PSA at 0.04 six months post RARP

This can be quite normal, especially when using different labs. Wait for the next test in three months before really getting concerned. While anything is possible this is normally not a big deal.

I don’t get the ultra sensitive test because I don’t want to worry about minor changes like this.

0.0 anything is a win & an excuse to celebrate.

I asked my surgeon at what point do they consider further action. he said when it gets to 0.2
Let's hope we don't get there.
Congrats on a 0.0 anything.

@jeffmarc Thanks, Jeff. This is reassuring. Maybe I should have stuck with the normal test.

@topf It’s normal at this point but do aim for consistency with your lab work.
I wanted to use Quest but Sloan insisted that I use their lab only, so it is an hour drive each way; it’s a pain in the ass but I know the numbers are arrived at in a consistent fashion.
If your PSA begins to trend upward at 3 month intervals, your PSA velocity (or a reading of 0.2) will determine your need for SRT. Nothing you can do at this point but test, test, test…
Phil

@heavyphil Thanks for the reply! I will stick with the lab I am at now.

@topf
We used UCSF and WalkInLab and both had exactly the same result. BUT, we will try to use hospital lab from now on, just for the sake of consistency. Same as Phil's sitiation - it is one hour drive in one direction, but I think that it is better to do it always at the same place.

Since my husband is gleason 9 and had some tiny EPE etc,. our MO suggested that 0.05 could be an action initiation point for early salvage. We do ultra sensitive test for that reason and we do it every month (on our dime and that is why we use WalkInLab) to be on a safe side.

You will know more in 3 mos and fingers crossed it will drop back to 0.02 . At this point all of us can only test and hope ; ).

Agree with Jeff on changing labs. It can make a difference.

@topf
My UHFPTI R/O stated to me first day I met with him to do the PSA test at same lab every time. If not you are going to see different results when there is different lab equipment and procedures'.

My Mayo PCP said same thing and agreed to schedule all my PSA tests at Mayo Jacksonville. Talk to you doctor about the lab they refer you to and what is considered undetectable at that lab. If me would go to same lab even if have to drive further.

The labs at Mayo Jacksonville a >.10 is considered undetectable and no lower numbers are given. My last PSA was .12 at 2.5 years after treatments. My PSA at time of diagnosis was 3.75.

You will see numbers listed below >.10 from posters who use different labs. It depends on the lab you are using and what their equipment and test indicate a undetectable number.

I found this article on the clinical significance (or insignificance) of ultra-low PSA values to be vey informative.
https://biologyinsights.com/is-0-04-psa-considered-undetectable/

@melvinw Thsnks for posting. Good article.