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Early symptoms prostate issues
Prostate Cancer | Last Active: Aug 22 10:36am | Replies (16)Comment receiving replies
@brianjarvis
Per my Mayo R/O and UHFPTI R/O quite common for those with radiation only to have a non detectable standard PSA test.
What I have seen on MCC (Mayo Community Connect) and from the feedback of my doctors is those who get a low risk Decipher (like me) are routinely given treatment plans that do not have hormones. But this is up to the Urologist and R/Os. I got the same treatment plan by doing a second opinion from another major medical institution and two separate R/Os.
On a standard PSA test, “undetectable” means anything below 0.1 ng/mL. This comes from PCP, Urologist, and my R/Os. The differences in types of PSA test information is available from medical web sites and major medical institutions like Mayo, Cleveland Clinic, John Hopkins.
When I brough this up with my PCP, urologist, R/O they said they decide which PSA test is appropriate for each patient. Per my PCP a patient who had proctectomy, or medium or high risk Decipher along with other parameters medical professionals to use decide treatment plans would get the sensitive test or ultra sensitive test (Mayo's lab can do both).
The sensitive and ultra sensitive PSA test are much more in depth and "sensitive." But I have the ongoing "standard test" with anything below 0.1 ng/mL is considered undetectable. Could I have some PSA show up on a sensitive and ultra sensitive most likely as you said the prostate keeps making PSA when it has not been removed.
I started with a 3.75 PSA. After radiation treatments it slowly went down until if reach undetectable on the standard PSA test.
I hope this answered your question.
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@jc76 As I understand the terminology, in order to actually be “undetectable,” the PSA must be preceded by a < (the mathematical “less than”) symbol. Without that symbol preceding the number, the PSA isn’t “undetectable.” (They may consider it undetectable without that symbol, but that’s an arbitrary decision.)
As for the term “undetectable” itself, all that it means is that the PSA is below the detectable limits of the lab equipment being used. So, if the lowest detectable limit of the lab equipment being used is 0.1 ng/mL, then any PSA less than that - i.e., “undetectable” - will be indicated as <0.1 ng/mL.
At the cancer center where my PSA is tested, the lab can test down to 0.008 ng/mL. For them, undetectable is indicated as <0.008 ng/mL. At the local CompuNet labs, they can only test down to 0.02 ng/mL. For them, undetectable is indicated as <0.02 ng/mL. The LabCorp facility PSA testing has different sensitivity.
What you’ll find is that without ADT, PSA will rarely reach “undetectable” following external radiation treatments - unless the testing lab equipment has limited sensitivity. In fact, without ADT it can take many months (up to 18 months I’ve read) for PSA to reach nadir.
ADT is rarely given for 7(3+4) - unless there are other significant risk factors; and is usually given for 7(4+3) - unless it’s indicated as not beneficial by one of a number of biomarker (genomic) tests. NCCN guidelines set the baseline (here in the U.S.) as to whether ADT is recommended, from there it’s up to the Urologist and R/Os (& patient) to tweak treatments as needed.
What is considered “undetectable” at various PSA testing centers depends on the sensitivity of the various lab testing equipment as well as the calibration methodology used (of which there are at least three).
As for ultra-sensitive PSA testing, the number of significant digits for those varies from facility to facility as well.