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Prostate Cancer | Last Active: 1 day ago | Replies (11)
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Yes. the threshold is important. The standard PSA test can detect down to 0.1 these days, give or take. That's fine for screening, but not for detecting early signs of recurrence (there have been few — *very* few — cases of recurrence near that range). The ultrasensitive PSA (uPSA) test that I get goes down to 0.01, and I have not yet found any mention of recurrence when PSA is undetectable on the uPSA test.
So that's the application of uPSA: treatment has brought your PSA to effectively 0, and you want the earliest available warning of possible recurrence.
Agreed that the uPSA test would have no extra value if your PSA is already detectable on the regular test.
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Language, terms and definitions are powerful.
Early in my journey i confused undetectable with no prostate cancer.
I think over time I've adjusted to understand it simply means that it is not that the results mean here are no PCa cells, simply for that equipment and that assay, below the level of reporting, it cannot detect PCa cells which may be present, the infamous "sleeping" ones.
I, and you, know folks who treat very early one using USPSA. That is their choice, and they are comfortable with their approach and decisions doing so.
I have seen the other end of the spectrum, people and their medical team don't pull the trigger until PSA 10 or greater. again, they and their medical team are comfortable with that approach and decision.
Certainly, increasing PSA over several labs using USPA portends recurrence. The questions is, what do you do with the clinical data. As I've said before, my medical team and I use .5 as the trigger, image, then go from there. I'm high risk as you know, GS 8. GG4, 18 months to BCR, rapids PSADT and PSAV, so we treat "early."
Someone with say GG3, a GS 3+4, a PSADT >12 months...may decide to wait longer than I do, and likely they and their medical team are making a good decision.
Kevin