSA tests and document my doings in my: "An engineer's Bicalutamide maneuvers" thread. My best advice to you is to get an anxiety divorce by yesterday.
Can you expand on your objectives of taking CASODEX 50mg at 50% every 5th day. As well as tamoxifen at what level. Is the tamoxifen for preventing breast growth (gynecomastia).
Do you feel any reduced strength or stamina doing so?
Currently, my effective dosage is 5 mg/day. It keeps my PSA at the vicinity of 0.010. I am totally against any undetectable reading. It may lead to the extinction of all hormone sensitive cells, paving the road for the proliferation of their resistant counterparts. In fact, I am lower than where I would wished being. My comfort zone extends up to 0.050, so a baseline around 0.025-0.030 would allow +/- deviations that serve as guidance for increasing/decreasing dosage. But, we are heading towards the winter months, when PSA gets a seasonal boost and as such I estimate that current dosage will land me into the targeted range. If there were 5mg tablets, it would be my ideal. Yet, there are only 50 mg ones that I split in two and take one half every 5 days. This is better than one 50 mg every 10 days. Both of them produce a saw-tooth pattern, re serum concentration of Bicalutamide, but the teeth of the split tablet version is shallower. With Tamoxifen dealing is tough. I have tried 3 times to reduce dosage but I get tender nipples in a matter of days. So, 10 mg daily, no discounts here. Due to familial hypercholisterolaemia my Testosterone was 800-900 just post RP. With Avodart, that I also take for DHT, it ranged 1200-1500. Bicalutamide at standard dosage brought it up to 2500-3000. Current dosage had it subside to 1700-1800. With that much Testosterone mental functions ar razor sharp and body performance good for age. Only problem was caught by long Covid during recent June-July that brought me down.
Undetectable is a marketing term. Can be -and usually is- set by the marketeer at any convenient level. It is only good for keeping the client happy. In my book it is plainly disastrous. I seek to establish an equilibrium of the hormone sensitive (HS) and PSA emanating cells. For every such cell dividing, another cell should be killed or brought to a senescent state. This mechanism shall keep PSA at constant value (the stress to constant, not value). Resistant cells will proliferate when HS cells are driven into extinction by disproportionate drug pressure.
It is a hypothesis based on fluid mechanics. It stroke my mind when my PSA abruptly declined after taking Beta Blockers for Tachycardia inherited from long Covid.
I had my RP five years ago. First three years all ultrasensitive PSA tests were sent to Quest and came back <.03. The past two years they've all been sent to LabCorp and have all come back <.006. I am always triple careful to make sure I'm getting the uPSA test. Your .02 is extremely low. I understand your having some anxiety but not much. Listen to TA.
Quest uses a different method for their PSA tests than you'll find elsewhere like LabCorp or hospitals.
You can't compare Quest tests to any other PSA testing as they will show a different PSA, one will be lower, if memory serves me right Quest will give a lower result.
This is also stated on the results you get from Quest.
I did one Quest PSA test and have never done one since. Always labcorp, LabCorp matches all the hospital tests, regardless of sensitivity.
And on a different angle here, rounding up is done on regular PSA tests. So a regular PSA test might show 0.1. Where a ultrasenitive PSA might show 0.095, or 0.089, or 0.075. I don't know specifically where the round up occurs. You get the idea.
my doc is very good i think he told me to retest this week and then again in 2 weeks and only then we talk. He txt me from his personal cell super nice guy and out of the box thinker He is part of Medical College of Wisconsin and specializes in prostate cancer primarily
Try to find a Wim Hof Method class near you and attend. I'm an instructor for Wim. The Wim Hof Method is a 3 legged stool of breath work, mindset and cold exposure, with the primary intent to strengthen your immune system (and yes, humans can influence and strengthen their immune system through breath work, if anyone is interested, I'll link to the study that was done at Radboud University in Amsterdam).
But the real superpower of the WHM is mindset. The top reason practitioners practice the method is for anxiety and depression (and stress). It absolutely gives you the tool to live consciously, in the present moment, where the past and the future don't exist. The past is the source of depression and the future is the source of anxiety.
Please read about and learn, you will benefit. If you can't find a class nearby, PM me and we'll schedule a call and I'll teach you myself.
My care provider is MD Anderson and they don’t show any results below . 1. My results have been coming back as <.1. Oncologist says anything less than .1 is noise.
I think most of us would be happy to have those results. For years, and in some cases, still, the medical community only measured to a single decimal (technical capabilities..) and the generally agreed upon definition of CR was two or more readings greater than .2 90 days apart. Fast forward, now we can measure 2-3 decimal points with USPSA. That begs the question, "what does that mean..."
In my case, cancer of one, my cancer, not yours...when my medical team switched me to USPSA we agreed on decision criteria:
No reaction to single results.
Trend was key, three or more consecutive increases, spaced 2-4 months apart.
When PSA rose above .5 but not higher than 1, we would image and use that data along with other clinical data to make any decision on treatment, when, with what, and for how long. That range was decided upon as statistically it improved the ability of the Plarify scan to find any recurrence, from 30 at <.5 to 60%.
In April this year we met that criteria.
Our decision criteria certainly allowed for more time off treatment and did not place me at risk for starting back treatment too late.
It isy sense that you are stressing yourself out unnecessarily and spending a lot of money and emotional capital that may not be necessary . I am 15 plus years post surgery for my PCa. In that period of time, my PSA has been undetectable only one time. The PSA at the time my PCa was detected was 1.43 - well outside of any sort of danger range. In fact, I was never in any sort of danger zone range for PCa. I was age 55 when the cancer was detected with "ye olde finger wave" by my GP.
PCa killed my Dad, so my MD had been watching for trouble. My first PSA test occurred in 5/1996 ( age 43 ). For me, clearly, he vigilance paid off with the early detection of my cancer
Surgery was performed manually by a very skilled urologist surgeon at my local hospital . He had patients who were willing to talk about their experiences and there was a support group. I knew two of these people, one of which was a neighbor. Per these guys, this surgeon (who has since passed away) "walked on the water". And it was true. This guy was amazing!
Pre surgery, my Gleason score was 3+4. Post surgery, the lab scored it 3+3 T2 N0 MX. I required no follow up radiation, hormones or chemicals. There was no nerve damage from the surgery.
My 3 month post surgery PSA was 0.06. 5 months out it was 0.03. 8 months out it was 0.01. For next 23 tests it blipped to 0.05 one time (6 /2011 - immediate recheck came back 0.01). Another time it climbed over 2 years from 0.01 to 0.04 in 2/2014. A recheck in 8/2014 came back as less than 0.01 (I.O.W. undetectable). In 9/2020 it was 0.03. My most recent test in 5/2023 was 0.01. All other tests 0.01 or 0.02.
In summary, don't freak out. Yes, you are a member of a club no one wants to join. But your post procedure PSA level is not at all unusual and is not necessarily a harbinger of doom. In fact, there are women (female at birth) who throw PSA readings in their blood work.
First as stated below make sure the assay, or test protocol, being run is to two or three digits...the 3 digit test would provide uPSA (ultra low PSA) values. Did you PSA come back > 0.02 on a 2 digit test, or 0.020 on a 3 digit (thousands of ng/dL) assay test? Difference for sure. But, at 0.020 you are still doing good. Check this article out to determine where you are.
Before you consider any additional treatment, make sure your PCa has metastasized...the SOC (standard of care) now must be PSMA PET scans; I dont see that you have had one. I would not proceed with any treatment, even ADT (androgen deprivation treatment) without a scan. Check this article if it helps. The good news is that you are way, way, way below the levels where PSMA PET will be even 50% Specific in finding tumors...so, if I were you I would not worry...yet...
Pull the ADT trigger when you need it, if you need, for the length of time its needed, but understand what its going to do to you. Especially, understand ADT's impact on sexual function. If all this has been explained to you already, great...I did now know much of any of this and went into 21 months of ADT Lupron. If sexual function is important to you then YOU must take charge of its preservation. In my experience this function is not part of most Dr's treatment regime selection process...again, if your Dr is on top of this, great.
Last, is very interesting to see a downgrade in Decipher testing; amazing really. My Decipher taken from my post operative tissue sample was a 0.97 (why they just did not make it an even 1.00 is anyone's guess)...my score was off the charts high...why would yours go down? If I were you I would ask that another test be run on the tissue stored for you at your surgical location; they can do this. Decipher is critical to know how aggressive you need to be with your post RP treatment...a Decipher of 0.40 would be great! If its really 0.90 that makes a world of difference. Can it be that they sampled the wrong location in the tumor and got a much lower score? Sh#t happens, even at the best of surgical locations. So, for me your PSA is nothing to worry about; your downgrade in Decipher scores IS something that I would focus on...
PS the Decipher matrix report, which comes with your post surgical analysis, can tell you if you will respond to ADT treatment, or not...IF you went that way would it not be good to know if you will respond to ADT and which treatment would be best to choose from...I can send the LINK to this if you need it.
I will turn of the firehose now...sorry for the long reply. Check out the articles I have published at my site on this forum for any other info and let me know if you have any other questions...Rick
OMG -- you definitely need help, find yourself a close friendly condiment asap ........maybe a Saltree (and maybe the two of you can mix it up together)....
Say some, Lettuce alone without Dressing... catch my drift?
I feel your pain - or I should say - anxiety. I was dx in 2017 with oligometastatic PC. Treated with chemo, Zytiga and whole pelvic radiation. Went undetectable 6 moths after dx and stopped treatment 2 years later. Got a 0.01 result 2 years ago and freaked out. When I expressed concern to my oncologist, he wasn’t sure whether to laugh at me or yell at me. Results crept up to 0.03, but then dropped to 0.01 six months ago. Most recent reading was 0.02.
The Doc’s plan is to do a scan if and when PSA reaches 0.20, and to discuss going back on ADT after that.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
No Longer Undetectable
Beware the Undetectable 
Officially Undetectable 
PSA of <0.1 undetectable?
