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Detectable PSA 9 years post prostatectomy

Prostate Cancer | Last Active: Sep 27, 2023 | Replies (19)

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@jcrist1027

In general, I don't think any Oncologist or Urologist is going to recommend any action until you hit > 0.03 and rising (I think many won't go ahead with treatment until 0.05) There are many studies on prognositic accuracy of Ultrasensative PSA results. 0.01 is generally considered a "coin toss" point. Other studies think that .006 is useful but there are too many other variables I think to accurately predict the reliability at that low of a level. In a study the cohort is going to have varying pre and post treatment factors including pre-treatment PSA, genetics, lifestyle factors, etc. My University of Washington, known for their Urology clinic and cancer expertise, uses a test that considers undectable to be < 0.02. Which makes sense as some studies have shown men > 0.01 and < 0.03 that never had recurrence. You don't want to overtreat. Salvage treatment used to be done with two consecutive reading > 0.2! The > 0.03 cutoff now gives roughly 2 years more advance warning compared to the 0.2 cutoff giving the salvage treatment a much higher chance of success.

This is a good article:
https://prostatecancerinfolink.net/2015/09/12/johns-hopkins-ultrasensitive-psa-after-surgery-predicts-biochemical-relapse/
I would guess you would have gotten salvage treatment by now if you hit a 0.1 (not 0.01)

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Replies to "In general, I don't think any Oncologist or Urologist is going to recommend any action until..."

I just read that article you cite. That is just what I was looking for yesterday!

The related question I have is about variance. With uPSA tests, how much test/retest variance is there? In my case, I now have 3 3 month uPSAs, 0.012, 0.016, 0.012. Is that likely to be random variation or something else? (I'm using LabCorp, I understand there is more than one assay (testing strategy).)

Your article suggests that 0.03 is a meaningful cutoff, in which case I have at least one more, possibly several or many, to find out how the sequence emerges for me.

Since I'm new to this forum, I didn't see the first page of responses before my comments. I see @kujhawk1978 provides an extensive sequence, which is helpful. I notice he uses USPSA for what I've seen abbreviated uPSA and he adds KCUC, which I'm guessing is his testing site in Kansas City. It's encouraging to me to hear from people farther out in the journey.