Post prostatectomy: What do rising PSA levels mean?

I had prostate removed in 2015. Since then, my PSA results had always come as one of the following (I guess depending on the lab): < 0.1 , < .05, < .01, or simply "undetectable". But my latest, using a new doctor, says simply "0.04" (without the < symbol). . I am worried. Any advice?

With USPSA comes "sensitivity" about changes in our PSA results. Think about this, were you using conventional single decimal place PSA tests which many do, you would be consider undetectable, <.2 and you would be having your next PSA tests in 6-12 months.

Since you are using USPA, every change becomes something to worry about. As you saw from my post and clinical history chart, there can be variability in an USPSA test which can be a function of different labs, type of assay used, calibration of equipment, pre-lab activity and routine...

My medical team and I continuously monitor my PSA every 2-4 months using USPSA but no action unless it continuously rises, no imaging until its between .5 and 1 and no decision on treatment until we image.

With the clinical data you shared, I would consider not doing any treatment and continue to actively monitor, determine decision criteria for when you would act - image, with what, where, at what PSA, what constitutes a cintinuos increase vice random variability...

I appreciate it, Kujhawk. I was just able to access my old lab results, going back to 2017, which I list below.
I am pretty sure that the last one came out of a different lab (based on the other blood results). The one I just got this month, 0.04, is also from a new lab, as I have moved to a new city. My worry is that if the 0.00 was accurate up to 2 decimal places, then the 0.04 would indicate a jump. I am hoping that the 0.00 is just their way of saying "undetectable" but that it is not actually accurate through 2 decimal places.
9/2017 < .1
4/2018 < .1
10/2018 < .1
4/2019 < .1
10/2019 < .1
11/2020 < .1
8/2021 0.00 (looks like a different lab)
8/2022 0.04 (different doctor and different lab)

Prostate removed 6/14/19 all psa tests since have been.01 had another psa Friday 9/3/22 came back <0.10ng/ml can’t get ahold of dr on vacation concerned about new results

Hi @gfletch, I can imagine you're concerned about the rise in PSA. Not being able to get a hold of your doctor who in on vacation compounds that concern. You've come to the right place to get some guidance and reassurance.

You'll notice that I moved your message to this existing discussion:
– Post prostatectomy: What do rising PSA levels mean? https://connect.mayoclinic.org/discussion/post-prostatectomy/

I did this so that you can read previous posts and see the multiple reasons that may cause a rise in PSA. And also so you can easily connect with fellow members like @ken82 @mrbill @hoard @bruto1 @oumike @itterac @dandl48 and many more

As @kujhawk1978 advised @natem: "No reason to hit the panic button" to which @jdill added "but you should learn the facts and work with your doctor."

There are several reasons why one's PSA level may rise after being stable for a time. This article explains it well:
– PSA levels after prostatectomy https://www.medicalnewstoday.com/articles/323899.php

Was this recent test evaluated by the same lab as previous tests? Were you scheduled for a followup test?

After prostate removal 2019 all psa tests have been 0.01 new test 9/2/22 psa 0.10 at a different out state lab , been reading that a sera psa reading of 0.10 is negative or same as native psa of 0.01 is this true

Edited this to update. It looks to me like you asked the question twice with two different sets of numbers.

If all those tests were 0.01 I'd and now you're getting <0.1 I'd suggest the new test is not ultrasensitive, in other words the two numbers might actually agree. < 0.1 could easily be 0.01.

#1 I'd take a deep breath as the new test as written <0.1 isn't really telling you anything other than you're not over 0.1.
#2 I'd call my urologist and see what they had to say, ask for his on call or person listed as replacement/stand in while on vacation.
#3 I'd suggest having another test in 2 or 3 months with the same (new) lab and look for movement in the number. If it's still 0.1 then it's likely not increasing. ...or go back to lab #1 and see if you still get 0.01. (second method preferred)

The issue here is making sure you're comparing apples to apples.

To answer your question literally, I've always understood anything in the non sensitive test realm less than .2 (post surgery) to be considered negative (at least the government thinks that). However, I believe that to be based on old technology testing wise.

It appears you were checked at .1 for quite some time.....and there did not seem to be a concern (as far as I know).....now you are at .04 and that is less than .1 ......if you are concerned and it appears you are...,I would have another test shortly and see the results. Was the Dr. concerned about the change from .1 to 0.00 and then up to .04 and is your Dr. a Urologist....if not, maybe he would refer you to one.

Dr David Thiel at Mayo Florida robotic removal 11/2009 with 3+4 Gleason. Have not been to urologist since back to Mayo 2015. PSA was .01 first 3-4 years and then going up. Went back to Mayo 2015 and PSA .18. Here are test results going forward: 8/15 .22. 6/16 .23. 9/16 .27. 10/16 .26. 3/17 .26. 6/17 .28. 11/17 .31. 3/18 .31. 6/18 .28. 9/18 .32
12/18 .35. 11/19 .5. 12/30 .47 10/21 .72. 5/22 .74. 9/22 .965x
Prostate oncologist at Vanderbilt
Said no concern in may 22 check 6 months and now says no concern and check in 6 months. ??????

Why does he say not to be concerned . And at what threshold does he recommend radiation?