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Will PSA ever hit 0 or close to it?
I think you "regular" guys on here, know my husband's story.
Stage 4 diagnosis in Feb. Gleason 8 and 9s, PSA was close to 300!
Firmagon and Zytiga and prednisone and chemo over the summer.
PSA is still trending down but it's 0.33 now, last month it was 0.37, before that 0.44 and maybe before that 1 something then 2 something and so on, but the last few months it's slowed down drastically and we're worried that it's bad news, that it will never hit close to 0 (undetectable), I try to be positive that it's still going DOWN! but I've read online that if it's not 0 by 6-9 months, it's not a good future outcome.....I also read that Firmagon IS better than Lupron in these cases. So he'll stick with that for now, unless it's insanely $$ next year as our insurance won't cover it.
Anyways, I don't want replies about the Lupron, just what your thoughts are on the PSA levels.
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@jc76
I meant "undetectable" but I get what you're saying
@jc76 From my personal PoV, my PSA is undetectable if the test I'm using can't detect it. The regular PSA test makes perfect sense for routine screening and monitoring, because most men who haven't had a prostatectomy or radiation will have (normal, healthy) PSA well above 0.1 anyway, so the extra senisitivity brings no benefit.
For me, on multifaceted treatment for stage 4, I want the earliest possible warning when my mCSPC might be developing castrate resistance. As long as my PSA remains < 0.01 on the ultrasensitive test, my medical team is highly confident there's no _active_ prostate cancer in me, and that helps me feel more secure living day to day. It also helps them interpret scans: for example, with PSA < 0.01, its highly probable that lucency near my spinal surgery site is benign bone remodelling rather than new cancer activity, so we're just keeping a casual eye on it, but not doing any new radiation.
If/when my PSA becomes detectable on the ultrasensitive test, I'll have to deal with it, but I'm enjoying the deep remission right now.
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3 Reactions@jc76
I think you have the arrow backwards I think you meant to say < .1 not >.1.
I did say the medical community GENERALLY Considers < .1 As undetectable. I did not say they always consider that. I then followed it up by another message discussing other opinions, where some doctors consider < .03 as undetectable.
I’m not sure what you mean by < .10 Since that’s the same as < .1, though I never do include the zero After the < .1
Mayo does tell people that the undetectable PSA is < .1. They don’t just stop at .1. Other people have talked about it, people that are Mayo patients. One of them said they thought Mayo used < .001, But then they came back and said they were wrong and it was < .1.
And then there’s what AI says about it, They used widely instead of generally
After a radical prostatectomy, a PSA level of less than 0.1 ng/mL is widely considered by major institutions and medical professionals to be undetectable or negligible.
This threshold is a common clinical benchmark, as the goal of the surgery is to remove all prostate tissue, the source of PSA production. Different laboratories may report varying lower limits of detection (e.g., < 0.02 ng/mL or < 0.05 ng/mL using ultrasensitive tests), but for practical clinical purposes, anything below 0.1 ng/mL is generally viewed as an absence of detectable PSA.
@jeffmark
I will not speak or infer I am speaking for medical profession and experts on PC. This goes for test results, diagnosis, treatments. I will limit my post to my personal experiences with PC and what I told by my medical professionals for me specifically and my journey with PC. I will also per MCC guidance try to provide inspirations to others when ever possible.
You posted: "Actually the medical community generally considers < .1 as undetectable." Thus an inference you are providing the medical community.
Then you post you collected more information and posted:
"The threshold for an undetectable PSA level is not universally standardized." And give examples.
It is why I refrain from trying to post or infer speaking for medical industry, medical community, and medical professionals. I will post what my personal experience is and what I am told personally from my medical doctors. If I read something I will bring that information to my medical doctors and discuss that with them. Thus when I post not a medical post but what my doctors tell me for my specific case.
Mayo Jacksonville just opened it's $325 million dollar cancer center. It has many new diagnosis, treatments, etc. that they now offer versus what was available to me back in 2023.
You mentioned you don't post .10 just .1 I post what I am given per my labs. My message on undetectable comes from my personal experience of the numbers given to me and the answer to my question: "How low will m numbers go with my recent .10 results." Answer, You are not going to see numbers below .10 as Mayo Jacksonville considers PSA numbers below .10 as undetectable.
As I mentioned to another poster I am going to check with my PCP next month if Mayo Jacksonville uses a different ultrasensitive test on PSA when it applicable for different type patients.
I think we all know that 0 is not exactly 0 but "undetectable" 0.1 or the like...
My question was if anyone had teetered close to it without actually hitting it.
Will my husband's PSA get low enough before it eventually goes up again (what I've read online that's worse outcome)
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2 Reactions@jc76
A .10 result is not the same as < .10. It’s interesting they add a zero after the one and you’re not getting an ultra sensitive test. I’ve never gotten anything, but one digit after the decimal point.
Did they tell you it was below .10, Not that it was .10. It’s not quite clear from what you’re writing And those results Are not the same. For the last 25 months, my test has come back as < .1. I don’t expect it to last forever, but it’s nice to get a vacation.
The same as an AI search shows that < .1 is widely recognized as undetectable By many institutions, Are you saying people shouldn’t be informed about that? I’ve seen it in documentation from one of the major prostate cancer standard groups. But it’s not OK to tell people? They are also saying effectively that the medical community generally considers < .1 to be undetectable.
It’s an educational thing not a personal point of view.
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2 Reactions@beaquilter
I know a lot of people whose PSA has stuck around in the.1 to .3 or .4 Range after radiation and chemo. It doesn’t always have to hit Undetectable (< .1) To be considered the bottom for people that have those types of treatments.
The one place they expected to hit < .1 Is for people who have a prostatectomy since there is no tissue left to Produce a PSA. In those cases if it starts to rise at all, it means that the cancer has come back somewhere.
My brother is a perfect example. His PSA hit a bottom of .11 after radiation. It has risen a little since then, but not a significant amount. I know people who’ve had chemo that have had the PSA produce all different types of results, For some people, it is very successful in their PSA gets very low for others. It stays in range like my brothers or even higher, because the chemo was not 100% successful.
That’s one reason they do chemo again adding carboplatin. A neighbor of mine’s father has stage “five?” prostate cancer and is going for chemo plus carboplatin on a pretty continuous basis. It seems to keep him alive. I asked her about this stage five diagnosis and she tells me that’s what the doctor calls it, I think it’s really an advanced stage four Since technically there is no stage five.
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1 Reaction@jc76
> 0.1 means higher than 0.1. Some people posting do not seem to understand that < 0.1 is the normal way to present a PSA less than 0.1.
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3 Reactions@jc76
You disagreed with this
You posted: "Actually the medical community generally considers < .1 as undetectable." Thus an inference you are providing the medical community.
The article I referred to later said
The American Urological Association (AUA) and the European Association of Urology (EAU) generally define undetectable PSA as below 0.1 ng/mL post-prostatectomy.
Are you saying that the AUA and EAU are not the medical community? They sure seem to be exactly that. I even included the “generally” reference they used.
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2 Reactions@jeffmarc
You guys need to not your panties in a knot...lol
It's basically the same thing you're all saying.