PSA post RP - Interpretation please

Posted by undetectable @undetectable, Oct 27, 2023

ORIGINAL POST:
My husband just got this as part of his lab report almost 7 weeks post RP. Hasn't heard from doc yet. Can someone explain what F/T PSA >0.00 means? And 55% probability of prostate cancer??

Specimen ID: 1
Collection Start Date: 10/25/2023 3:43 P
FREE PSA [FREEPSA] 0.00 ng/mL
Free/Total P S A [F/T PSA] >0.00 % >25.00
55% PROBABILITY OF PROSTATE CANCER.
Performed on Beckman Coulter Access Analyzer

UPDATE: Assistant just called and said this is the correct PSA number, found elsewhere on report (so all good, I guess - assuming the above was a lab error??)

PSA HYBRITECH [PSAHYB] < 0.10 ng/mL 0.0-4.0

TEST PERFORMED USING HYBRITECH TEST KIT.

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Not a doc, but,
I can't really tell you what "Free/Total P S A [F/T PSA] >0.00 % >25.00" means, but it might just be a guideline like IF Free/Total P S A [F/T PSA] >0.00 % >25.00 THEN 55% PROBABILITY OF PROSTATE CANCER.
Doesn't matter, we know he had prostate cancer.

I'm assuming this is just a lab report of a blood sample.
We know he had prostate cancer, the testing / reporting system might not be different for those already diagnosed (mine is, Labcorp). It might be the same reporting as if he hasn't been diagnosed as of yet. If his psa is currently less than 0.10 I'd say things are looking pretty good, it depends on how high his PSA was at the time of surgery. I'm fairly certain my surgeon said PSA has a half life of 3 days. The important thing is that it doesn't start to trend upward.

It also appears he's not getting the ultrasensitive PSA test, there are arguments for and against this, but, it can help determine early if the PSA is rising again at an earlier point in time. For example, my reports don't go into the < category till the get to the 0.00X level.

As an example, my PSA was 13 at the time of my surgery and went down to < 010 at around the four month mark, which looking at my records, might be the first time I had a post RP test.
07/20/21 13.8
9/2/21 Surgery
01/26/22 0.039

best of luck to you! Hopefully someone will have a better answer on exactly what that line means.

REPLY

It seems what it says is that PSA is < 0.1. The general view is that it can be scientifically determined that 99% of the cancer cells are dead or removed. There is currently no technology to determine whether the remainder 1% exists or not. The clinical experience is that the amount of abnormal cells is so small, and/or so inactive that it does not do any harm. Probably for years. Hope that helps.
Dont mind me. I am just another layman trying to make some sense of the whole thing.

REPLY
@web265

Not a doc, but,
I can't really tell you what "Free/Total P S A [F/T PSA] >0.00 % >25.00" means, but it might just be a guideline like IF Free/Total P S A [F/T PSA] >0.00 % >25.00 THEN 55% PROBABILITY OF PROSTATE CANCER.
Doesn't matter, we know he had prostate cancer.

I'm assuming this is just a lab report of a blood sample.
We know he had prostate cancer, the testing / reporting system might not be different for those already diagnosed (mine is, Labcorp). It might be the same reporting as if he hasn't been diagnosed as of yet. If his psa is currently less than 0.10 I'd say things are looking pretty good, it depends on how high his PSA was at the time of surgery. I'm fairly certain my surgeon said PSA has a half life of 3 days. The important thing is that it doesn't start to trend upward.

It also appears he's not getting the ultrasensitive PSA test, there are arguments for and against this, but, it can help determine early if the PSA is rising again at an earlier point in time. For example, my reports don't go into the < category till the get to the 0.00X level.

As an example, my PSA was 13 at the time of my surgery and went down to < 010 at around the four month mark, which looking at my records, might be the first time I had a post RP test.
07/20/21 13.8
9/2/21 Surgery
01/26/22 0.039

best of luck to you! Hopefully someone will have a better answer on exactly what that line means.

Jump to this post

Congrats to you - great numbers! His PSA was 8.8 before surgery. He just found out that the F/T PSA test was indeed done in error. His surgeon sent an email clarifying that the < .10 result meant undetectable and he's cancer free. Not sure if he will get an ultrasensitive test at some point in the future. So all good for now!

REPLY
@wellness100

It seems what it says is that PSA is < 0.1. The general view is that it can be scientifically determined that 99% of the cancer cells are dead or removed. There is currently no technology to determine whether the remainder 1% exists or not. The clinical experience is that the amount of abnormal cells is so small, and/or so inactive that it does not do any harm. Probably for years. Hope that helps.
Dont mind me. I am just another layman trying to make some sense of the whole thing.

Jump to this post

Thanks, The doc acknowledged that he shouldn't have had the f/t (free) PSA test after surgery. So we're very happy with the < .10 - Not sure if he'll get the ultrasensitive test next time, but for now we're celebrating.

REPLY

Hopefully you will continue to get checked the next couple of years. There is a good start to recovery. So fare I have had 2 post-op PSA tests. They are 0. My PSA levels were never 0 for the last 7+ years. Praying for many happy 0's in those tests!

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@undetectable

Thanks, The doc acknowledged that he shouldn't have had the f/t (free) PSA test after surgery. So we're very happy with the < .10 - Not sure if he'll get the ultrasensitive test next time, but for now we're celebrating.

Jump to this post

We all make mistakes.

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Celebrate and enjoy life as before.

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Hi @undetectable, have you met with the oncologist in the meantime? What did you learn about the interpretation of the report?

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Thanks for checking in. Yes, the doc got back to my husband that evening and said to ignore F/T PSA (free) number because that test not meant to be administered after an RP. The surgeon said < .1 meant "PSA undetectable and cancer free!" Next test is in three months and not sure if it will be the ultrasensitive one. Meanwhile, all good!

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By all means, celebrate and be thankful!!! A PSA of < .1 % (less than one tenth of one percent) means that it is less than one in a thousand. In “layman’s” math, the pre-RLP PSA of 8.8 would equate to 8800/1000 odds. You’ve now gone to LESS THAN 1/1000! Yay!!! < .1 was defined by my Mayo urologist/surgeon as “undetectable.”

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