How accurate are the PSA Tests?

Posted by richardB @richardblackman, Aug 29, 2023

I posted earlier that after 2+ years post surgery, my PSA had been undetectable < .006 on all my tests. Then my test 2 weeks ago, registered .117 (point 117). My urologist said she'll see how the results are in another test in 3 months. I wrote Hopkins Dr. Patrick Walsh ("Guide to Surviving Prostate Cancer." -- we go way back), asking who he would recommend for treatment if I get another spike at my next test in 3 months. I figured it would be radiation & maybe ADT for sure. Before anything he had me take a repeat test at the Hopkins lab . The results were < .03, the lowest they go. Go figure. An anomaly? The bike riding and ejaculation I did just before the test? Not complaining, but my lesson is that if I get a really odd test, I'd want a retest.

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spino | @spino | Sep 6, 2023

In reply to @wellness100 "Is it possible to have undetectable and declining PSA and develop bone mets?" + (show)

Good question. Let's say that it's not the most likely situation, but unfortunately we can't rule it out completely, because that's not how science works. Some aggressive forms of prostate cancer are known for not being reflected by PSA levels. This is just my reflection on what I've read, not a statement by a researcher.

wellness100 | @wellness100 | Sep 7, 2023

In reply to @spino "Good question. Let's say that it's not the most likely situation, but unfortunately we can't rule..." + (show)

Thanks for sharing. Like they say we dont know what we dont know. We know PSA < 0.1 means no prostate cancer. That is pretty much generally accepted. That is we know what we know.

spino | @spino | Sep 7, 2023

In reply to @wellness100 "Thanks for sharing. Like they say we dont know what we dont know. We know PSA..." + (show)

I might disagree with that statement. Being the skeptic I am, I assume that medical people allow clients to believe that undetectable cancer is not there, but they still know it is. That's why once you have stage 2 cancer, they never back you up to stage 1, etc. I will always have stage 2 cancer "in remission" if you like until I have stage 3, and "in remission" really means we have no evidence of its progress at the moment.... But again, this is a skeptic. Other people will look at this situation far more optimistically 🙂 (and I assert the medical personnel generally don't mind if they do!)

wellness100 | @wellness100 | Sep 7, 2023

We dont know what we dont know. The point is not that. Rather it is about what gives? Say you have PSA < 0.1 or whatever after surgery. You have hormon treatment and same PSA. What is the difference?

mrscott | @mrscott | Sep 11, 2023

In reply to @melcanada "PSA 7.8 then on Xtandi 1.7 then 2.3 then 3.0 do I worry" + (show)

You talk to an oncologist. The steadily increasing numbers are a bad sign.

melcanada | @melcanada | Sep 12, 2023

In reply to @mrscott "You talk to an oncologist. The steadily increasing numbers are a bad sign." + (show)

9.8 down to 1,7 then 2,3 now 3 with L2 bone mets and on Xtandi Comment please

Xgeva and Zolodex too Testosterones 0

jc76 | @jc76 | Sep 23, 2023

I am at the after radiation treatment (proton beam 30 treatments) phase and had my first PSA after treatment test on 09/22/23. Prior to radiation PSA was 3.75. 3 months after end of treatments my PSA is now 1.2. Not sure if this is good, common, low or high feedback would be helpful.

Can I asked those who have had radiation only treatments what their first PSA after radiation treatments were? I am told that the first PSA tests are not indicator of treatment cure as prostrate is still very irritated after radiation. Is this something you have heard also. I was also told that radiation does not kill cancer but damages the cells of cancer so it cannot reproduce itself unlike the regular prostate cells which can repair themselves and grow back. Have you heard the same?

I have found MCC as one of the most valuable resources for those with prostrate cancer. I thank Mayo and the moderator for having this forum. Will have next visit with oncologist/radiologist on 10/04/23 so will be asking about PSA then but would be helpful with feedback from others.

melcanada | @melcanada | Sep 24, 2023

In reply to @jc76 "I am at the after radiation treatment (proton beam 30 treatments) phase and had my first..." + (show)

Get on Zolodex to stop testosterone the food for PC after 30 days of Cosodex

Immune system support Turkey Tail mushroom's ww.realmushrooms.com

jc76 | @jc76 | Sep 24, 2023

In reply to @melcanada "Get on Zolodex to stop testosterone the food for PC after 30 days of Cosodex Immune..." + (show)

Because I have heart failure Mayo Jacksonville oncologist/radiologist ruled out hormone treatments during initial consultations. Then after I did my Decipher test that came back low risk not intermediate. Mayo Oncology/Radiology said hormone would not be a treatment needed with low risk.

UFPTI also did not recommend hormone treatments.