Difference between "PSA" versus "Screening PSA" ?

Posted by rockin2047 @rockin2047, Aug 4, 2023

Not long ago my PSA was 3 ng/ml as reported by LabCorp. Then, on July 15, 2023 my Consultation Notes from a Radiation Oncologist mentioned that my "Screening PSA" was 7.6 ng/ml. However, on this same report it indicated a PSA of 3 ng/ml. So, what's going on here? Is there some sort of secret algorithm being used? Historically, my PSA over the last 10 yrs has been rising slowly up to 3 ng/ml.

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Hey @rockin2047

I see this has been sitting for a couple days. It may mean we haven't heard of this. I haven't It may be a phrase your doctor uses as opposed to an actual "status" on your labs.

I took a quick look at the titles of your other posts coupled with the fact you're seeing a radiation oncologist, I'm guessing your been diagnosed with pca but I don't see if/how you were treated.

I would contact the office and get a clarification for sure on this. This is obviously causing some anxiety or you wouldn't be posting it here. I'd get an answer, maybe there's a portal for your doc? If not, I'd call.

This is a WAG, (Wild A** Guess) It may be something as simple as that's the target PSA he's decided to use for further screening like a PSMA PET scan or other diagnostic tool. Please let us know what it turns out to be.

Best of luck to you!
Mike

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@web265

Hey @rockin2047

I see this has been sitting for a couple days. It may mean we haven't heard of this. I haven't It may be a phrase your doctor uses as opposed to an actual "status" on your labs.

I took a quick look at the titles of your other posts coupled with the fact you're seeing a radiation oncologist, I'm guessing your been diagnosed with pca but I don't see if/how you were treated.

I would contact the office and get a clarification for sure on this. This is obviously causing some anxiety or you wouldn't be posting it here. I'd get an answer, maybe there's a portal for your doc? If not, I'd call.

This is a WAG, (Wild A** Guess) It may be something as simple as that's the target PSA he's decided to use for further screening like a PSMA PET scan or other diagnostic tool. Please let us know what it turns out to be.

Best of luck to you!
Mike

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Yes, I have been diagnosed with PCa. Well this is interesting, I just checked my hotmail inbox where there is my Consultation Notes which have now been Updated showing a Screening PSA of 3.0 ng/ml which is correct. The takeaway is to be alert and detailed concerning any reports and lab results where there may be questions or possible errors.
At this time I'm narrowing down my treatment options between Viewray MRdian versus CyberKnife radiation approaches. Even though my Decipher test result was 0.37 Low Risk, I do have a family history of various cancers including my dad who died of PCa because it was diagnosed too late. One tumor I have is (3+4=7 Gleason). While Active Surveillance(AS) is very tempting, I don't want it to evolve into a 4+3=7 tumor. In the U.S., "about 60% of low-risk patients choose monitoring, now called active surveillance" according to this report: Study finds prostate cancer treatment can wait for most men https://www.nbcnews.com/news/us-news/study-finds-prostate-cancer-treatment-can-wait-men-rcna74512

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I was told by my doctor, that a Screening PSA is done for the average guy during a checkup or if he has symptoms. The other PSA , is called a Diagnostic PSA. This is done when the doctor already knows that you’re being treated for cancer and wants to know how it’s progressing or if the treatment is working. I have a diagnostic test done every 4 months. Both tests will give you the same results. It’s just different names given for billing purposes. By the way , Medicare won’t pay for multiple Screening PSA tests per year. This billing department told me this. Hope this helps.

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@firespooks

I was told by my doctor, that a Screening PSA is done for the average guy during a checkup or if he has symptoms. The other PSA , is called a Diagnostic PSA. This is done when the doctor already knows that you’re being treated for cancer and wants to know how it’s progressing or if the treatment is working. I have a diagnostic test done every 4 months. Both tests will give you the same results. It’s just different names given for billing purposes. By the way , Medicare won’t pay for multiple Screening PSA tests per year. This billing department told me this. Hope this helps.

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Thanks @firespooks for clarifying things. By visiting the Medicare FAQ webpage it states that "Medicare Part B will cover prostate-specific antigen tests once every 12 months." Therefore, a screening PSA in Nov 2022 is covered, but another one in say June 2023 would not be UNLESS the doctor deems it medically necessary. So it's based on a 12 mo period and not on a calendar year. How did you arrive at a 4 mo cycle for diagnostic PSA tests? Your choice or your doctor's? What type of treatment did you decide on? If you had any side effects were they temporary? Again, your input is appreciated.

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My oncologist recommended my PSA testing every 4 months . I have recurrent prostate cancer for the 2nd time. I had a Prostatectomy in 2006 then 39 salvage radiation treatments in 2013. I am now watching my PSA slowly rise again . Both of my doctors want to hold off on any further treatment, because of the side effects.

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64 yrs old. Overall healthy. Was told by urology that tumor escaped to SV (seminal vesicle) after RP in April this year. I req to have PSA done very month. First PSA was 0.049 in June, 0.067 in July and jumped to 0.087 in August in two months. Although still un-detectable, oncology suggested ADT + RAD. Took bicalutamide a wk ago. Have no side effects so far, Waiting for hormone injection (Trelstar) in couple wks then radiation in couple months.

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@benice268

64 yrs old. Overall healthy. Was told by urology that tumor escaped to SV (seminal vesicle) after RP in April this year. I req to have PSA done very month. First PSA was 0.049 in June, 0.067 in July and jumped to 0.087 in August in two months. Although still un-detectable, oncology suggested ADT + RAD. Took bicalutamide a wk ago. Have no side effects so far, Waiting for hormone injection (Trelstar) in couple wks then radiation in couple months.

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As long as your doctor says a PSA test is medically necessary, Medicare and secondary insurance will cover it. Rising PSA generally means the PCa is spreading, but for you very slowly. Taking ADT is supposed to bring down the level of Testosterone which acts like fertilizer for PCa tumors I believe. Don't hesitate to get a second opinion (or even a third) from completely different providers (radiation oncologists). Tip: I always seek out the head of a radiation oncology department since they have the most yrs of experience. There are also certain foods that can lower Testosterone See 6 Foods That Lower Testosterone Levels at this site https://www.healthline.com/nutrition/foods-that-lower-testosterone Of the 6, I'd enjoy eating flaxseed and walnuts. Walnuts are great on oatmeal with some maple syrup.

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@firespooks

I was told by my doctor, that a Screening PSA is done for the average guy during a checkup or if he has symptoms. The other PSA , is called a Diagnostic PSA. This is done when the doctor already knows that you’re being treated for cancer and wants to know how it’s progressing or if the treatment is working. I have a diagnostic test done every 4 months. Both tests will give you the same results. It’s just different names given for billing purposes. By the way , Medicare won’t pay for multiple Screening PSA tests per year. This billing department told me this. Hope this helps.

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Biopsies results from 8 lymph nodes confirmed cancer in one of them. I’ve gone the active surveillance route. I’ve been tested every three months. My tests requests have come from my oncologist and my family doctor. Medicare and Tri-care have paid for the tests. It’s been 20 months now since my surgery, and the good news is my PSA has been less than 1.0.

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@rockin2047

Thanks @firespooks for clarifying things. By visiting the Medicare FAQ webpage it states that "Medicare Part B will cover prostate-specific antigen tests once every 12 months." Therefore, a screening PSA in Nov 2022 is covered, but another one in say June 2023 would not be UNLESS the doctor deems it medically necessary. So it's based on a 12 mo period and not on a calendar year. How did you arrive at a 4 mo cycle for diagnostic PSA tests? Your choice or your doctor's? What type of treatment did you decide on? If you had any side effects were they temporary? Again, your input is appreciated.

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Luckily we have Quest Labs in our city. I can order and get a PSA test for $59 if I feel I need extra testing. and the lab will send the results to Dr or Medical facility if I request it. My insurance has covered all of my testing, which is every 3 months right now. At some point the Dr will change that. It is nice to know that if I feel I need to check on it sooner, I can go and get the test without a Dr.

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@firespooks

My oncologist recommended my PSA testing every 4 months . I have recurrent prostate cancer for the 2nd time. I had a Prostatectomy in 2006 then 39 salvage radiation treatments in 2013. I am now watching my PSA slowly rise again . Both of my doctors want to hold off on any further treatment, because of the side effects.

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I have the same history. My urologist put me on finestride. R u on any meds now. My second bcr psa went .24,.32,.41 over 7 months. Any future treatment recommendations? 4/15/23 psma pet scan negative

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