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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@jc76

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.

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See Rising PSA after treatment video at Prostate Cancer Foundation pcf.org Jan 17 2023.
My understanding is that each radiation patient reaches his low PSA point, or nadir, some length of time after radiation.
Then you monitor and watch for BCR from the nadir.
Best wishes.

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@wellness100

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.

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You are quite wrong about this and I'm quite surprised you would repeat this type of claim. I won't repeat my reply made Sept 7.

You need to reassess your level of knowledge in this area. I'm sorry, but these statements are incorrect.

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@drj

You are quite wrong about this and I'm quite surprised you would repeat this type of claim. I won't repeat my reply made Sept 7.

You need to reassess your level of knowledge in this area. I'm sorry, but these statements are incorrect.

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I am not aware of your reply. Sorry.
Anyway I was engaged with another member. My initial question was PSA after surgery under < 0.1 regarded as cure. How is that different from PSA < 0.1 as result of hormone or other systemic treatments.
As far as I know, undetectable means PSA is undetectable.
As for getting prostate cancer years after surgery, or hormone, the medicals have an answer to that.
That is all I have to say or want to say on this subject. I am not a medical professional. Just here to share whatever I know. That is all.
BTW. There is still a lot even the medical professionals do not know either.

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@michaelcharles

See Rising PSA after treatment video at Prostate Cancer Foundation pcf.org Jan 17 2023.
My understanding is that each radiation patient reaches his low PSA point, or nadir, some length of time after radiation.
Then you monitor and watch for BCR from the nadir.
Best wishes.

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Thanks michaelcharles. I will go on that web site and review

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It's not so much the number itself, it's how much it goes up and down from that reading. If it goes up a few points and then down again, I wouldn't worry about it. The time to start worrying is if it starts rapidly rising and doubling.

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