ARE THESE HYPER SENSITIVE PSA TEST'S CAUSING TOO MUCH STRESS!

User

Posted 06 Oct 2015 at 02:08

Hi Guys, it's been a while since I last posted. However I've recently had a psa test result which is the highest yet.

What on earth is going on! Back In October 14 I had a rise from 0.03 to 0.046. Then in Feb 15 ( 4 months later) my psa fell back to 0.03. My consultant was so pleased with my set of psa results from op in September 13 that he wanted me to go 8 months till next psa test. I was very apprehensive about going so long without a psa test as the other results were in the main every 3 months. I have had a rise from 0.03 to 0.056!

Yep you've guessed it ! I am Stressed to Hell !! I am now starting to think that maybe..............just maybe these types of new hyper sensitive test's /results are actually doing me more harm than good, due to stress levels rising to a level of nuclear MELTDOWN!!!

The only good thing is that I believe I am technically still 'undetectable' !

But a rise is still a rise?

Other factors since operation, incontinence issues are the occasional rare dribble, with EF being very Goodhttp://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-laughing.gif

If anyone can tell me what is going on in this mad mad world of psa testing, I would be very grateful.

My profile shows all my psa results to date.

All the best,

Sweep.

User

Posted 06 Oct 2015 at 16:14

at these tiny numbers, you might simply have had a big poo just before your blood test

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 17 Oct 2015 at 23:31

Hi psa is probably the best we've got at the moment. Prior to any dx it is just an indicator as there can be false positives and negatives. This is one of the arguments for not using it in a screening programme.

Your consultant will be right about your PSA but if they have found cancerous cells the PSA in yiur case is not necessarily reflecting this. Likewise you can have men with high PSA's who don't have cancer.

The level of PSA does not indicate the aggressiveness of the cancer.

Once men have had treatment the PSA becomes more useful. This is why you will see a concern when there is a rise as it is an indicator that the cancer is still present and active.

Bri

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User

Posted 06 Oct 2015 at 16:08

Sweep,

PSA can rise and fall for a number of reasons and you are talking about very small movements so much too early to be over concerned. The next two or three PSA tests may give a better indication of the way things are going. Perhaps you get agreement to have these at 4 monthly or 6 monthly intervals until a better picture is established.

Barry

User

Posted 06 Oct 2015 at 16:14

at these tiny numbers, you might simply have had a big poo just before your blood test

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 06 Oct 2015 at 16:16

John's post-treatment PSA wanders between 0.02 and 0.05 - everyone involved is happy that these are just normal variations between tests and do not indicate anything to be concerned about as they are so far below the threshold of 'undetectable'

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 06 Oct 2015 at 18:00

During my 23 yrs with ????? , at one point millions of dolllars of product were written off due to being off-spec !! The reason ?? The laboratory Tech eating salt and vinegar crisps and confusing the machines . I don't know loads about this but my Onco said they start post operative RT when PSA reaches 0.2 , or if it has climbed three times in a row .

Edited by member 06 Oct 2015 at 18:52 | Reason: Not specified

User

Posted 06 Oct 2015 at 18:25

In the UK a biochemical recurrence is usually defined by a rise above 0.2 or three successive rises towards 0.2 - not everyone starts salvage treatment at that point though - some oncos (or their patients) will wait until it goes towards 2.0 or even higher before starting more treatment.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 07 Oct 2015 at 06:07

Sweep
They are still incredibly low readings. Your PSA has shown that it does go up and down. I would wait to see what your next test is but would probably want it sooner than the recommended 8 months but that's just my opinion.

Regarding sensitive testing there was an article about this wrote by a doc from the USA (John Hopkins centre?). He wrote about the stress and anxiety the sensitive test can cause. My oncol has said I should now be on standard tests which I understand as I have had all curative trestment. If my PSA rises they are not going to offer treatment at any level below 0.1 so what's the sense in testing me below that level and causing stress should it rise. I think I can settle for a <0.1.

Your case is different as you still have salvage RT as a back up. The sensitive test in your case can pick up three consecutive rises that may be the deciding factor in further treatment even if still below 0.1

Hopefully it will just be another blip

Bri

Edited by member 07 Oct 2015 at 06:09 | Reason: Not specified

User

Posted 08 Oct 2015 at 13:04

Ultrasensitive PSA Testing has produced regular debate for a number of years with mixed views from clinicians about its use.

Several years ago one of the problems for clinicians with the Ultrasensitive PSA was that although there were a number of article and studies about using the test there was no results published from randomised trials.

There was an interesting article on the Yananow website a few years ago about how ultrasensitive PSA tests can be distorted by a number of factors. Some medical teams use the Ultrasensitive Test but others do not. You can read the Yananow article at the link below. The technical comment is interesting. Have a look at the information added to the article in November 2011 which, at that time, went against using the Ultrasensitive PSA test to establish a base to take a decision about when to start salvage therapy following a prostatectomy .

http://www.yananow.org/UltraPSA.shtml

The findings from two clinical reviews on the ultrasensitive PSA test were published this year. The purpose of both reviews were broadly similar in that they were looking how best to identifying early biochemical failure. The respective conclusions each had something positive to say but with differences.

http://www.ncbi.nlm.nih.gov/pubmed/25463990

http://www.ncbi.nlm.nih.gov/pubmed/25444980

I heard some time ago that there is now a supersensitive PSA test that goes to 4 decimal places. I am not sure what this is all about but if you have a product you can generally find a market for it.

Alan

User

Posted 08 Oct 2015 at 15:47

I think mostly everything that can be said has been said in this thread. Just looking dispassionately, any scale of measurement that goes from two, three or apparently even four places of decimals to many thousands has to be subject to noise at the lower end of the scale. Our health board is cash-strapped so the sensitive test is not available. I get quite stressed enough waiting for my once-yearly < 0.1 result. I shudder to think what I would be like with the sensitive tests.

Tony

TURP then LRP in 2009/2010. Lots of leakage but PSA < 0.1 AMS-800 Artificial Sphincter activated 2015.

User

Posted 10 Oct 2015 at 19:18

Hi All, thank you so much for all your comments and advise. I am seeing my consultant next Tuesday 13th October, so I shall be able to relay his thoughts. Unfortunately I have now been shown by ultra sound that I have a Hernia. I am not sure how that works, should I decide to stall a Hernia op , and then being told that I need RT. Would RT affect a Hernia OP, its just a thought? I will let you know the thoughts of my consultant.
To all on this site, I wish you well,
with many thanks,
Dave ( AKA Sweep)

User

Posted 10 Oct 2015 at 19:49

Hernia? Get it done asap! If it is anything like mine was (inguinal) the repair is not too difficult (in and out of the hospital on the same day). I don't have any feel for the impact of RT - that's for others to comment on, but the danger of leaving a hernia to, perhaps, become strangulated is not to be underestimated.

Tony

TURP then LRP in 2009/2010. Lots of leakage but PSA < 0.1 AMS-800 Artificial Sphincter activated 2015.

User

Posted 17 Oct 2015 at 21:16

I have recently been diagnosed with prostate cancer. PSA is obviously very important to us all, but I'm getting confused. My PSA was 0.5 and my consultant said this was quite normal. I have read grades of PSA like 5 to 10 fairly aggressive and 10 to 20 more aggressive. I have seen posts where guys have stated they have had PSA >900 and other getting concerned that their PSA has risen from 0.03 to 0.031. Can anybody help me with my understanding.

User

Posted 17 Oct 2015 at 23:31

The level of PSA does not indicate the aggressiveness of the cancer.

Once men have had treatment the PSA becomes more useful. This is why you will see a concern when there is a rise as it is an indicator that the cancer is still present and active.

Bri

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