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PSA sensitivity query
  1. #1
    MZB Guest

    Default PSA sensitivity query

    I often read that folks have a PSA of <.1, which is good.
    Mine is 0.01 (< .01 would be termed undetectable).

    Does this mean the first type is the "regular" PSA test and mine is the
    ultra sensitive PSA test?

    But don't they have readings of 3 decimal points?

    Is that a super-sensitive PSA test?

    I guess I am getting confused with the terminology

    Mel



  2. #2
    Heather Guest

    Default Re: PSA sensitivity query

    I believe the standard garden variety test can only go as low as 0.05, so
    yours would be the super sensitive test.

    Hey, it is an amazing number you have.......stop worrying!! If it goes up
    to 5.0 or more, then you have a reason to worry........okay??

    Relax........Heather

    "MZB" <[email protected]> wrote in message
    news:hnj6q8$ng1$[email protected]..
    >I often read that folks have a PSA of <.1, which is good.
    > Mine is 0.01 (< .01 would be termed undetectable).
    >
    > Does this mean the first type is the "regular" PSA test and mine is the
    > ultra sensitive PSA test?
    >
    > But don't they have readings of 3 decimal points?
    >
    > Is that a super-sensitive PSA test?
    >
    > I guess I am getting confused with the terminology
    >
    > Mel
    >




  3. #3
    safire Guest

    Default Re: PSA sensitivity query

    On 3/14/2010 7:32 PM, Ignorant Heather wrote:

    > "MZB"<[email protected]> wrote in message
    > news:hnj6q8$ng1$[email protected]..
    >> I often read that folks have a PSA of<.1, which is good.
    >> Mine is 0.01 (< .01 would be termed undetectable).
    >>
    >> Does this mean the first type is the "regular" PSA test and mine is the
    >> ultra sensitive PSA test?
    >>
    >> But don't they have readings of 3 decimal points?
    >>
    >> Is that a super-sensitive PSA test?
    >>
    >> I guess I am getting confused with the terminology
    >>
    >> Mel
    >>

    > I believe the standard garden variety test can only go as low as 0.05, so
    > yours would be the super sensitive test.
    >
    > Hey, it is an amazing number you have.......stop worrying!! If it goes up
    > to 5.0 or more, then you have a reason to worry........okay??


    No not OK. In fact, stupid.

    "For Chan, and the scientists and physicians at Hopkins, the number to
    take seriously is 0.2 nanograms/milliliter. ''That's something we call
    biochemical recurrence. But even this doesn't mean that a man has
    symptoms yet. People need to understand that it might take months or
    even years before there is any clinical physical evidence."

    >


    >


    >
    >



  4. #4
    Heather Guest

    Default Re: PSA sensitivity query

    Piss off, cretin!!

    Btw......have you ever had PCa or do you just like to (s)troll in and harass
    people who don't really give one sweet damn about you!! Back in the box
    with you......

    "safire" <[email protected]> wrote in message
    news:hnjamo$sel$[email protected]..
    > On 3/14/2010 7:32 PM, the uber-intelligent Heather wrote:
    >
    >> I believe the standard garden variety test can only go as low as 0.05, so
    >> yours would be the super sensitive test.

    >
    > No not OK. In fact, stupid.
    >
    > "For Chan, and the scientists and physicians at Hopkins, the number to
    > take seriously is 0.2 nanograms/milliliter. ''That's something we call
    > biochemical recurrence. But even this doesn't mean that a man has symptoms
    > yet. People need to understand that it might take months or even years
    > before there is any clinical physical evidence."
    >
    >>

    >
    >>

    >
    >>
    >>

    >




  5. #5
    Steve Kramer Guest

    Default Re: PSA sensitivity query

    "MZB" <[email protected]> wrote in message
    news:hnj6q8$ng1$[email protected]..
    >I often read that folks have a PSA of <.1, which is good.
    > Mine is 0.01 (< .01 would be termed undetectable).
    >
    > Does this mean the first type is the "regular" PSA test and mine is the
    > ultra sensitive PSA test?
    >
    > But don't they have readings of 3 decimal points?
    >
    > Is that a super-sensitive PSA test?
    >
    > I guess I am getting confused with the terminology


    -- skramer remarks

    The last I heard there are at least 26 assays now. It is probably
    sufficient to know that some test to one-tenth of a nanogram; some test to
    two digits past the decimal; and some test to three digits past the decimal.
    When you are looking at three digits past the decimal, you are talking
    thousands of a nanogram. Example: .001 PSA would be 1,000,000,000,000th of
    a gram.


    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 undetectable since. Next Assay 10/10/10
    Illegitimati non carborundum



  6. #6
    Steve Kramer Guest

    Default Re: PSA sensitivity query

    "Heather" <[email protected]> wrote in message
    news:hnja36$m8o$[email protected]..
    >I believe the standard garden variety test can only go as low as 0.05, so
    >yours would be the super sensitive test.
    >
    > Hey, it is an amazing number you have.......stop worrying!! If it goes up
    > to 5.0 or more, then you have a reason to worry........okay??


    -- skramer remarks

    Actually, he's coming off surgery. So, he pretty much should start worrying
    at 0.2, or less if he discerns a trend over 0.1. After successive PSAs of
    ..27 and .37, my doc scheduled SRT.

    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 undetectable since. Next Assay 10/10/10
    Illegitimati non carborundum



  7. #7
    MZB Guest

    Default Re: PSA sensitivity query

    Thanks Steve.
    Geeezzzzz, I never said I was worrying. We all worry about the other shoe to
    drop with this f-disease.

    But, frankly, I was merely asking a simple question.

    Let me rephrase: what does ultra-sensitive mean? What does super-sensitive
    mean?

    Maybe there is no clearcut definition.

    Heather-- I've been told that 0.20 is the major cutoff point. That's when
    (if confirmed by a 4-week follow-up PSA) I have to seriously consider doing
    salvage radiation, and best to do it quickly. I was also told that if it is
    0.1 I should repeat the test in 4 weeks as we need to stay on top of things
    (I have a G 4+3 with one focally positive margin of < 0.5 mm). From my
    reading, one has a better chance of a cure if one does salvage radiation
    before the PSA gets to 0.5.

    Mel

    Mel


    "Steve Kramer" <[email protected]> wrote in message
    news:hnjidh$hpe$[email protected]..
    > "MZB" <[email protected]> wrote in message
    > news:hnj6q8$ng1$[email protected]..
    >>I often read that folks have a PSA of <.1, which is good.
    >> Mine is 0.01 (< .01 would be termed undetectable).
    >>
    >> Does this mean the first type is the "regular" PSA test and mine is the
    >> ultra sensitive PSA test?
    >>
    >> But don't they have readings of 3 decimal points?
    >>
    >> Is that a super-sensitive PSA test?
    >>
    >> I guess I am getting confused with the terminology

    >
    > -- skramer remarks
    >
    > The last I heard there are at least 26 assays now. It is probably
    > sufficient to know that some test to one-tenth of a nanogram; some test to
    > two digits past the decimal; and some test to three digits past the
    > decimal. When you are looking at three digits past the decimal, you are
    > talking thousands of a nanogram. Example: .001 PSA would be
    > 1,000,000,000,000th of a gram.
    >
    >
    > 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 undetectable since. Next Assay 10/10/10
    > Illegitimati non carborundum
    >




  8. #8
    Heather Guest

    Default Re: PSA sensitivity query


    "MZB" <[email protected]> wrote in message
    news:hnjlv4$bf5$1@news.eternal-s[email protected]..
    >
    > Heather-- I've been told that 0.20 is the major cutoff point. That's when
    > (if confirmed by a 4-week follow-up PSA) I have to seriously consider
    > doing salvage radiation, and best to do it quickly. I was also told that
    > if it is 0.1 I should repeat the test in 4 weeks as we need to stay on top
    > of things (I have a G 4+3 with one focally positive margin of < 0.5 mm).
    > From my reading, one has a better chance of a cure if one does salvage
    > radiation before the PSA gets to 0.5.
    >
    > Mel
    >

    Thanks Mel.......my husband's category is totally different than yours and
    as he never had surgery, I goofed. Thanks to Steve for setting that
    straight. FWIW, Ron had 2 types of radiation and then HT.

    Heather



  9. #9
    Steve Kramer Guest

    Default Re: PSA sensitivity query

    "MZB" <[email protected]> wrote in message
    news:hnjlv4$bf5$[email protected]..

    > Thanks Steve.
    > Geeezzzzz, I never said I was worrying.


    Nor did I get that impression. I was strying to put a point to the
    differences in assays. I have often opined herein that the ultra sensitive
    tests, while an scientific marval, are almost useless.


    > Let me rephrase: what does ultra-sensitive mean? What does super-sensitive
    > mean?


    I think (but based only on listening to folks here);

    standard tests to 0.1
    super sensitive tests to 0.01 to 0.05
    ultra sensitive tests to 0.002 to 0.003



  10. #10
    ron Guest

    Default Re: PSA sensitivity query

    On Mar 14, 11:36*am, "MZB" <m...@noway.prudigy.net> wrote:
    > I often read that folks have a PSA of <.1, which is good.
    > Mine is 0.01 (< .01 would be termed undetectable).
    >
    > Does this mean the first type is the "regular" PSA test and mine is the
    > ultra sensitive PSA test?
    >
    > But don't they have readings of 3 decimal points?
    >
    > Is that a super-sensitive PSA test?
    >
    > I guess I am getting confused with the terminology
    >
    > Mel


    Hi Mel...Just to be clear, you are asking about the total PSA test, as
    opposed to the free PSA test. There are two types of total PSA test,
    standard and ultrasensitive. A number of different companies produce
    their own version of these tests. Generally, the standard test is
    accurate enough to detect 0.1 ng/ml of PSA with +/- 10% accuracy under
    controlled laboratory conditions. So even though the standard test
    could differentiate between 0.1 and 0.09 ng/ml, most labs just report
    anything below 0.1 as <0.1. Most ultrasensitive tests read accurately
    to three decimal places (0.001). Most labs only report the result to
    two decimal places with a lower limit of <0.01 ng/ml, however some
    labs do report all three decimal places.

    Things can get confusing. For example, Hybritech's standard PSA test
    is actually accurate down to 0.02 ng/ml. If you ask for the standard
    test and your hospital uses the Hybritech assay or sends out to
    Hybritech, Hybritech runs their assay and reports results with a lower
    limit of <0.1. If you ask for the Hybritech ultrasensitive test, the
    same exact assay is performed but now the results are reported back
    with a lower detection limit of <0.02 ng/ml. The only difference is
    the lab code!

    As to the future, well here is an interesting reference...ron

    Proc Natl Acad Sci U S A. 2009 Nov 3;106(44):18437-42; Nanoparticle-
    based bio-barcode assay redefines "undetectable" PSA and biochemical
    recurrence after radical prostatectomy; Thaxton CS, Elghanian R,
    Thomas AD, Stoeva SI, Lee JS, Smith ND, Schaeffer AJ, Klocker H,
    Horninger W, Bartsch G, Mirkin CA.

    We report the development of a previously undescribed gold
    nanoparticle bio-barcode assay probe for the detection of prostate
    specific antigen (PSA) at 330 fg/mL, automation of the assay, and the
    results of a clinical pilot study designed to assess the ability of
    the assay to detect PSA in the serum of 18 men who have undergone
    radical prostatectomy for prostate cancer. Due to a lack of
    sensitivity, available PSA immunoassays are often not capable of
    detecting PSA in the serum of men after radical prostatectomy. This
    new bio-barcode PSA assay is approximately 300 times more sensitive
    than commercial immunoassays. Significantly, with the barcode assay,
    every patient in this cohort had a measurable serum PSA level after
    radical prostatectomy. Patients were separated into categories based
    on PSA levels as a function of time. One group of patients showed low
    levels of PSA with no significant increase with time and did not
    recur. Others showed, at some point postprostatectomy, rising PSA
    levels. The majority recurred. Therefore, this new ultrasensitive
    assay points to significant possible outcomes: (i) The ability to tell
    patients, who have undetectable PSA levels with conventional assays,
    but detectable and nonrising levels with the barcode assay, that their
    cancer will not recur. (ii) The ability to assign recurrence earlier
    because of the ability to measure increasing levels of PSA before
    conventional tools can make such assignments. (iii) The ability to use
    PSA levels that are not detectable with conventional assays to follow
    the response of patients to adjuvant or salvage therapies.

    PMID: 19841273

  11. #11
    MZB Guest

    Default Re: PSA sensitivity query

    Ron:

    That's interesting. So I should assume that my reading of exactly .01 is
    really a round-off of the ultrasensitive test? I know from friends that the
    lowest report from this lab is <.01. So my .01 could be as high as .014? But
    could it be as low as .005? Would that be listed as .01 and anything less
    than that reported as <.01?

    Just curious.

    Mel


    "ron" <[email protected]> wrote in message
    news:[email protected]...
    On Mar 14, 11:36 am, "MZB" <m...@noway.prudigy.net> wrote:
    > I often read that folks have a PSA of <.1, which is good.
    > Mine is 0.01 (< .01 would be termed undetectable).
    >
    > Does this mean the first type is the "regular" PSA test and mine is the
    > ultra sensitive PSA test?
    >
    > But don't they have readings of 3 decimal points?
    >
    > Is that a super-sensitive PSA test?
    >
    > I guess I am getting confused with the terminology
    >
    > Mel


    Hi Mel...Just to be clear, you are asking about the total PSA test, as
    opposed to the free PSA test. There are two types of total PSA test,
    standard and ultrasensitive. A number of different companies produce
    their own version of these tests. Generally, the standard test is
    accurate enough to detect 0.1 ng/ml of PSA with +/- 10% accuracy under
    controlled laboratory conditions. So even though the standard test
    could differentiate between 0.1 and 0.09 ng/ml, most labs just report
    anything below 0.1 as <0.1. Most ultrasensitive tests read accurately
    to three decimal places (0.001). Most labs only report the result to
    two decimal places with a lower limit of <0.01 ng/ml, however some
    labs do report all three decimal places.

    Things can get confusing. For example, Hybritech's standard PSA test
    is actually accurate down to 0.02 ng/ml. If you ask for the standard
    test and your hospital uses the Hybritech assay or sends out to
    Hybritech, Hybritech runs their assay and reports results with a lower
    limit of <0.1. If you ask for the Hybritech ultrasensitive test, the
    same exact assay is performed but now the results are reported back
    with a lower detection limit of <0.02 ng/ml. The only difference is
    the lab code!

    As to the future, well here is an interesting reference...ron

    Proc Natl Acad Sci U S A. 2009 Nov 3;106(44):18437-42; Nanoparticle-
    based bio-barcode assay redefines "undetectable" PSA and biochemical
    recurrence after radical prostatectomy; Thaxton CS, Elghanian R,
    Thomas AD, Stoeva SI, Lee JS, Smith ND, Schaeffer AJ, Klocker H,
    Horninger W, Bartsch G, Mirkin CA.

    We report the development of a previously undescribed gold
    nanoparticle bio-barcode assay probe for the detection of prostate
    specific antigen (PSA) at 330 fg/mL, automation of the assay, and the
    results of a clinical pilot study designed to assess the ability of
    the assay to detect PSA in the serum of 18 men who have undergone
    radical prostatectomy for prostate cancer. Due to a lack of
    sensitivity, available PSA immunoassays are often not capable of
    detecting PSA in the serum of men after radical prostatectomy. This
    new bio-barcode PSA assay is approximately 300 times more sensitive
    than commercial immunoassays. Significantly, with the barcode assay,
    every patient in this cohort had a measurable serum PSA level after
    radical prostatectomy. Patients were separated into categories based
    on PSA levels as a function of time. One group of patients showed low
    levels of PSA with no significant increase with time and did not
    recur. Others showed, at some point postprostatectomy, rising PSA
    levels. The majority recurred. Therefore, this new ultrasensitive
    assay points to significant possible outcomes: (i) The ability to tell
    patients, who have undetectable PSA levels with conventional assays,
    but detectable and nonrising levels with the barcode assay, that their
    cancer will not recur. (ii) The ability to assign recurrence earlier
    because of the ability to measure increasing levels of PSA before
    conventional tools can make such assignments. (iii) The ability to use
    PSA levels that are not detectable with conventional assays to follow
    the response of patients to adjuvant or salvage therapies.

    PMID: 19841273



  12. #12
    ron Guest

    Default Re: PSA sensitivity query

    Hi Mel...See my comments within your post...ron

    On Mar 15, 11:25*am, "MZB" <m...@noway.prudigy.net> wrote:
    > Ron:
    >
    > That's interesting. So I should assume that my reading of *exactly .01 is
    > really a round-off of the ultrasensitive test?


    Yes

    > I know from friends that the
    > lowest report from this lab is <.01. So my .01 could be as high as .014?


    Yes

    > But could it be as low as .005?


    That's a good question Mel. I have assumed that for labs performing
    the ultrasensitive test and then reporting the result back to 2
    decimal places lower limit results are not rounded, but rather cut
    off; anything less than 0.01, for example 0.001 or 0.009, would be
    reported back as <0.01. You could contact the company that
    manufactures the analysis used to produce your test result (Lab Corp,
    Quest Diagnostics, etc.) and ask that question (are lower limit
    results rounded or clipped). If you do, I'd be curious what you
    learn.

    > Would that be listed as .01 and anything less than that reported as <.01?


    > Just curious.
    >
    > Mel



  13. #13
    prostwell Guest

    Default Re: PSA sensitivity query

    Hi MZB, Steve,

    Interesting thread

    I just had my third post RLRP PSA test at <.1 on Feb 26.

    > *After successive PSAs of
    > .27 and .37, my doc scheduled SRT.


    Did you use the standard test?
    I am pondering if I should be using a more sensitive test.
    (My PCP and URO both say this is unnecessary.)
    But in your case, it seemed to have been useful to establish a
    doubling time, no?


  14. #14
    Steve Kramer Guest

    Default Re: PSA sensitivity query

    "prostwell" <[email protected]> wrote in message
    news:[email protected]..
    Hi MZB, Steve,

    Interesting thread

    I just had my third post RLRP PSA test at <.1 on Feb 26.

    > After successive PSAs of
    > .27 and .37, my doc scheduled SRT.


    Did you use the standard test?
    I am pondering if I should be using a more sensitive test.
    (My PCP and URO both say this is unnecessary.)
    But in your case, it seemed to have been useful to establish a
    doubling time, no?

    ==> No uro or onc that I know of (based on my readings) acts upon
    post-operative assay results when they are less than 0.10. I don't think I
    have seen any one of them act on PSAs of less than 0.20. In my case, we
    acted when my PSA rost to 0.37 and that was considered "aggressive treatment
    for aggressive cancer."

    ==> There are those here, and I have no argument with them, who want to
    know their full history, hoping to understand that aggressiveness of the
    cancer, even if they will not treat the disease until the number surpasses
    0.20, 0.30, 0.50, or even 1.00. My personal opinion is that the value of
    knowing is trumped by the uneccesary angst that is almost always going to
    attend that knowledge.



    --
    skramer remarks
    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 undetectable since. Next Assay 10/10/10
    Illegitimati non carborundum




  15. #15
    starrin Guest

    Default Re: PSA sensitivity query

    On Mon, 15 Mar 2010 13:25:46 -0400, "MZB" <[email protected]>
    wrote:
    >That's interesting. So I should assume that my reading of exactly .01 is
    >really a round-off of the ultrasensitive test? I know from friends that the
    >lowest report from this lab is <.01. So my .01 could be as high as .014? But
    >could it be as low as .005? Would that be listed as .01 and anything less
    >than that reported as <.01?


    Of interest, my lab reports my PSA as <0.014, which is as low as they
    go


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