Second PSA after RP

[Paulo1968]

6 months after surgery and PSA test was 0.04. The same result as 3 months ago.

I take this as good news, right?

I am figuring out whether this is the lowest PSA level the lab can do.

[Whipper]

According to my hospital (Vanderbilt University Hospital), <0.10 ng/mL is the lowest measurable and that is reported as "undetectable".

[Tall_Allen]

Do they write it as <0.04 or 0.04? Call them to find out their lower limit.

[Paulo1968 in reply to Tall_Allen]

I have just called the lab. This is the lowest level the machine can detect PSA.

[TimCo]

Hi Paulo, My post surgery psa readings have been 0.01 for 4 years. It sounds like you are doing well and you have a great attitude which is paramount in healing and recovery from RP. I do wish you all the best going forward.

[Paulo1968 in reply to TimCo]

Thank you Tim. I wish you all the best.

[alfredoghi1]

Congratulations Paulo!!!!!!!

[Bcgkelly]

That’s great news Paulo. My second is in November and hopefully mine will be the same as well. I was 0.035 last time.

[Paulo1968 in reply to Bcgkelly]

Cross fingers it will be!

[Bcgkelly in reply to Paulo1968]

I take comfort in the fact that yours was and with a bit of luck mine will be to .

[Hidden]

There seems to be a variety of answers on this. In the UK, the test used can detect amounts as low as 0.01 ng/mL. This is considered to be zero. In the US there is a test which doesn't detect anything less than 0.1 but there is another available which is much more sensitive than this even.

It depends on which test is being used.

A few months after RP there may still be detectable amounts but it should hopefully become undetectable. Whatever is, if it should rise and reach 0.2 then this is considered a "biochemical recurrence".

It does depend on which test is used as to whether 0.04 is good. Mine was less than 0.01 3 months after surgery and stayed that way for a year. It then rose to 0.02 which caused some concern. It then went up to 0.02 and then back to 0.02 and fluctuated like that for 2 years. Then it went to 0.04.

Obviously if it starts going up, as mine did, it just depends on how much it goes up and how fast.

If it stays the same more or less then that's OK. My urologist describes mine as "bumping along the bottom".

I know some men who had RP years ago, one of them it's 10 years. Their PSA is less than 0.01. Unlike them, I have to continue having a PSA test every six months. For the last 18 months it has stayed at 0.07. I am effectively on Active surveillance.

I hope not, but perhaps, realistically, you may be facing the same situation. At six months it's too premature to say.

On the positive side, at worst for me, it might mean that I need further treatment, but it is still potentially curable.

[Hidden]

PS I just re-read your posts. If your lab confirms that their test can't detect anything less than 0.04 AND, as Tall Allen asks it says LESS THAN 0.04 then that's great news.

However, there's a couple of things you might want to check. If you can arrange a test that is sensitive at the 0.01 level and your result is LESS than that, that would be fabulous. Doubly so, since I've never heard of a test sensitive at 0.04

[Paulo1968 in reply to Hidden]

Thank you for your messages Tim. Indeed I only realized the PSA test had an unchanged lower mark at 0.04 this time and last Monday. As I had 2 results of 0.04 in a row and pushed by Tall_Allen I picked the phone and called the lab.

I have a doctor appointment only next week, but I wonder he will agree on me having a second test as he texted me already stating it was a great result. I will insist though and waiting for the reply. I need to look for a place that does those ultrasensitive tests here in Lisbon in case he doesn't know.

Thanks again. I also read through the article about PSA testing after RP.

[Hidden in reply to Paulo1968]

Hi, sorry I didn't realise you were in Lisbon. Most guys on this site are from the US. I'm from the UK. It may be that the test used in Lisbon isn't as sensitive.

Your post has prompted me to do a bit of research.

One of the things which attracted me to having a prostatectomy was that if successful, PSA would be undetectable and as long as it remained undetectable you would know you were OK.

The problem with that is, the more sensitive the test is the more reassured you will be if it's undetectable. BUT, the more sensitive it is, the more likely it is to detect the very small amounts that are produced in the body by other means OR by non-cancerous prostate cells that have escaped the surgeon.

It must be tricky for the surgeon detaching the gland from the two urinary sphincters. If too little tissue is removed then prostate cells will be left behind, too much and it could cause incontinence.

Basically, and it's recognised as a problem, the more sensitive a test is, the more likely it is to cause anxiety. I feel OK with a test that detects 0.01 perhaps because I'm now used to it. I've read on here there is a test that is sensitive to 0.0001 or less, which to me seems ridiculous. If your test is only sensitive to 0.04 and your result is LESS, as I previously said , that's fabulous.

More good news, it's only counted as "elevated" if it reaches 0.02 or above. And more good news even if it is detectable but stays at low levels you may never have to do anything about it.

Let us kniow what your doctor says

[Hidden in reply to Hidden]

SORRY again 0.2 NOT 0.02 !!!

[Hidden]

PPS you might find this website helpful

healthline.com/health/prost...