My friend had a radical prostatectomy a year ago. Since then his monthly PSA results were stable, at 0.006
3 months ago his PSA went from 0.006 to 0.012, then the next month to 0.029. His MO wanted to see the third month's results in order to consider salvage radiation therapy. Luckily, third month's result came in at 0.012.
Is it normal for PSA to fluctuate that much, from 0.006 to 0.029, then 0.012?
Could this be a lab error? All tests were done at the same lab.
Could this be related to something other than Pca?
Thanks
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traveller64
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I settled on usPSA <0.010 (post RP) as best indicator. When mine began to rise I tested monthly and came to do imaging and blood biopsy testing at 0.03, now will take treatment action if/when 0.05. Been testing very frequently for six years, and yes see some fluctuations and accept several explanations (lab error is not one). I graph results for easy visual trends - with a focus on the trend line of the lows. I am not accepting of other than cancer explanations as I do not want to give this beast time and obscurity, for if it come to it, I want to delay ADT/chemo/CR as long as possible.
Yes I believe it could be a lab issue. However. I had a radical prosectomy nearly 6 years ago. I asked about radiation of the prostate bed after some months which he said he did not believe I needed it.I went 2 years with my PSA basically at zero. At 2 years it began to climb. They performed prostate bed radiation at that time which did nothing. If I was to do it all over again, I would find a ecologist who would say I needed the prostate bed radiation just to be sure all the cells were removed. I'm on 3 and a half years on hormone therapy of my metastatic prostate cancer now. The therapy is still working well now. Wishing you well.
PSA seems very low. Post op I was at 0.06 and it gradually went down to 0.03 and then 3 consequetive rises of 0.01 back up to 0.06 when we pulled the trigger on SRT which did not cure. In retrospect I should have pulled the trigger straightaway at 0.06 and, as I was a young man, I would use 0.03 as the cut off. Hopefully with these very low levels there should be enough time for curative treatment.
I had my prostate removed in 2009 and my PSA was undetectable until 2017 when it was 0.01. In 2021 it was 0.12 and my urologist suggested radiation to the prostate bed which did nothing other than causing urgency and incontinence. My PSA has been going up and down since and it is now 0.65. Because of my age (82) and my bladder cancer treatment, my MO wants to start ADT when PSA reaches 1.
My MO at Johns Hopkins does not use the ultra sensitive PSA test because he says the results at such low levels are unreliable and fluctuate. I have my labs drawn at Labcorp. They report PSA as 0.1, so following an ultra sensitive PSA (if accurate) is only anxiety producing. If my PSA climbs above 0.1 he will order a PSMA PET to determine if there is a site of metastasis to radiate.
I’m with Kaiser and they only measure PSA down to 0.0. . My last test, yesterday, was <0.1 again thankfully. My last 5 oncologist have all said they only care about PSA down to a tenth , 0.1 , because they don’t worry until it gets up to PSA 2.0 and has a fast doubling time.
At #s that low it could be affected by exterior influences. Not sure if your friend still has sex or rides a bike but these are just 2 activities that have been said to effect PSA.
It is my understanding that < 0.1 is considered undetectable. (Essentially, remission.)
Once you exceed the less that value < 0.1 that's when cause for concern begins. I was advised that the break point for a PSMA SCAN was 0.2, the doubling effect.
Mine prior to RP 10.3. Post RP, <0.1 then 0.13 then 0.25.
PSMA scan revealed chemical resurgence to lower lymph nodes. Baseline treatment intervention PSA number 0.29.
Treatment: Lupron and Taxotere chemotherapy. Last two PSA tests... < 0.1 (undetectable).
0.006 is very low, undetectable, I gather.. But I wonder if it is done by nuclear medicine test or by serum? My lab once tested my blood with two results, by serum it was 0.006 and by nuclear medicine, it was <0.05. I assume 0.006 = 0.05. My PSA went up from 0.05 to 0.159 last December, then the next month it went down to 0.076. I went to another hospital for testing last week the result came back <0.05 again. I had RP in Jan 31, 2023 and is on hormonal therapy (ADT?) since April 2013. Which method of PSA testing is the standard that we can rely on? I hope someone can answer to help me understand.
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