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Do I Need a Better Test?
  1. #1
    Bill Anderson Guest

    Default Do I Need a Better Test?

    In January it'll be a year since the doc and his five-armed friend
    chopped my prostate out and I'm still having PSA tests every three
    months. The results remain good -- the doc says my PSA level is
    "undetectable." But if I'm understanding him correctly, what he's
    really saying is that my PSA level is somewhere less than .04 which is
    the lowest level the machine in his office can detect. So sure, for
    this machine at least, my PSA level is "undectable."

    Well, in the spirit of over-thinking this thing I'm wondering ... is
    there anybody around here who got similar results at first but later
    discovered there was activity at a level beneath .04 and you wish you'd
    sprung for a more accurate test sooner?

    --
    Bill Anderson

    I am the Mighty Favog

  2. #2
    Steve Kramer Guest

    Default Re: Do I Need a Better Test?

    "Bill Anderson" <[email protected]> wrote in message
    news:[email protected] ...
    > In January it'll be a year since the doc and his five-armed friend chopped
    > my prostate out and I'm still having PSA tests every three months. The
    > results remain good -- the doc says my PSA level is "undetectable." But
    > if I'm understanding him correctly, what he's really saying is that my PSA
    > level is somewhere less than .04 which is the lowest level the machine in
    > his office can detect. So sure, for this machine at least, my PSA level
    > is "undectable."
    >
    > Well, in the spirit of over-thinking this thing I'm wondering ... is there
    > anybody around here who got similar results at first but later discovered
    > there was activity at a level beneath .04 and you wish you'd sprung for a
    > more accurate test sooner?


    Since going on ADT, I have had my PSA tested numerous times and the type of
    assay has been based purely on whatever my lab got the lowest bid on. As
    such, my results might have been < 0.10, <0.04, or < 0.05. Of course,
    different assays might have given me down to < 0.003. But, to what purpose.
    Readings under 0.10 are like cork in the water.

    I preferred assays to 0.10 and, by chance, that's all I had since 2008.

    My last PSA was = 0.10, so I now have to be more cognizant of my changes in
    PSA. But, I didn't have to worry about that for years and I'm happy about
    it.


    --
    PSA 16 10/17/2000 @ 46
    Biopsy 11/01/2000 G7 (3+4), T2c
    RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
    PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
    EBRT 05-07/2002 @ 47
    PSA .34 .22 .15 .21 .32 PSAD 0.56 years
    Lupron 07/03 (1 mo) 8/03 and every 4 months there after
    PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
    Casodex added daily 07/06
    PSA <0.1 until =0.1 10/10 PSAD 2.99 years
    Illegitimati non carborundum



  3. #3
    I.P. Freely Guest

    Default Re: Do I Need a Better Test?

    Anything below 0.040 -- even twice that, from what I can tell -- is not
    only useless but overly alarming to worriers.

    I.P.

  4. #4
    Steve Jordan Guest

    Default Re: Do I Need a Better Test?

    On 11/7/10, Freely wrote:

    > Anything below 0.040 -- even twice that, from what I can tell --
    > is not only useless but overly alarming to worriers.


    It appears that IP lost track of his point.

    Why would a PSA *below* 0.04 be "overly alarming to worriers?" Or
    to anyone? Well, it wouldn't/shouldn't; the lower the better, no?

    I will ride along with IP just this far: A PSA in the
    undetectable range (=/< 0.05 ng/mL), just like any other PSA
    result, is pretty much useless. What is needed is a series of
    tests so that the trend if any can be detected.

    Regards,

    Steve J



  5. #5
    Bill Anderson Guest

    Default Re: Do I Need a Better Test?

    On 11/7/2010 5:48 PM, Steve Jordan wrote:
    > On 11/7/10, Freely wrote:
    >
    >> Anything below 0.040 -- even twice that, from what I can tell --
    >> is not only useless but overly alarming to worriers.

    >
    > It appears that IP lost track of his point.
    >
    > Why would a PSA *below* 0.04 be "overly alarming to worriers?" Or to
    > anyone? Well, it wouldn't/shouldn't; the lower the better, no?
    >
    > I will ride along with IP just this far: A PSA in the undetectable range
    > (=/< 0.05 ng/mL), just like any other PSA result, is pretty much
    > useless. What is needed is a series of tests so that the trend if any
    > can be detected.
    >


    OK, thanks everybody. Nobody has said, "OMG he's checking only down to
    ..04? You need a better test." That's the reassurance I was looking
    for. I'll continue to have it checked on a regular schedule. When
    something changes, then I'll worry.


    --
    Bill Anderson

    I am the Mighty Favog

  6. #6
    I.P. Freely Guest

    Default Re: Do I Need a Better Test?

    Bill Anderson wrote:
    > Steve Jordan wrote:
    >> Freely wrote:
    >>
    >>> Anything below 0.040 -- even twice that, from what I can tell --
    >>> is not only useless but overly alarming to worriers.

    >>
    >> It appears that IP lost track of his point.
    >> Why would a PSA *below* 0.04 be "overly alarming to worriers?"
    >> What is needed is a series of tests so that the trend if any
    >> can be detected.


    Maybe I simply expressed my point poorly. One such reading is great and
    actually means something (i.e., that you're virtually undetectable), but
    even if it kept rising very steadily, as mine did twice for 3-4
    successive readings, it might easily alarm some pts even before it
    reached a still harmless 0.040. In fact, PSA is apparently pretty
    useless *at present* until it gets a lot closer to 0.100 or even higher,
    even if it looks like a consistent and ominous trend on a chart. I get
    three decimal points solely because that's what my lab provides, not
    because it's what I or my docs want or request.

    Mine's run something like 0.035, 0.054, and 0.077 the last three 6-month
    periods. My onc team (tumor board) says that if this pace continues --
    if it hits something like 0.120 NEXT fall, I might consider resuming my
    reading. Until then, and maybe for long afterwards if it continues
    creeping up at this lazy pace, I may be cured for all practical
    purposes. My uro actually uttered that word Friday, cautiously and
    casually.

    > Nobody has said, "OMG he's checking only down to
    > .04? You need a better test."


    The consensus seems to be just the opposite. Most pts and physicians
    regard such small numbers as not only useless but overly alarming to
    worriers ... thus my phrase above.

    > I'll continue to have it checked on a regular schedule. When something
    > changes, then I'll worry.


    Why? It WILL change, very likely both upwards and downwards, by large or
    even extreme *percentage* changes such as my <0.002 to 0.031 to 0.051
    (those third decimal points are mostly from memory, but you get the
    picture) before it dropped back to a successive pair of <0.002s. Until
    it starts tripping that first decimal point it can easily be random
    noise, and it often stops and stays there until we die of something else.

    I.P.

  7. #7
    Bill Anderson Guest

    Default Re: Do I Need a Better Test?

    On 11/7/2010 10:52 PM, I.P. Freely wrote:
    > Bill Anderson wrote:
    >> Steve Jordan wrote:
    >>> Freely wrote:
    >>>
    >>>> Anything below 0.040 -- even twice that, from what I can tell --
    >>>> is not only useless but overly alarming to worriers.
    >>>
    >>> It appears that IP lost track of his point.
    >>> Why would a PSA *below* 0.04 be "overly alarming to worriers?"
    >>> What is needed is a series of tests so that the trend if any
    >>> can be detected.

    >
    > Maybe I simply expressed my point poorly. One such reading is great and
    > actually means something (i.e., that you're virtually undetectable), but
    > even if it kept rising very steadily, as mine did twice for 3-4
    > successive readings, it might easily alarm some pts even before it
    > reached a still harmless 0.040. In fact, PSA is apparently pretty
    > useless *at present* until it gets a lot closer to 0.100 or even higher,
    > even if it looks like a consistent and ominous trend on a chart. I get
    > three decimal points solely because that's what my lab provides, not
    > because it's what I or my docs want or request.
    >
    > Mine's run something like 0.035, 0.054, and 0.077 the last three 6-month
    > periods. My onc team (tumor board) says that if this pace continues --
    > if it hits something like 0.120 NEXT fall, I might consider resuming my
    > reading. Until then, and maybe for long afterwards if it continues
    > creeping up at this lazy pace, I may be cured for all practical
    > purposes. My uro actually uttered that word Friday, cautiously and
    > casually.
    >
    >> Nobody has said, "OMG he's checking only down to
    >> .04? You need a better test."

    >
    > The consensus seems to be just the opposite. Most pts and physicians
    > regard such small numbers as not only useless but overly alarming to
    > worriers ... thus my phrase above.
    >
    >> I'll continue to have it checked on a regular schedule. When something
    >> changes, then I'll worry.

    >
    > Why? It WILL change, very likely both upwards and downwards, by large or
    > even extreme *percentage* changes such as my <0.002 to 0.031 to 0.051
    > (those third decimal points are mostly from memory, but you get the
    > picture) before it dropped back to a successive pair of <0.002s. Until
    > it starts tripping that first decimal point it can easily be random
    > noise, and it often stops and stays there until we die of something else.
    >
    > I.P.


    Got it. Thanks.

    --
    Bill Anderson

    I am the Mighty Favog

  8. #8
    Steve Kramer Guest

    Default Re: Do I Need a Better Test?

    "Steve Jordan" <[email protected]> wrote in message
    news:ib7ab0$k11$[email protected]..

    > It appears that IP lost track of his point.
    >
    > Why would a PSA *below* 0.04 be "overly alarming to worriers?" Or to
    > anyone? Well, it wouldn't/shouldn't; the lower the better, no?
    >
    > I will ride along with IP just this far: A PSA in the undetectable range
    > (=/< 0.05 ng/mL), just like any other PSA result, is pretty much useless.
    > What is needed is a series of tests so that the trend if any can be
    > detected.


    Seņor Jordan has a wonderful writing style. I wonder if he has ever read
    Jeff Cooper; a man who I greatly admired in almost every way including this
    same writing style.





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