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PSA "undetectible" for amost a year
Prostate Cancer | Last Active: 6 hours ago | Replies (38)Comment receiving replies
I have a background question. If a "normal" PSA for men over 60 can be in the 3.0ng/mL range, for men who have been diagnosed and treated for prostate cancer why are the levels of concern 1.0ng/mL or lower, to the point of "detectable"? I put this to Copilot that pointed out that the prostate is usually much smaller after treatment, which is reasonable, but is that it? Thanks.
Replies to "I have a background question. If a "normal" PSA for men over 60 can be in..."
@carbcounter
The answer to this question Is based on the treatment the person received.
If someone gets a prostatectomy then the PSA should stay undetectable. If It reaches .2 It is considered a case of reoccurrence and should be treated with radiation. There are a few cases where people have reached .2 and it just stayed there.
When it comes to radiation treatment for prostate cancer, the standard is that they don’t treat until the PSA reaches two points above the lowest it ever reached following radiation. If after radiation, it hit .1 then they would not treat until it hits 2.1. It would make sense to do a PSMA PET scan after it hits 1 since it is more likely to show if a Metastasis is causing the rise.
@carbcounter
Your PSA numbers are pertinent to the type PSA test you are taking. I have the standard one every 3 months and mine is now undetectable. <0.1 You posted <0.02 so you are having the ultra sensitive test done. I have no experience even though I am aware of what they mean from A.I. so will not comment on the numbers from it.
But just know not all labs have the same undetectable range for ultra sensitive test versus a standard number when using standard.
From Co-Pilot A.I. it describes it much more accurately than I can. But same information was given to me by my PCP but it was verbal.
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A.I. Co-pilot:
"Professional guidelines (AUA, EAU, NCCN) keep the universal definition at <0.1 ng/mL:"
"Different institutions define “undetectable” differently because their ultrasensitive PSA machines have different detection limits. Standard PSA tests use <0.1 ng/mL, while ultrasensitive labs may use <0.03, <0.02, or even <0.01 depending on the assay."
Hope this helps. Always talk to your urologist or medical provider who is ordering your test of what type test is being done and what they mean for you. Not what someone gives you on MCC as you are an individual and it depends on what type test is being done the specific lab doing it.
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@carbcounter
The key is that the PSA ranges are being used in two completely different settings. In a man with an intact prostate, PSA comes from normal prostate tissue as well as cancerous tissue, so a PSA around 3 ng/mL may be within range adjusted for age.
After radical prostatectomy, however, the prostate has been removed, so there should be little or no PSA-producing tissue left. That's why PSA is expected to become undetectable. A subsequent detectable and especially rising PSA can therefore be an early warning that prostate cancer cells may have returned. That's also why post-treatment PSA thresholds are much lower than the "normal" PSA ranges used for men who still have a prostate.