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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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@jc76 - nothing too interesting, I studied psychometrics in graduate school.
I asked about a post-op Decipher @jeffmarc and several times about ultra-sensitive PSA tests @brianjarvis and my surgeon at the Cleveland Clinic doesn't think either are necessary. I'm not too sure what the updated Decipher would add since I'm already considered high risk (no BRCA1/2 mutations). I also asked about a referral to a GU/MO but was told that happens if/when PSA > 0.2.
For now, I'll get my PSA tested every three months. If it becomes detectable, I will up my squeaky wheel level considerably.
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3 Reactions@psychometric Same at Mayo. So that's two top-notch that don't do it.
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1 Reaction@dhasper I did consider getting an ultrasensitive done myself but what is the point? They are not going to act on anything below .1 or even .2 anyway. .1 will give you plenty of time to get treatment plans in place. I guess you could get an estimate of doubling time but that isn't going to change the treatment plan either.
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1 ReactionI can see and understand everybody's view point (both doctor's and member's here). However, once you get blindsided (actually twice in our case) by false sense of "correct protocol", one gets super vigilant. We were advised to do ultra sensitive by our surgeon and also RO and my husband will always do ultra sensitive test anyways since doubling time has it's "prediction" quality - if it is really fast than a more aggressive salvage should be implemented (maybe longer ADT, or maybe triplet instead of doublet therapy, etc). IMHO having extra data is never bad idea, and catching cancer super early is always important. Salvage can be done earlier that 0.2 BTW. If there is clear rise and fast doubling waiting to 0.2 can cause PSA to rise ABOVE 0.2 while waiting for marker placement and scheduling etc. and one does not wish to go above 0.2 if at all possible.
Yes, having ultra sensitive test is more nerve wracking but what is not nerve wracking about having PC *sigh ?
CONGRATS !!! : ))) And may it stay that way forever !!! 🍀✨
@psychometric
I had RARP in April at Cleveland Clinic and was likewise told that there was no need for a post-op Decipher or an ultra-sensitive PSA. Fortunately both of my PSAs have been "< .02" which I understand to be undetectable.
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