Hi All, 6 months ago <0.02, 3 months ago <0.05 and latest result was <0.08,
should I be concerned?
PSA Latest results: Hi All, 6 months... - Prostate Cancer N...
PSA Latest results
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ukpete
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Are you currently on any treatment, meds, etc?
No treatment or meds
Find a lab with a jokeless reporting policy. The current one is only good for stand-up comedians.
Sorry I don’t understand?
What don't you understand? The less than sign "<" is only used in the lowest range of the measurement scale to denote that the quantity detected is less than the minimum value the lab can (within a certain accuracy) measure. If "<" precceds the series of ALL measurements this is not serious staff, it is a slapstick JOKE. Like someone pulling your leg.
I’m sure you think it’s a slapstick joke but I’ve been through hell and back, grade 3 cancer, Gleason 4+3, radical prostectomy , catheter etc etc, let me guess you are American . All I was asking was should I be concerned, please don’t tell me what I’ve been through is just a slapstick joke
No, I am not American, I am Greek and a retired engineer, hence numbers carry a meaning to my eyes. And the meaning I received from the time series you posted (<0.03, <0.05, <0.08) can only be found in a Monty Python's comedy (they were moving the property line pegs during the night). Finally, from your understanding of my messages I highly doubt that our English is compatible, so I bow out.
I’m also an engineer and just for the record my mother was Greek, I may have put the < symbol by mistake, It is obvious I am not very good with the terminology of prostate cancer, it’s all new to me, I must apologise for my ignorance, maybe I was looking for a bit of sympathy or reassurance, every time I comment on here I always end up feeling down, maybe I should bow out
Stick around brother. I noticed you had some issues with anxiety before you even developed PC. I'm sure this has been a rough ride.My work trips to the UK (Nottingham) over the years confirmed you guys are a tough bunch but also considerate and caring. The "chin up" attitude is the truth with you guys. Stoic. Great hosts. Traditionally having some of the best beer always helps too.
I don’t get the < either. It’s as you were told only used when the lab results can’t read any lower which is the case with non ultra sensitive tests which go out to three places to the right of the decimal point. The real issue is although low your psa is low it’s doubling rapidly so you need to be on systemic treatment.
Yes. The message for me was to use the same lab. I had gotten readings of <0.05, <0.05, then <.1 from another lab, then <.1, then 0.1 (which sent me into a blind panic). Followed up with the original lab, which yielded <0.05 again.
I think it's an honest question that deserves an honest reply. Hate people that are rude, no matter how intelligent they may think they are. Take your rudeness somewhere else, this is a forum for support, not for putdowns.
I would keep a close eye on it after a RP. What does your Dr say? (revised)
Just have to wait till my next PSA blood tests in 3 months
Probably because there's not much they can do with it now and it has to come up quite a bit to be actionable. As hard as it may be, enjoy life and try to put it out of your mind for 3 months. Thats the best advise I have. As far as should you be concerned, for me, these days its hard not to be regardless of what my test results are. The straight answer to your question, to the best of my knowledge, is your PSA shouldn't rise after a RP. I believe BioChemical Recurrence is defined by 3 consecutive increases, but I may be mistaken. There may be reasons it increases that are not due to progression but I am not aware of what they are.Please wait for somebody like TA to reply for more reliable info before letting your anxiety get the best of you. Your still very early in the treatment and there's plenty of treatment to go and still offer a curative result.
I hope your journey will be successful
Hi, I can appreciate your anxiety, but your PSA level and the movements are so low, I doubt that the level would be considered actionable yet as treedown said.
If your PSA did continue to rise, you still have salvage curative options available.
I don’t know what level of PSA you would need to have before your medics would propose salvage radiation (with or without the addition of androgen deprivation therapy ADT for some months) in the U.K.
They may want to ensure that if it is a recurrence of cancer, that they can image it so as to target the radiation with the most accuracy.
I do understand that it is a worrying time for you and unfortunately not everyone on here responds with an emphasis on compassion, bluntness can be off putting but please persevere; there is an abundance of high quality support and guidance to be had that is invaluable.
Having to wait for some months before you get in front of your NHS consultant isn’t easy, but given such a low PSA level, it ought not to have much impact on any disease progression. Given that your urologist may not be of much use if there is disease progression, you could ask now for a referral to a (prostate cancer specific {if possible} radiation oncologist and thereby cut out an urology visit which will just result in the referral anyway. It would at least reduce your overall waiting time. The oncologist would conduct imaging tests to be certain how best to proceed. If there was nothing to do, you’d be told so and referred back to the urologist.
You would have reduced worry time either way.
I hope that you can get through the wait without letting it get you down, I find that by trying my best to live in the ‘now’ rather than next week or next month, I reduce my stress and increase my enjoyment of life.
I continue to wish you the best on your journey.
Hugh
All of those are the same - the "<" means your value is below the lowest value that the lab can report.
think I put the < symbol in by mistake,
I would also not let your guard down like i did. Eat healthy exercise and enjoy life Until otherwise. Also we are all under stress and most of us have rollercoaster emotions because of ADT.
Yes, the '<' symbol tells you your PSA is below what the lab's equipment can measure. All you know is your PSA is below .08. It could be .001 or it could be .07. IMO, you should not worry but be sure to use the same lab for all of your ultrasensitive PSA tests. I've been getting uPSA tests for several years following my RP and I always use the same lab. Enjoy your summer!
I'm proof using the same lab (and the same tech and the same machine and the same blood from the same day) doesn't guarantee accurate results. Two reads from blood taken 60 seconds apart, same machine, same tech, same lab - and significantly different results means I don't take tiny changes in the test results all that seriously.
Pete,
I find it extremely unfortunate that any of our warriors would ever come up with rude replies to a post! Just ignore this person and hope that you never have to deal with this disease anymore. Actually those numbers are so low that they are insignificant. A post-op PSA should be in the range of .2 before recurrence (BCR/BCR) is assumed. Stop worrying and enjoy life!
My best to you,
Ron
cheers Ron, sadly it is the modern way to call someone online, obviously I do worry but I do enjoy life , infact Ive just booked a B&B in Whitby next week, plenty of beer & the best fish & chips, thanks for your reply
! Hey UKPete! I don't know what this says of my mindset, but in screening this post I immediately saw beer + fish + chips and (even tho' I am American) my brain hit a hard stop of joy. Mmm...my favorite! I hope you enjoy the coast, company, and food in Whitby! As thanks for the visual, I guess I will throw in my PCa thoughts/experience as well:
Since PCa is such a huge part of our lives, changing lab numbers will always enjoin an emotional response. For me, it has been made much worse by my own engineer brain that wants formal categorization of risk for every number so I can add things up and neatly decide things. Of course, it doesn't work like that.
Going on 6 years at 4+5 and many emotional ups and downs, I can announce (admit?) that I've managed to bin all of these mixed emotions into 3 main understandable categories regarding my PCa and other test results: Relief, suspicion, and dread.
The "suspicion" category is almost always there for me - unless we are talking of the aforementioned beer + fish + chips. Relief can slide up into suspicion, but (thankfully) dread can slide down into it. My own PSA is creeping up from my absolute low of 0.09 5 years ago - now it's 1.8ish and highly suspicious, but my dread has been kept back by scans showing "no indication of radiographic progression".
Personally, I have found that I can live with suspicion, but I can't live with dread. Your PSA numbers are low, but since they've been lower, you are understandably trying to decide if your suspicion should be dread.
It's a personal choice on how to approach this so that some semblance of a normal life can be achieved. I live by seasons. My recent "no radiographic progression" has led to my completely arbitrary decision that I am okay for the summer (my own version of Whitby, beer, and fish) no matter the state of my PSA. With my late summer oncology appointment, I will make another decision of "ok/not okay" for autumn...and then another for winter, and of course I always hope for spring.
Maybe you can find the UKPete way over a pint and an ocean breeze! Cheers. - Joe M.
Hi UKPete,
My thoughts are with you. My partner Tony, is also going through the same things you are (in Australia - my background is Greek also) and as a psychologist I get the anxiety and the trauma people on this site (and their partners) are going through.
I will tell you what his Oncologist has told him after his PSA has doubled form an initial "undetectable 9 months ago". He had Gleeson 8 (4+4) with aggressive cancer, radical robotic prostatectomy, Radiotherapy, Chemo and ADT (the kitchen sink) in early to mid 2019!!
Anyway, its increasing in the last 12 months and while still under 1, he has to have an eye kept on it. The PSA is increasing but while doubling before, has slowed down a little. His Testosterone has also dropped from 12 to 4 with no intervention and this could explain the slow down - not sure at this stage why this has happened.
PSA readings every 3 months to watch it and while he had a PET scan, the little buggers were too small to see. He will have another blood test and this time another PET scan in Sept 2022 (12 months after it started increasing). This will determine treatment. If they can see it and its in one place, then radiation. If in many places then chemo I suspect. If they cant see it but still increasing may try ADT or a "wait and see approach" for a bit longer.
I freaked out (my partner is calmer) but we have to take it one day at a time and his Oncologist didn't look as worried as I was. He assured us that there are many options for treatment still. My partner tells me that he plans to live to 90 as he has many things he wants to do still. We are off to ski in New Zealand (our neighbouring country) next month and he keeps himself super fit with daily exercise as this helps his body and brain (done since he was 18).
We are both young 60 year olds (he is 60 in September).
Hope you stay strong and remember to take some time out in all of this and have fun.
Maria 👍
thanks for your reply and kind words
There will be some variability in PSA testing. As I understand it, no one will treat you unless your PSA rises to 0.1 & some say 0.2. I am told there are MO's who will require at least 2 readings at 0.1 or 0.2 before initiating additional treatment. It does help if the same lab & assay are used all the time. My assumption is you have had Prostatectomy since lab PSA values are in that range. When I read up on this, if there were no signs of metastasis outside the Prostate, about 2/3 of patients would never need add'l treatment & 1/3 would. If PSA rises sufficiently but there are no signs of distant spread then radiation to the pelvis is often considered. If the cancer is isolated to the pelvic area then there is the possibility it can be cured, but, beyond the pelvis it is not curable (at least at this time). So far your PSA's are good. Just keep getting them as this disease can come back even decades later (this is rare but can happen). Every year you progress away from Prostatectomy without a reoccurrence lowers your odds of ever having a reoccurrence with the first few years being critical and your odds NEVER being zero ..... so lifetime PSA testing is required. I hope this is helpful.
Hello Pete.I’m afraid I don’t have the actual answer to your question but, as the wife of someone treated for prostate cancer, and someone who knows how tough life can be ( he also has another cancer, which makes him at extremely high risk from Covid too) I am genuinely disappointed at the reply you received.
Please don’t think that everyone is like that… I believe there are some very supportive people here too… they have certainly helped me understand a little better.
Keep asking questions… I am a great believer in that, because we can’t all know everything and there maybe just the helpful answer out there that you need.
Stay safe and best wishes,
Fran 😷
I know this site is very helpful, I found it when I stopped smoking over 4 years ago, I also had trouble sleeping and suffered with anxiety, I found it helped me to speek honestly how I was feeling and any issues I had, as someone seemed to have been there and could talk about it, it really did help, as for the daft comment it is just the way it is these days, some people get a kick out of been nasty, thanks for your comment
According to my oncologist those levels are normal
Low. Not yet actionable. May be within the error range of your lab. Pay _some_ attention but not much. Remember "PSA" stands for permanent state of anxiety for those of us who share PCa. That other guy could have been kinder, more empathetic.
Boy is that for sure! Tomorrow is my quarterly Lupron shot and PSA test. In the days prior I get more and more anxious! I’ve been undetectable for the last 18 months and hope to keep that streak going!
Excellent!
Stay on course, exercise, and get your naps if needed. Watch your diet and yes, Meds will come into play.
Please stay here with us Pete. Thankfully there are plenty of understanding and knowledged people that can help you with any questions you have so keep asking away. My husband had RP 2 yrs ago 3+4=7 at a pSA of 11 and after 18 months post surgery his PSA began to rise monthly from Jan ‘22 at <0.03 to 0.15 in May.
Our Oncologist wanted Dave to have every chance at curative treatment so in June Dave started 33 radiation sessions, a single 6 month injection of Lupron/bicalutamide and a daily cosadex tablet for 6 months.
He’s got 2 Wks of radiation left and he is doing extremely well so far.
No doubt it’s a sneaky one so keep a close eye on your PSA. In Ireland they will start radiation soon as it gets to 0.12 not sure about UK.
Easy to say but at the moment there isn’t much you can do apart from monthly bloods which was recommended to me by some of the lads on here and by our GP which I’m so grateful for.
Keep us posted on how things go Pete, we are all very interested in YOU. 💚
I will keep you posted, and send Dave my regards, this has been a journey for me I never thought I would go on, I have been positive but occasionally the doubt creeps in, thanks for your reply
Just my $0.02 but once PSA starts rising, it seldom stops on its own. When mine started going up, I just watched it until I decided to do something to stop it from going up. Unfortunately, I waited until it got to 0.20. If I could go back with what I learned through experience, I would take BROQ (sulforaphane) per the clinical trial on men with BCR. I post the link to the study below. There are also a couple less solid things like the study on pomegranite juice slowing BCR. Study also posted below. Usually docs wont do anything until it gets to 0.20 and then salvage radiation therapy is a possible curative option. I finished that up about a year ago and PSA at 0.02. Hang in there brother.
Hi Pete,It’s the less than sign before the three readings that’s confusing. Are the readings from the same lab.Bill
My mistake I put the < symbol in , maybe lack of Knowledge, and yes my bloods are all at the same lab, thanks for your reply
In that case it does look like you’re at the early stage of a biochemical reoccurrence but sometimes the PSA can bounce around and you might be lucky yet. If it goes above 0.1 for the first reoccurrence they normally consider radiotherapy to the prostate bed. That’s the process in Ireland and the U.K. is probably similar.
As they all have a less than sign before them they appear to be from different labs and as such don’t give you a true picture. If the less than sign shouldn’t be there then you appear to be in the early stages of a biochemical reoccurrence but they won’t probably treat you until you are between 0.1 and 0.2 and then probably with radiotherapy .
Hi ukpete,
Like others have stated, when the results of your PSA tests begin to rise, I believe its time to pay more attention and prepare for an eventual PSMA PET CT scan when the PSA reaches .2 or greater. I had a RARP in 9/19, and following it, my PSA was undetectable by SOC measurements for awhile. But, the results began to come back with a slight rise each time. I kept getting uPSA tests every three months, and in 5/22, my PSA had risen to .21. I got my second PSMA PET CT scan, and two suspicious areas were identified. I begin SRT treatments at the Roberts Proton Thearpy Center at UPenn shortly. I've been classified as having reached BCR, so my care team has determined that additional treatment is needed. Everyone's PCa is different, but with this disease, one should pay close attention to changes. Good luck.
Jeff
There is an old article - but may have some merit and usefullness to you. See if you can search and find : "Low Detectable PSA After Surgery - Watch Or Treat" from The New Prostate Cancer Ifolink in 2015.
I'm kind of in the same boat as you are. My value was undetectable for a year after prostatectomy. That meant <0.1 because I've been told that is the lowest detectable level. Last check was at 0.1 and my urologist said not to be concerned until it reached 0.2 and then we can consider other therapy. That's what I'm doing. Another suggestion I can add to that which I've already seen is that maybe it wouldn't be a bad idea to have another lab repeat the test for confirmation if it ever reaches the magic 0.2 level. I don't know if I can trust a single lab or even multiple readings from the same lab, you know about systemic error in test equipment and measurements. An average of readings from different sources is always more accurate than multiple readings from the same source. I'm an engineer also, a measurements and instrumentation one at that.
Hi, Just to clarify, I had RD last September had my first PSA test December it was 0.02 , On my post I put the< symbol before my test results, obviously now I know I shouldnt have.March result was 0.05 and June result was 0.08, I have attended the same hospital for all my tests, after each test maybe a couple of days and my urology nurse calls me with the results. I did question the fact it has risen slightly on each occasion she told me not to worry but if it should reach 0.2 - 0.4 then radiotherapy could be used. I put a post on here maybe to get some positive feedback from the people that have been there, I am physically fit for a 63 year old, and would consider my diet to be a pretty varied, I feel good. I would like to thank most of you for the kind and uplifting messages I received, and I wont hesitate to ask any question, as no question is a daft question, kind regards, Pete
The "<" is a mathematical symbol to denote "less than." If anyone reads more than that into it they're wrong. Simple as that. All measurements have some inaccuracy, so more important than a small difference between readings is the accuracy of those readings. If the measurement error is large then a number such as 0.02 and 0.05 are basically the same. I don't know what the accuracy of the measurement is that you're being provided but the errors could be significant and in that case all of those small numbers are basically equivalent. Test equipment is subject to systemic errors in measurements due to drift, lack of calibration or other reasons. The numbers you're talking about might be very close to the noise floor of the test equipment and in that case they are not by themselves very dependable. You need a large number of readings and even from multiple sources in order to come up with a statistically meaningful value. Once the readings rise well above the noise floor then the accuracy improves with a smaller number of samples.
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