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First Post-op PSA result higher than expected

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User
Posted 03 Nov 2022 at 17:18

T2a N0 Mx Gleason 3+4 PSA pre op 8.75


Nerves spared on both sides of prostrate.


Just got the results back from my first post operative PSA test which was <0.04


From reading on here was expecting a result < 0.01. The clinical team seem to think that my result is normal. However this got me thinking what this result actually means.  This seems to indicate a result less than a threshold that the lab is able to detect. If I had a blood test at the hospital rather than my GP the threshold that they are able to detect might actually be lower if they are using more sensitive testing equipment. Clearly given the positive outcome immediately post op I am trying to convince myself that something more sinister is not going on here...

User
Posted 03 Nov 2022 at 22:24

Really good result Jim 👍


Our hospital measures to <0.03 and our GP <0.025. I always wonder if it’s better to get a more sensitive reading but generally no action would be taken until it reaches 0.2 or 3 consecutive rises above 0.1 so it would just cause us more anxiety for a longer period. We’re just enjoying the word undetectable while we can 👍

User
Posted 03 Nov 2022 at 17:58
The "<" sign implies that your PSA is below their lowest reporting value. From reading different people's posts here, I conclude that different hospitals use different reporting baselines. I don't know whether that is because they use different measurement technologies - I suspect it is more likely that they have different views on the level above which values are meaningful.

Either way the conclusion is that your PSA is not meaningfully different from zero. Which can't be said to be sinister.
User
Posted 03 Nov 2022 at 19:22

My first post op reading was <0.06 with a note 'undetectable'. Clearly the lab couldn't measure below 0.06.


Nothing for you to worry about. 


Good luck with your recovery. 


Peter

User
Posted 03 Nov 2022 at 20:25

Originally Posted by: Online Community Member
This seems to indicate a result less than a threshold that the lab is able to detect. If I had a blood test at the hospital rather than my GP the threshold that they are able to detect might actually be lower if they are using more sensitive testing equipment.


 


In all likelihood, your GP just sends the blood sample to the same lab that the hospital uses. The lower reporting threshold is determined by your NHS trust - in some areas, that will be 0.03 / 0.04 / 0.06 but ultra-sensitive PSA has been rather discredited recently so a number of Trusts have moved to 0.1. 


 


Your result is below the lowest possible in your Trust and therefore exactly what your surgeon hoped for when s/he removed your prostate.  

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 04 Nov 2022 at 22:54

Good result Jim and long may it continue. Hubby just had his third test (previous tests were <0.04). Today’s result <0.1 with an explanation “complexed PSA no longer available - total PSA results will not be reported below 0.1 ug/L”.  Thanks  Lynn for confirming as I did have a slight panic. Seems that a few Trusts are changing their parameters. 

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User
Posted 03 Nov 2022 at 17:58
The "<" sign implies that your PSA is below their lowest reporting value. From reading different people's posts here, I conclude that different hospitals use different reporting baselines. I don't know whether that is because they use different measurement technologies - I suspect it is more likely that they have different views on the level above which values are meaningful.

Either way the conclusion is that your PSA is not meaningfully different from zero. Which can't be said to be sinister.
User
Posted 03 Nov 2022 at 19:22

My first post op reading was <0.06 with a note 'undetectable'. Clearly the lab couldn't measure below 0.06.


Nothing for you to worry about. 


Good luck with your recovery. 


Peter

User
Posted 03 Nov 2022 at 20:25

Originally Posted by: Online Community Member
This seems to indicate a result less than a threshold that the lab is able to detect. If I had a blood test at the hospital rather than my GP the threshold that they are able to detect might actually be lower if they are using more sensitive testing equipment.


 


In all likelihood, your GP just sends the blood sample to the same lab that the hospital uses. The lower reporting threshold is determined by your NHS trust - in some areas, that will be 0.03 / 0.04 / 0.06 but ultra-sensitive PSA has been rather discredited recently so a number of Trusts have moved to 0.1. 


 


Your result is below the lowest possible in your Trust and therefore exactly what your surgeon hoped for when s/he removed your prostate.  

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 03 Nov 2022 at 20:51

Thanks Lyn that is good to know. Going to my GP is so much more convenient. If there is no benefit in going to the hospital for a more accurate blood test then I will refrain and calibrate future results against this one.


Managed to get online for my test results. The receptions at my GP missed out the less than '<'. Took a couple of phone calls to establish. 

User
Posted 03 Nov 2022 at 22:24

Really good result Jim 👍


Our hospital measures to <0.03 and our GP <0.025. I always wonder if it’s better to get a more sensitive reading but generally no action would be taken until it reaches 0.2 or 3 consecutive rises above 0.1 so it would just cause us more anxiety for a longer period. We’re just enjoying the word undetectable while we can 👍

User
Posted 04 Nov 2022 at 22:54

Good result Jim and long may it continue. Hubby just had his third test (previous tests were <0.04). Today’s result <0.1 with an explanation “complexed PSA no longer available - total PSA results will not be reported below 0.1 ug/L”.  Thanks  Lynn for confirming as I did have a slight panic. Seems that a few Trusts are changing their parameters. 

User
Posted 06 Nov 2022 at 08:56
They don't seem too concerned, unless your PSA rises above 1.0 - especially after RT - after all, you still have a Prostate in that case.
Probably more of concern, if you have had it removed.
The PSA test, is not too reliable - a lot of other factors in your life can effect it's reading. Which is why, it is not done, like some tests on the ladies are done.
 
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