Ultrasensitive PSA measurments

It's most useful after prostatectomy including salvage salvage RT following prostatectomy. You can see how quickly it might be progressing towards 0.1 if there's another decimal place, and some places will use this to start salvage treatments earlier than just hitting the 0.1 or 0.2 thresholds.

I had radiotherapy and hormone therapy, and my hospital did PSA tests down to 0.01 which I found useful and plotted. The fact I was <0.01 ever since RT meant my oncologist said I could stop my HT early. That wouldn't have been known if the lab only measured down to 0.1.

Some hospital labs have measured down to 0.003 in the past, but I don't know any still doing that.

Hi Andy62 !

A PSA less than < 0.01 as an indicator to perhaps come of hormone therapy faster sounds like a very useful prognostic factor after radiation and when you’re on ADT. So, how much did it shorten your hormone therapy if I may ask compared to your initial planning?

Regarding using less than 0.1 for initiating salvage treatment. Ok for perhaps seeing a trend that it might be time for salvage treatment. A total amateur here but what might you actually find when doing for example a PSMA Pet scan if your PSA is < 0.1 ?

Wow, 0.003!  With that sensitivity you really need to make sure don’t do anything that might affect PSA measurment and still I suppose you may see changes when you have your prostate left and have had treatments. I would have been a wreck in time for every PSA test

Anyway, < 0.01 seems to have a very good prognostic value. Thanks for the good insight 

Best wishes - Ulf

Hello ulfhbg

An interesting question because I had not realised that not measuring below 0.1 was normal in some countries! I must admit, I feel reassured when I see my husbands PSA in the 0.03 range ( give or take). I had not realised that this is officially classed as undetectable. I recall being quite anxious when it doubled from 0.03 to 0.06 one time! It reduced to 0.04 the next time around. We were told PSA can ‘bounce around’.

I think we all get anxious when it comes to PSA tests. 

Hi U

In a simple answer, No, Def not necessary after RT cos can fluctuate anyway with that treatment although obviously hopefully downwards.

When I finished RT in 2017 my PSA was 1.33 and continued downwards so more decimals wouldn't have meant much.

All the best

Steve 

Hi Worriedwife !

I suppose somewhere you perhaps can order ultrasensitive of course but I’ve never seen it myself. The last measurement was < 0.1 and now I’m up for my next 3 - month in the middle of this month so, like the wise people on this forum says; it will be what it will be but of course I’m really nervous and stressed.

I think I would be even more stressed from ultrasensitive because then any small change would proberbly would have scared me even it could be as easy as working out, having intimacy and etc to close to the test.

But like you said, everybody is always anxious when it’s time for PSA test. Anyway, it seems like your husband is doing very well and that”s fantastic news 

Best wishes - Ulf

Hi Steve (Grundo)

It”s interesting the information Andy62 provided that < 0.01 might be a good indicator for how long you may need to be on ADT.

Otherwise I beliebers, like you, that ultrasensitive PSA doesn’t provide you that much of clarity in the diagnos, especially if you’ve done radiation, is on ADT and the prostate is still there.

I think you make the best prognostic point; as long as PSA moves downward that’s the best indication  

Best wishes - Ulf

Hi Ulf

Yes downwards but not to be too worried if one upward blip which happened with me although went back down again.

Usually this is just with RT

Good luck

Steve 

Hi !

Good point and you are of course correct that there might be fluctuations and the famous ’bounce’ is of course also a possibility.

Good luck to you aswell and keep up the good trend you’re in

Best wishes - Ulf

At the outset, I was told I would be on 18-36 months ADT.

My PSA was 58 at diagnosis, and I was put on low dose Bicalutamide as a holding strategy because my diagnosis was taking a long time, which brought it down to 48. Having opted for RT+ADT, I started the ADT (Zoladex). 3 months in, I was to start RT. However, my PSA was still 5 and I wanted to get it lower first, and oncologist was fine with me delaying the RT as long as my PSA was still coming down fast. At 5 months, it was down to 0.12, when I started the RT.

I had a consultation at about 17 months into the ADT and reminded the consultant he'd said 18-36 months, so how long was it to be? He said that since my PSA had been <0.01 ever since the RT, I could stop at 18 months if I wanted to. If my PSA had been nearer to 1, he'd want me to do the full 36 months. I don't know where his threshold was, but I guessed maybe 0.1-0.5?

I actually decided to continue on the HT a bit longer - it wasn't giving me any major issues I couldn't put up with for a bit longer, even if it only gave me a 1% increased chance of a cure. I stopped at 22 months.

Having COVID temporarily pushes your PSA up significantly. This has also been seen with some COVID vaccinations.