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PSA undetectable!
PSA < 0.1 ng/mL on my first test since my RARP on June 18th. Labcorp (non-ultra) test using Roche ECLIA methodology. It's only the first result of many tests to come, but I'll take it!
Initial PSA: 6.68.
Pathologic Gleason Score was 3 + 4.
Grade Group: 2.
Biopsy Gleason Score was 3 + 4.
Pathologic Stage: pT3bN0M0R0.
Positive Margins: No.
Cribriform Histology: Yes.
Intraductal Histology: No.
Number of Lymph Nodes Removed: 15.
Number of Positive Lymph Nodes: 0.
Unfavorable histology: Present (Less than 10%).
Large cribriform pattern 4: Present.
Intraductal carcinoma: Atypical intraductal proliferation, suspicious.
Risk Group: High.
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🙂 Great news 🙂 That's a great score and it *should* continue to drop! 🙂 Go Celebrate! 🙂
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1 ReactionHappy for you. I am stage 3a and have my first blood test in a few weeks.
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1 Reaction@jayhall That won't continue to drop that is the lowest the non ultra test goes.
That’s the best you can hope for. Surgery definitely got it for now.
I don’t see a decipher score. Because you have large cribriform it would be good to see what results of a decipher score are. According to UCSF large cribriform make a Gleason score have a five, So That 3+4 is not really a 3+4.
I suppose that’s why they gave you a risk group high.
Hopefully, you will not have any issues in the future.
@jeffmarc
My Decipher score at time of my original biopsy was 0.56.
@psychometric
Quite a unique I.D. Is there something behind it. Don't have to answer but I find the I.Ds. used interesting.
Great news on you PSA!
@psychometric
I suspect that decipher test was before they found large cribriform. That would increase your decipher score a lot. You may want to have another one done if possible.
A PSA of < 0.1 ng/ml is a good number. However, you don’t know if that < 0.1 ng/mL might be a 0.01 ng/mL or a 0.001 ng/mL because the test equipment they’re using isn’t sensitive enough to test that low. (The cancer center that I go to tests down to 0.008.)
Following any treatment, you’d really want to know how low it really is. You should ask your doctor about this.
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1 Reaction@brianjarvis My urologist/surgeon at Mayo told me they stopped using the ultra-sensitive PSA post RALP. Has anyone had a different experience?
@dhasper I had 28 sessions of proton radiation, but during our months of decision-making, my medical team discussed the post-treatment nuances of both radiation and RP with me. The way they described it to me —>
Following radiation, in time PSA should be < 0.1 (with “< “ meaning “less than,” i.e., undetectable). Over time, following radiation PSA should rise since there’s still a healthy prostate producing PSA at a new (low) normal. (I do agree that following radiation, testing to >0.00x is probably overkill; but, if they’ll offer it, I’ll take it!)
A few months (3-6 months) following RP, PSA should be well below 0.1 ng/mL since there’s no longer a prostate producing any PSA. (There may be remnants left in the bloodstream, which is why retesting at 6 months is helpful if PSA isn’t quite there at 3 months). But, you’ll never know how much “well below” 0.1 ng/mL it is if the equipment can’t test below that. In fact, following RP, if PSA begins to rise and approaches 0.1 ng/mL, that’s a heads-up that there might be a problem. But again, you’d only know that if the equipment could test PSA < 0.1 ng/mL. (At the very least, they should test to 2 decimal places.)
As always, discuss all this with your medical team.