The prognostic value of ultrasensitive PSA test

[ulfhbg]

Hi !

In Sweden (and Finland) we never (or selldom) have ultrasensitive PSA testing so the lowest PSA is < 0.1 or ’undetectable’.

i have seen several discussions regarding ultrasensitive PSA measurments and I can understand the value after prostatectomy because you have removed the major source of PSA in your blood.

But for us with the prostate left, radiated for example and perhaps on ADT. Is there any significant value of trying to get a ultrasensitive PSA measurments?

Like I said, I can understand the use of it after prostatectomy or perhaps even after radiation and ADT and when it’s time to stop ADT.

But, what value do you bring to the table knowing more decimals compared to < 0.1 from a prognostic perspective?

Best wishes - Ulf

[Tall_Allen]

"But for us with the prostate left, radiated for example and perhaps on ADT. Is there any significant value of trying to get a ultrasensitive PSA ?"

Even less value after radiation, because biochemical failure is not suspectected until nadir + 2.0 is reached.

[ulfhbg in reply to Tall_Allen]

Hi TA !

Thanks for a clear respons. Have you seen any studies or documentation that a PSA value of < 0.01 is a predictor of how long you need to stay on ADT and if so; what are the findings on how long you need stay on ADT?

Well, just curious anyway for me as in Sweden we only do to < 0.1 as a standard measurment.

// Ulf

[Tall_Allen in reply to ulfhbg]

The duration of ADT is based on the protocol you are following.

[j-o-h-n]

Is there any significant value of trying to get a ultrasensitive PSA measurements?

Yes for the doctor there is, doctor needs a new automobile.

Good Luck, Good Health and Good Humor.

j-o-h-n

[ulfhbg]

Hi John !

Haha, well that’s one part of the prognostic value I have not considered and of course we always have to think of our underpaid doctors

Well like i wrote, I really can see some of the prognostic value when you’ve had prostatectomy and remove the major source of PSA.

But for me having my prostate left, having had lots of radiation treatments and also being on Orgovyx and Abiraterone I think I’m more ok mentally having the PSA result <0.1 as an indicator.

My nerves and my anxious levels are bad enough waiting for my next PSA level measurement now in October so ultrasensitive PSA measurement probably would have put my mind in a mental loop.

Best wishes - Ulf

[Xavier10]

TA has a point. I think that's why Mayo Clinic just does <.1 on their tests. I did a few ultrasensitives on my own but I can't see why knowing a number would be significant that low.

[ulfhbg in reply to Xavier10]

Hi !

I agree totally when it comes to having your prostate left, had radiation and perhaps being on ADT and even 2nd gen because then I think the prognostic value of more decimals is low and the stress is bigger because the PSA may actually fluctuate.

The prognostic value, i believe, may perhaps be bigger after prostatectomy as you have removed the biggest source producing PSA.

But even then, if I understand TA correct, you still need to try to cool down a little bit and I think I can understand it somewhat, especially that to low levels of PSA might not be very useful if you perhaps need to do a PET Scan and perhaps miss micromets because the PC is still extremelly low volume or something

Best wishes - Ulf