My husband just got this as part of his lab report almost 7 weeks post RP. Hasn't heard from doc yet. Can someone explain what F/T PSA >0.00 means? And 55% probability of prostate cancer??
Specimen ID: 1
Collection Start Date: 10/25/2023 3:43 P
FREE PSA [FREEPSA] 0.00 ng/mL
Free/Total P S A [F/T PSA] >0.00 % >25.00
55% PROBABILITY OF PROSTATE CANCER.
Performed on Beckman Coulter Access Analyzer
free to total (F/T) is meaningless after a prostatectomy and should not be done, let alone reported. It is only the total that should be done.
Wow, TA, thanks for your prompt response! So the F/T was a lab error or reporting error? Do you think we can trust the 0.00 regular PSA result?
Update: Assistant just called and said this is the correct PSA number, found elsewhere on report (so all good, I guess) :
PSA HYBRITECH [PSAHYB] <0.10 ng/mL 0.0-4.0
TEST PERFORMED USING HYBRITECH TEST KIT.
They did an extra lab test (for free PSA) that they should not have done. The report tried to divide by zero, which caused a screwy number to pop up.
Thanks. Most anxiety-causing lab error ever. Do you agree with the comment below that the PSA value should be more specific (ultrasensitive test)?
No. We've now had 3 randomized clinical trials now that have definitively proven there is no value to an ultrasensitive PSA test. They only cause anxiety - not any change in therapy.
prostatecancer.news/2019/09...
>.1 mean’s undetectable and is the lowest you can go with non ultra sensitive psa test.
<0.10 doesn't mean much. For better understanding you need a number without the less than sign " <" preceding it.
Hmmm, not sure if they do a more sensitive test....or maybe the results take longer. Still waiting to hear from doc. I guess this is the danger of sending labs to the patient in advance
I think it's up to the individual if s/he wants the standard PSA test after RP or if they want the ultrasensitive test. Mine have all been <.006 (ultrasensitive) which gives me some calm and confidence. Quite certain you just had the standard PSA test with a result of <0.1 which is as good as you can get. That is a cause for celebration. I remember five years ago I asked my uro. and he just said, some guys like getting the standard test and some like to get the ultrasensitive.
Congrats on your undetectable number! I don't think my husband was given a choice. I can see pros and cons to both. Tall Allen makes the point that the ultrasensitive can cause neurosis without changing treatment options, but if it were me I would probably want an exact number. My husband is more chill, so the best score on the standard suits him. At any rate we are celebrating tonight - surgery turned out to be the right choice for him.
I’m just about to start radiation. One of the drawbacks is not being able to know you have zero psa or prostate cells afterward and just have to monitor trends, but all the studies to date seem to indicate it’s just as effective as surgery so trying to trust the data. Hoping to have less risk of incontinence which is my biggest long term concern. Seems like some level of ED is going to happen with either choice.
Good luck! I'm sure you'll do well. My husband, 72, active, ruled out radiation although some of the treatments seemed easy and excellent. But he was Gleason 8 and would have needed ADT for 18-24 months, a deal breaker for him - he's still working and couldn't risk brain fog. Also had enlarged prostate and would have to treat separately. Turns out he was downgraded to Gleason 4+3, but he's glad he's had the surgery. Nerves were spared, no ED issues, even at this early date. Still wearing pads for minor leakage, but that's practically resolved as well. Choosing a rock star surgeon was key.
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