PSA, total

[Elkguide]

Hello. I know this forum is about advanced prostate cancer. I’m really hoping I’m not there yet. I had a RP June 2023 I just got the results from my forth PSA test the first three were a post prostatectomy PSA test and all three were 0.02 this last one was a PSA, total. That’s what the Urologist wanted and it came back 0.10. I can’t find anywhere that would explain the difference and am hoping for one of you guys to enlighten me. Going crazy. Thanks in advance. More info in my bio

[Tall_Allen]

Congratulations on your continuing negligible PSA. Several clinical trials have proven no advantage to salvage radiation before PSA reaches 0.2:

prostatecancer.news/2019/09...

[Elkguide in reply to Tall_Allen]

thank you TA ill be able to sleep tonight. You’re a force on this site. Thanks

[NotDFL]

You will need more tests (monthly intervals is a suggestion) to see if anything significant is happening. Use the same test and the same lab, please.

[Elkguide in reply to NotDFL]

Thanks Notdfl the urologist switched from an ultra sensitive PSA to a PSA total. That is why I’m a little confused with the results

[Still_in_shock in reply to Elkguide]

Are you sure the result from the last PSA test wasnt <0.1

Look again carefully!

[Elkguide]

hello still in shock my last post prostatectomy was PSA with quest was 0.02 the previous two post prostatectomy PSA was>0.02 with plus minus symbol

[Still_in_shock in reply to Elkguide]

Did you mean. <0.02?

[Elkguide in reply to Still_in_shock]

yes you are correct the first two post prostatectomy PSA test were <0.02 the third test (every three months)was 0.02 without any less than symbols. This last test the urologist ordered a PSA total test and it came back 0.10 he said it is still below threshold for recurrence

[MobilityTech]

First of all, what lab you had and what test you had makes a difference. One test is not conclusive, especially if you changed labs. You need another test in 3 months

[Still_in_shock in reply to MobilityTech]

You can draw 2 vials of blood at the same sitting. Send them to the same lab 1 hour apart, so that 2 separate techs test, and you will get 2 different readings.

[j-o-h-n]

Don't panic the way most of us did..........(note "did").......Keep posting here and I think you should be saving for your retirement which will be around the age of 92.....

Good Luck, Good Health and Good Humor.

j-o-h-n

[NanoMRI]

Sharing what I have learned having over 50 PSA tests since my RP nine years ago, and in different labs including different States and even other countries. An important BTW, all test results were consistent and reliable.

If I read correctly, you had three usPSA results of 0.02 and latest result, a PSA Total, of 0.1. It would be helpful to see the actual lab reports - I know some medical practices repost lab results to patient portals and can by accident or intentionally leave off a "<". Based on my experiences having three sequential exact 0.02 results jump to 0.1 needs an explanation; it just seems unlikely PSA would hold exactly stable at 0.02 for over six months (a guesstimate), then suddenly jump to 0.1.

A key difference between ultra sensitive and Total test is the limit of (lowest) detection. In other words ultrasenstive testing is capable of reporting to lesser values than Total test. (The "<" is key here).

If your usPSA results were actually <0.02, then the Total result of 0.1 indicates a jump that needs verifying by additional tests (I would test again straight away). It is not critical that the latest result is a Total test as the ultra sensitive would have also come back as 0.1 if this is the correct current value.

Another possible scenario is that the Total result is actually <0.1 - this would make sense and be consistent with three usPSA results of (<)0.02.

Based on my experiences and my lessons, I only use usPSA testing that reports to <0.010, as this is the value I rely on as best indicator, and values above get my attention. Even the slightest values above 0.010 get my attention and I consider no value above 0.010 post RP as negligible. I hope this helps. All the best!

[Still_in_shock in reply to NanoMRI]

" it just seems unlikely PSA would hold exactly stable at 0.02 for over six months (a guesstimate), then suddenly jump to 0.1."

Mine held stable for 4 years, then 0.2, then 0.3, then 0.4 , 1month apart.

[NanoMRI in reply to Still_in_shock]

Nuance in my reply to Elkguide's details and his query. In my experiences (again, over 50 tests), to report as exactly 0.02 (no deviations) over six months (guesstimate based on info supplied), then singular jump to 0.1 indeed seems unlikely. Not a one of 0.03 or 0.04 or 0.05 etc all the way up to 0.1? Two years after my ePLND nadir of <0.010 (I seek tests to thousands), the < dropped and my usPSA held 0.01X range for eight months. Then 0.02X range for next seven months. Then 0.03X range past thirty-three (33) months. Awaiting current bi-montly result - should have it in morning - blood draw was last Friday.