UPSA BLOOD ASSAYS

Seems to be a lot of controversy and confusion around this issue. In all of my research on this topic I have come to understand that there appears to be a consensus that this test seems to have excellent prognostic utility after a RP.

This is a recent study clearly demonstrating this.

doi.org/10.1002/bco2.413

Interestingly, ultra sensitive PSA can also predict the likelihood of a high risk BCR ( doubling time < 9 months ) using a PSA cutoff of 0.03 at 2.5 years.( Doubling time measured from 0.1)

So even though recent trials have shown no benefit in starting salvage radiation at PSA levels below the accepted BCR definition of 0.2, there may very well be a sub population of patients with a more aggressive phenotype who may indeed benefit from UPSA testing and earlier intervention.

[NanoMRI]

Outlier alert! IMO and experiences do not give cancer time and obscurity. Ten years ago I sorted through this harmful noise and settled on <0.010 as best indicator post RP and dismissed BCR and doubling time.

My RP nadir was 0.05. In under year PSA rose to 0.1. Had salvage RT - nadir 0.075. Back up to 0.1 in under year, had (unconventional in US) salvage ePLND - nadir <0.010. Cancer as far as para-aortics.

Simple clear reasons why death rate is not dropping and why number of men on ADT is rising.

[Tall_Allen]

No, it says the opposite. It says those who consistently have a uPSA of 0.01 for several years can be spared PSA monitoring every year. It does not say that those with,say, a uPSA of 0.03 need earlier intervention. In fact, the only valid predictor of intervention is a BCR or certain high-risk features (for which one shouldn't wait for any PSA at all).

[NanoMRI in reply to Tall_Allen]

I strive to be spared from ADT and death by this disease. Blood tests can help us have many more walks in the park!

[NanoMRI]

From the findings - "This strategic approach optimizes resource allocation in busy urological outpatient clinics, especially valuable in publicly reimbursed healthcare systems like Finland."

Men who die from prostate cancer are acceptable losses.

Managing this disease as a chronic illness with ADT is a tragedy of its own.

[Cyclingrealtor]

I test at the .xxx that's offered through Labcorp after my experience.

Why?

Because 8 months after my RALP I was back at .1 and obviously that meant that some cancer was missed. In a matter of 7 weeks my PSA was at .3 and 9 weeks was .4.

While clinically most HCP's wouldn't do anything until some point between the .1 to .2 PSA level knowing that it was rising for 8 months may have allowed me more time to investigate options and have a better understanding of the seriousness of my disease.

It was ALL minimized by my Kaiser Permanente urologist from the start. "You're only 1 of 6 (G7/ 4+3 at 90%) no need to move so fast to surgery". Tertiary 5 margin at the bladder neck, "no need to worry, we may have gotten it all during surgery". How about uPSA testing? "It's really not worth it, all it does is drive anxiety".

Since RALP and recurrence I test with uPSA to allow myself a heads up to hopefully stay ahead of the disease since everything before was nothing but a "late to the game" screening, diagnostics and treatment.

One phrase HIGHLY OVERLY used is, "there's no benefit". Most often than not, the truth is there haven't been any studies or trials to show if there IS or IS NOT any benefit but people run their mouth that there's "no benefit".

And to that I share Dr. Peter Attia's advice after working at the NCI for a few years on cancer research. It goes something like this....... Cancer is simply a numbers game, the fewer the cells the easier to treat and typically the better the outcome.

Advocate for yourself to shoot for the outcome you desire! The Industrialized Healthcare Complex isn't doing too well with distant metastasis up 43% (2010 - 2018) and a PCa death rate that is projected to almost double by 2040 to 70K deaths a year!

[ManuteBol1 in reply to Cyclingrealtor]

You have a lot of great comments here. They are appreciated.