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Undetectable?

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User
Posted 08 Aug 2019 at 09:58

psa 6.6, Gleason 3+4, RP surgery

Nine weeks post op my surgeon tells me results could not be better - cancer contained, margins & lymph nodes clear, psa undetectable (0.04), placed on 6 monthly psa tests.  I am now virtually dry and back to normal activities, gardening, diy, woodworking, golf etc.

Question, should I be concerned with a psa of 0.04? Shouldn’t it be zero if all cancer was removed? 

 

 

User
Posted 08 Aug 2019 at 13:22
Even with no Prostate you can produce a very small amount of PSA from the Adrenal Glands so not an absolute zero. Your PSA is low enough to be regarded as 'undetectable'. Nevertheless it is important to monitor your PSA at regular intervals to check if/to what degree/trend PSA increases as regardless of what was seen during the op and subsequently in the lab, it sometimes happens that minuscule micro cancer cells have escaped and there is a potential for these to cause a problem in due course. So be pleased with result so far but take nothing for granted.
Barry
User
Posted 08 Aug 2019 at 17:51

hi Neil ,

Fine to me. See my profile. See what 6 months brings. Enjoy life.

I'm on 3 months testing. admin 'error' maybe however I don't fret.  I find we are much more relaxed as time passes.  

best wishes Gordon 

 

User
Posted 15 Aug 2019 at 12:38

Hi

Like you, I have an 'undetectable' PSA following surgery, actually 0.01.  I have read on academic websites (sorry I can't remember where) that the test is not very accurate at very low levels, as it is easy to mistake PSA for similar proteins.  Although I would like it to be 0, I still live my life as if I'm cured, despite knowing that there is a small risk that it will recur.

Given the slow-growing nature of prostate cancer and the salvage treatments available, I am more likely to die of another type of cancer that has not yet formed.  That may seem to some to be weird way of looking at it, but I find it helpful and positive. 

User
Posted 15 Aug 2019 at 17:33
Wondered what all the moaning was in Clarks!
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User
Posted 08 Aug 2019 at 10:31
Very pleased to hear your good news.

My hospital only tests to 0.1, so <0.1 is classed as undetectable. The top cancer hospital in Britain, the Royal Marsden only tests to 0.04, but other labs test to multiple decimal places.

One urologist and one oncologist told me โ€˜super sensitive assayโ€™ to umpteen figures is a waste of time, and another oncologist told me it is only of limited use.

So keep calm and keep on recovering.

Cheers, John.

User
Posted 08 Aug 2019 at 10:47

Thank John, thought that was the case. It was just that I posted this news on a Facebook forum (mainly USA contributors) and had comments saying 0.04 wasn’t undetectable, demand another opinion, 6 monthly psa test too long etc.

Edited by member 08 Aug 2019 at 13:19  | Reason: Not specified

User
Posted 08 Aug 2019 at 12:07

Neil


My PSA on DX was 7.7, my margins post surgery were positive and my PSA was 0.03. It took two years to exceed 0.1 and three years post op I was having SRT. Two years post SRT my PSA is now 0.22.  

 

That is my actual experience.

 

Thanks Chris

 

 

User
Posted 08 Aug 2019 at 13:22
Even with no Prostate you can produce a very small amount of PSA from the Adrenal Glands so not an absolute zero. Your PSA is low enough to be regarded as 'undetectable'. Nevertheless it is important to monitor your PSA at regular intervals to check if/to what degree/trend PSA increases as regardless of what was seen during the op and subsequently in the lab, it sometimes happens that minuscule micro cancer cells have escaped and there is a potential for these to cause a problem in due course. So be pleased with result so far but take nothing for granted.
Barry
User
Posted 08 Aug 2019 at 15:56
What was your final pathology??

If you are hi risk of BCR (T2c +) I would be inclined to insist on a test at 3 months.

0.04 is not an ideal result using the supersensitive assay BUT double check it wasnt a <0.04 which would be ideal. You may still have some PSA knocking about so a test in 3 months would be a safer bet IMHO.

Welcome to the world of stress that is ultra sensetive PSA!

User
Posted 08 Aug 2019 at 17:51

hi Neil ,

Fine to me. See my profile. See what 6 months brings. Enjoy life.

I'm on 3 months testing. admin 'error' maybe however I don't fret.  I find we are much more relaxed as time passes.  

best wishes Gordon 

 

User
Posted 08 Aug 2019 at 18:13

I’ve decided I’ve stressed enough over psa readings, if an experienced and highly regarded surgeon tells me my results could not be better and then puts me on 6 monthly psa tests, I’m guessing he knows what he’s doing. Yes I’ll give it some thought when my 6 monthly comes around but in the meantime I’ve got stuff to do, golf to play and a life to enjoy  ๐Ÿ‘

User
Posted 15 Aug 2019 at 12:38

Hi

Like you, I have an 'undetectable' PSA following surgery, actually 0.01.  I have read on academic websites (sorry I can't remember where) that the test is not very accurate at very low levels, as it is easy to mistake PSA for similar proteins.  Although I would like it to be 0, I still live my life as if I'm cured, despite knowing that there is a small risk that it will recur.

Given the slow-growing nature of prostate cancer and the salvage treatments available, I am more likely to die of another type of cancer that has not yet formed.  That may seem to some to be weird way of looking at it, but I find it helpful and positive. 

User
Posted 15 Aug 2019 at 12:42
I think our Matron here will tell you that some pregnant and post-orgasmic women have detectable levels of PSA, so my advice to you is to keep calm and carry on being โ€˜curedโ€™, until if and when you are advised otherwise.

Best of luck.

Cheers, John.

User
Posted 15 Aug 2019 at 13:30

Originally Posted by: Online Community Member
I think our Matron here will tell you that some pregnant and post-orgasmic women have detectable levels of PSA

 

Yes, my PSA must be about 10 today because I have been out shoe shopping ๐Ÿ˜‚

Seriously, our onco told us that Leeds Teaching Hospitals Trust did some research and found that women could have PSA readings up to 0.06 ... that's healthy non-prostate related PSA produced in other parts of the body. LTHT do not do ultra-sensitive testing any more. 

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

User
Posted 15 Aug 2019 at 17:33
Wondered what all the moaning was in Clarks!
User
Posted 15 Aug 2019 at 18:05
๐Ÿ˜‚๐Ÿ˜‚๐Ÿ˜‚
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Aug 2019 at 18:49

More like Jimmy Choo or Manolo Blahnik in the footballers’ wives shopping boutiques in Leeds!

Edited by member 15 Aug 2019 at 18:49  | Reason: Not specified

User
Posted 15 Aug 2019 at 20:51
Ah, you have nearly but not quite got me worked out - I like my shoes to be a little more unusual since people have to spend hours looking at them!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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