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PSA "undetectible" for amost a year

Posted by soli @soli, 2 days ago

The fourth consecutive PSA result came back at <0.02 ng/mL, nearly one year after surgery.

Four consecutive undetectable PSAs over nearly a year are certainly reassuring and indicate that there is currently no detectable biochemical recurrence. However, they do not mean it is “all clear.” They also do not erase my longer-term recurrence risk given my adverse pathology and biology: Gleason 3+4, pT3b with seminal-vesicle involvement, extracapsular extension, lymphovascular and perineural invasion, and a high Decipher score.

For now, I plan to continue with my current strategy of regular PSA monitoring and reserving salvage radiation for a confirmed rising PSA rather than automatically pursuing adjuvant radiation. Why subject myself to treatment and its potential side effects before I need it? If there is roughly a 50% chance that I will not experience a recurrence, why undergo treatment now that may ultimately never be necessary?

I’m encouraged by the continued undetectable PSA and, as always, I welcome any and all input from the group.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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heavyphil | @heavyphil | 4 hours ago
In reply to @diverjer "I was also a Gleason 3+4, pT3b with seminal-vesicle involvement, but they cut them out. 1)..." + (show)
Profile picture for diverjer @diverjer

I was also a Gleason 3+4, pT3b with seminal-vesicle involvement, but they cut them out.
1) Also had Non-focal extraprostatic extension is present.
2) Then further down said Margin Involvement by Invasive Carcinoma in Area of Extraprostatic Extension (EPE): Not identified.
That seems to be a contradiction? First one means Non-focal extraprostatic extension (EPE) means prostate cancer cells have grown through the outer edge of the prostate gland into the surrounding fatty tissue in a more extensive or widespread manner rather than just a tiny, isolated spot.

The second one means the cancer does not touch the outer edge of the removed tissue sample in the area where it grows outside the prostate.

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@diverjer That’s pretty much what mine was…a ‘tiny’ break in the capsule, but surgical margins negative.
Needed SRT 5 yrs later anyway…
Phil

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jc76 | @jc76 | 4 hours ago
In reply to @carbcounter "I have a background question. If a "normal" PSA for men over 60 can be in..." + (show)
Profile picture for carbcounter @carbcounter

I have a background question. If a "normal" PSA for men over 60 can be in the 3.0ng/mL range, for men who have been diagnosed and treated for prostate cancer why are the levels of concern 1.0ng/mL or lower, to the point of "detectable"? I put this to Copilot that pointed out that the prostate is usually much smaller after treatment, which is reasonable, but is that it? Thanks.

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@carbcounter
Your PSA numbers are pertinent to the type PSA test you are taking. I have the standard one every 3 months and mine is now undetectable. <0.1 You posted <0.02 so you are having the ultra sensitive test done. I have no experience even though I am aware of what they mean from A.I. so will not comment on the numbers from it.

But just know not all labs have the same undetectable range for ultra sensitive test versus a standard number when using standard.

From Co-Pilot A.I. it describes it much more accurately than I can. But same information was given to me by my PCP but it was verbal.
+++++++++++++++++++++++++++++++++++
A.I. Co-pilot:
"Professional guidelines (AUA, EAU, NCCN) keep the universal definition at <0.1 ng/mL:"

"Different institutions define “undetectable” differently because their ultrasensitive PSA machines have different detection limits. Standard PSA tests use <0.1 ng/mL, while ultrasensitive labs may use <0.03, <0.02, or even <0.01 depending on the assay."

Hope this helps. Always talk to your urologist or medical provider who is ordering your test of what type test is being done and what they mean for you. Not what someone gives you on MCC as you are an individual and it depends on what type test is being done the specific lab doing it.

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