PSA of <0.1 undetectable?

[pj1121]

I am on ADT, lupron and Zytiga, at Kaiser Oakland. My latest PSA came back as <0.1. My MO sent me a message with the results: "congratulations, great news, your PSA is undetectable!"

I thought undetectable was 0.01, is it more likely she misread the number or that the lab used by Kaiser only reports an undetectable number as <0.1? I have heard trials in Europe have shown too many inaccurate readings when a lab tries to read extremely low psa ng/ml.

My PSA test was performed on Siemens Atellica at TPMG REGIONAL LABORATORY, MWS 914 Marina Way South Richmond CA 94804.

I'm happy either way

Thanks!

[dac500]

Even though PSA can be measured with 3 decimal point accuracy, any value less that <0.1 is considered undetectable, specially after hormone treatment.

[Tall_Allen]

Undetectable is any lab result with "<" in front. It means that actual value is lower than what that lab test could detect. Congratulations!

[pj1121 in reply to Tall_Allen]

Thank you, I was ecstatic at first but after an internet search. I found that PSA nadir and time to PSA nadir are are regarded as good indicators of PFS and OS. Although my PSA nadir of <0.1 seems to be a positive indicator my rapid time to nadir (300 to <0.1 in 5 months ) seems to be a negative indicator for OS and PFS? Your thoughts are appreciated.

[Tall_Allen in reply to pj1121]

You misunderstood. Rapid time to nadir when the nadir is high is an adverse indicator. Take the win, and stop looking for reasons not to.

[pj1121 in reply to Tall_Allen]

thank you

[anony2020 in reply to pj1121]

May be there are two measures? One is breaking 0.1, the other is reaching <0.1 and staying there. The latter is the nadir. It may take longer. Does that make any sense?

Dont mind me. I am just another layman trying to make some sense of the whole thing.

[tango65]

Congratulations.!! It is undetectable with the test they used. There may be more sensitive techniques which may detect some minimal amounts of PSA but it does not have any clinical meaning.

[Justfor_]

It was during the early 60 when a prominent politician (majority party leader, PM, etc) during a heated discussion in the Greek Parliament made the following remark: "The nice thing with numbers is that deputies can argue in favour or against a motion making references to the exact same set of data".

[Hidden]

"ADT, lupron and Zytiga" Kaiser SOC!!! Im at Kaiser Los Angeles.

Kaiser wont do ultra sensitive PSA. Cause if you're <0.1 while on the Kaiser Kocktail, it doesnt matter to them what the numbers are below. As Ronny said to Gorby, trust but verify, I get an ultra sensitive through Labcorp, every 3 months. My last was <0.02, the lowest they can test.

[NecessarilySo]

<0.1 should be called "undetectable" (in quotes) because it is in fact, detectable, i.m.o.

[Hidden in reply to NecessarilySo]

No, because the test wont read below 0.1, it means they don't see any PSA at that resolution.

[EdBar]

You can have an ultra sensitive PSA test done that will show lower amounts if you choose to. When I was seeing Snuffy Myers he would opt for the US test, this way you can closely track the beginning of any uptick. I used the US test for around 6 years while I was undetectable and switched to the regular test when I became castrate resistant. The US test gave me an early heads up that resistance was starting. Personally I’d rather know than not know so I can plan a course of treatment once my PSA hit a certain level.

Ed

[ron_bucher]

If you are interested in a prostate cancer support group of patients led by a Santa Clara Kaiser staff member, send me your email in a private message. They meet online a couple times per month. The group is open to Kaiser and non-Kaiser patients.

[dmt1121]

Although, Tall Allen makes a valid point, I would tend to want to have blood test results with a more sensitive test range (i.e. <.01 to <.05) . <0.1 as undetectable is not sensitive enough for my peace of mind.

[pj1121 in reply to dmt1121]

The Siemens Atellica assay used by my kaiser is sensitive to between .02-.03. So im not sure why they would say <.1 rather than <.03. My local labCorp uses ECLIA psa test sensitive to .003 $59.00

[Justfor_ in reply to pj1121]

You are looking at it from a technical aspect. I can view two, non technical, alternatives: a) Go along with the typical oncologist that they don't like ultra sensitive resolutions. Why? Because they have nothing to offer at a 2nd and -more over- 3rd decimal place variance. The silly argument after which more decimals create more patient anxiety says it all. On the other hand, your case is a good example supporting the docs' preference for lower resolutions. Would you receive a congratulatory email if the lab reported, say, 0.05? b) Marketing reasons: Ultra sensitive should be priced more, even if both originated from the same analyzer!