Early symptoms prostate issues

@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.

@brianjarvis
Mayo Jacksonville uses standard, sensitive, and ultra sensitive. My Mayo PCP states the urologist, R/Os, etc. decide based on your specific cancer and risk level decide which test you will get. My R/O at UFHPTI ordered the same standard test as my PCP base on my individual and specific P.C. diagnoses.

I cannot comment on what other labs do or not do as I have no direct experience with them. .

Per my PCP different Labs and institutions define “undetectable” differently because they use the sensitive or ultrasensitive PSA machines. The labs or institutions may have different detection limits. Standard PSA tests use <0.1 ng/mL, while ultrasensitive labs may, and he repeated may, use <0.03, <0.02, or even <0.01 depending on the lab and institutions. Mayo uses it's own specific numbers but the <0.1 ng/mL for standard PSA undetectable is common standard.

With a new person on MCC I used the term undetectable on the Standard test. For me citing that is easier to understand than a number <0.1 ng/mL and defining what those number mean as much easier to say with the standard PSA test mine was undetectable.

My specific number came back, <0.1 ng/mL which my PCP stated does not go lower than that for standard test as they consider on standard test you have reached undetectable score.

I know for me it took several years to understand standard, sensitive, ultra sensitive as I could see lower numbers that mine and being reported on MCC as undetectable.

A good and thorough briefing by my PCP really helped me understand the different sensitivities and why he said you see different numbers for undetectable.

@tuckerp
The wording you used "This is not the group I preferred to join, but....." is something several of us in the past have said "We hope you do not join our group."

It was interpreted by some to be a rude comment not recognizing what was being said was "we hope you don't get diagnosed of having P.C. thus don't need to join I am diagnosed with P.C.

I wish in fact would have been an option for me but sadly got and was treated for P.C.

@jc76 sorry if that came across as rude. None intended. I was trying to say to @front that I followed a very similar path. His best option, as others mentioned is to not let it go but get a diagnosis. As someone else said, get the physical examination first. That led to my biopsy. Most likely BPH but he is doing the right things by reaching out for comments. The words "you have cancer" were a total shock to me. This is not the group I would have preferred to join. But what a wonderful well educated group it is.

Hi,
Like others have said, get this checked out by a Urologist. Your symptoms are not normal. If your current Urologist is blowing you off then go find another one.

Dave 3+4

@tuckerp
Hay @tuckerp, not sure why you thought you came across as rude. I certainly did not intend that to come across as that. I don't see anything in your post that was rude. I will return the "Sorry" if you felt, I felt it was rude. I had and do not have any any issue with your post.

When I was at Mayo Jacksonville seminar on prostate cancer one of the speakers said that the P.C. group was a very different story with the doctors. He went on to explain that no other cancer group is so well informed, done so much research, and full of questions. But I see that as a positive comment. It is your body and your cancer.