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Anyone “below detection" with an ultra sensitive PSA test?
Prostate Cancer | Last Active: 1 hour ago | Replies (23)Comment receiving replies
@surftohealth88 Yes, I recall that from a 1997 paper now that you mentioned it, at least about the periurethral glands and breast tissue. Which then raises the question, why bother measuring PSA to three decimal places? If other organs can produce even minuscule amounts of PSA, can anything meaningful regarding prostate cancer be inferred from a PSA trend that goes from 0.003 to 0.009? I am not stressing out over this personally, I just don’t see the point of measuring PSA to such limits if it is not medically meaningful.
Replies to "@surftohealth88 Yes, I recall that from a 1997 paper now that you mentioned it, at least..."
@melvinw LabCorp charges 5x as much for uPSA that goes to .002 vs. their standard that goes to .1; so now more of a commercial / marketing reason (LabCorp is the only one to go to 3 decimals) vs. medical. The standard Quest PSA goes to .02 and is priced competitively with LabCorp's standard PSA. Most labs report to 2 decimal places on standard PSA tests now. There are over 5 different methods of PSA lab analysis. Quest, LabCorp std., and LabCorp uPSA use 3 slightly different methods. That is why it is recommended to get the PSA with the same lab. LabCorp may report standard PSA to 1 decimal to market their uPSA test. Other labs us the same PSA analysis and report std. PSA to .02.
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@melvinw Ultrasensitive PSA is medically meaningful in my specific situation (stage 4b, currently fully suppressed with ADT+Erleada):
< 0.01 (not detectable) means anything borderline that shows up in scans doesn't require too much additional investigation, beyond some follow-up scans to ensure it's not changing
>0.01 (detectable) could trigger biopsies or other more invasive tests for a borderline imaging result (or in the case of my thoracic spine, precautionary radiation, since the spinal fusion means it can't be biopsied).
My original cancer was very aggressive — I went from a twinge in my back to paraplegic in about 5 weeks — so I don't necessarily have the luxury to wait and see if something starts growing again.
I also recognise that my case is atypical (my original oncologist told me only about 5% of prostate cancer behaves like mine did).
Agreed that once it's detectable, it doesn't matter much whether it's 0.02 or 0.05.