Bit of a conundrum re the Ultra sensitive PSA test

The most sensitive for clinical reporting is 0.003 as far as I know. One hospital near me uses this for their prostatectomy patients.

There are more sensitive tests used for research, but not for clinical reporting.

I would disagree from the results shared with me from my local hospital. The usPSA results are very consistent for each patient. One prostatectomy patient who shares his results has been 0.006 for years now, and another is steadily increasing by 0.001 or 0.002 every reading. If graphed, the lines would be very smooth.

They only use usPSA for prostatectomy patients.

I am a fan of ultra sensitive.  After my prostatectomy, my PSA went from 0.014, 0.015, 0.019 to 0.023.

I had a PSMA scan which miraculously picked up some cancer in some nodes.

Salvage radiotherapy and bicalutimide followed.  PSA has been <0.006 since the of SRT in June 2018. 

Next PSA test early February.  If it is still <0.006, I'll be discharged from oncology and will have an annual PSA test through my GP.

Feeling butterflies in my stomach as I type - the pre PSA test jitters are starting.

What many do tend to forget is the oncologist has a full set of data to look at, not just PSA results.  0.023 was really low, but as I had Gleason 9, pT3b, positive margins, peri neural spread, extra capsular extention, the oncologist knew something was going on.  Given the mess I was in, it was pretty obvious from the start I'd need a range of treatments.

The only question I have about the normal PSA test is how long I would have waited until I got to 0.1 for investigations to begin.

That said, I do think we need to remember we are all individuals and that dictates our treatments.    Listen to your oncologist.

Hi,

My initial thought, Librajc, is your psa is so low it can only be used as reference for future tests and not to determine whether there is something to worry about.  It's a very small fraction of a thousand-millionth in a milli-litre.

It seems whatever the level you wonder what it really means.   I've wondered if say 0.05 means 0.0450 to 0.0549 or 0.05 to 0.599 as it could make a big difference in doubling time on the previous or next test at those low levels.

 Reducing anxiety appears to be one of the reasons hospitals adopt higher thresholds and it likely does work.   Although Ulsterman comes up to disprove it around 0.02 and I would support a minimum of <0.03 which has been said to produce a consistent minimum.

All the best
Peter

Edited by member 09 Jan 2022 at 15:51  | Reason: Not specified

0.04 is a usPSA test

Many labs have stopped offering usPSA as it is increasingly considered unreliable. If your consultant wanted you to have usPSA, s/he would have told you where you should go for your tests. 

Edited by member 08 Aug 2022 at 23:39  | Reason: Not specified

My prostate was removed in the US.  I was able to have ultra sensitive tests there,  but have struggled to find any since I moved back to the UK.  I had one in Singapore last year whilst travelling. My NHS GP says he's never heard of USPSA. Any help pointing me in the right direction would be appreciated.

0.05 absolutely should mean 0.0450 to 0.0549.