Post Op PSA query

Hi Fantic.

It seems your PSA result reads <0.1

This is a good result. Your PSA is undetectable within the capability of this particular test. Take this as very good news.

Do you need a more sensitive PSA test?  This question is a source of much debate in the post prostatectomy world. 

The reason many doctors prefer the test you had done is the fact that PSA detected at lower levels would not indicate the need for more treatment until it reached that 0.1 level. They would tell you ultra sensitive PSA tests are not clinically useful and only cause needless anxiety.

So what is the use for the ultra sensitive PSA tests? These test have significant statistical value. If your PSA is undetectable  to the <0.01 level, you are much less likely to have a recurrance than someone who had a detectable PSA at any higher level. 

Likewise, a PSA test that goes to the <0.03 level is very good statistically. This is the test that I use. This means I am still not likely to have a recurrence even if I do have some PSA at a level lower than that.

If a post prostatectomy PSA reading is .04 or higher, a recurrence is statistically more likely.

Always be aware of the less than(<) sign in this conversation. Your <0.1 is preferable to a 0.04 reading since 0.04 is detectable and <0.1 is not. 

Basically it is a matter of how much information you are comfortable with. A more sensitive  PSA test is not likely to change any treatment decisions in any event. 

I find it a bit frustrating that many doctors don't know these details or simply don't want to take the time to explain it all.

Personally, I take some comfort rather than anxiety from my ultra sensitive PSA test as I have been <0.03 going on 4 years now. 

I hope your PSA remains undetectable as well.

Wow what a great and informative reply which gives much reassurance, thanks so much for taking the time to reply in such detail it is much appreciated 

I agree it was slightly concerning when I realised the doctors simply didn’t understand the relevance of of what I was asking them,  for instance at first they advised that my PSA was normal but they were comparing it to what would be normal for a person who actually had a prostate and hadn’t had prostate cancer , they also hadn’t even heard of a ultra sensitive PSA test 

may I ask how/ where you get your ultra sensitive test done as a chat GBT search showed only 2 places that perform this test , both of which are quite a way from me?

thanks again

Nick

Hi Fantic240 , I agree with everything that Stampede has said. I should add that, for our post radiotherapy men, the <0.1 makes much more sense, as they still have a prostate. So a score of anything up to 0.1 is excellent and nothing to worry about and would not be treated. Indeed, a score of <0.5, or <1.0 would still not be a concern, if these figures are a result of post radiotherapy bounce and/ or the result of the restoration of testosterone after hormone therapy stops.  In these cases, PSA would be monitored for speed of change (doubling time) and a closer look if it reaches 2.0.  
In your case, after prostatectomy, I wouldn’t pursue more accurate readings - if you continue at <0.1 that will be absolutely fine.   AW 

Nick, 

I live in the States so can't help on the uPSA test. I am seen at the University of Iowa, a cancer Center of Excellence. uPSA tests are always arranged for prostatectomy  patients. I agree with AW. The test you are getting is fine.

Thanks both for your valued inputs it has certainly made me feel more confident that it was a success ( for now anyway) will be having a few beers later on the strength of that 

cheers

Nick