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Ultrasensitive PSA vs. Standard PSA Readings
I am interested in hearing from others the differences they saw between standard PSA tests and the ultra sensitive test. I have always had the standard PSA test leading up to and after my 2016 RP. Now with my PSA creeping up and meeting with my RO, they ordered the uPSA test. For reference it was through LabCorp using the Roche ECLIA Methodology.
So 3 weeks prior, my PSA was .68 and .7 on two sequential tests and now using the uPSA it is .863. To me, either way that is an increase. The fact that the uPSA reads out to 3 decimal places is inconsequential. I guess the real question is does the uPSA tend to read higher than standard PSA tests? More out of interest really since I already am moving forward with scans, Orthovyx and radiation. Thanks!
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According to my urologist, that more sensitive PSA is better. I had the normal PSA and the first thing he did was send me in to get the enhanced PSA to verify the results. I don't know all the details of the differences of how they calculate that but one verified the other and led to more tests and, in the end, found my cancer - so I don't know if I can argue with the logic of ordering it.
I cannot speak to the numbers you posted, as I am still pre-op and don't know much about what PSA's should be post-op.
PSA fluctuates from day to day anyway, so a decimal place (or two) doesn't matter.
The huge benefit of the uPSA test is distinguishing between detectable and undetectable when you've had radiation or a prostatectomy and are currently on ADT.
If your PSA is undetectable on the uPSA test (e.g. < 0.01), then it's almost certain that your cancer is still castrate-sensitive and isn't progressing (according to my oncologists).
If your PSA is undetectable on the regular test (e.g. < 0.1 or 0.2, depending on the test), there's still a *very* small chance that your cancer is becoming castrate-resistant and might be progressing— there have been a handful of cases of that in the literature.
Disclaimer: not a doctor, haven't played one on TV, etc etc.
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2 ReactionsI do not think it makes a difference which PSA test is used.
I had RP; followed immediately (90 days) with regular PSA tests .19 (30 day repeat .18); followed by Salvage Radiation Treatment to whole pelvic region and pelvic lymph nodes together with 4 mos ADT.
6 - 18 mos later RO ordered uPSA testing "undetectable" < .02 thru Quest Diagnostics. A Salvage Treatment buddy has been tested post tx using the regular PSA test at < .1
My sense is the uPSA just allows a more precise monitoring.
So good thoughts for you and your upcoming Salvage Treatment.