This forum is for the discussion of anything to do with Prostate Cancer. There are only four rules:
No fundraisers, no commercials (although it is OK to recommend choices of treatment or medical people based on your personal research; invitations to participate in third-party surveys are also acceptable, provided there is no compensation to YANA);
No harvesting e-mail addresses for Spam;
No insults or flaming - be polite and respectful at all times and understand that there may be a variety of points of view, all of which may have some validity;
Opinions are OK, but please provide as much factual evidence as possible for any assertions that you are making
Failure to abide by these simple rules will result in the immediate and permanent suspension of your posting privileges.
Since this is an International Forum, please specify your location in your post.
MY EVOLVING THINKING ON ULTRASENSITIVE PSA TESTING
I think that Ultrasensitive PSA testing has a legitimate claim for use by some PCa survivors.
I think that since the use of Ultrasensitive PSA testing can enable the initiation of follow-up treatment by up to 18 months or more sooner than standard PSA testing, the use of it becomes a critical consideration for those with aggressive cancer. That is why I am pleased that my doctor has me using an ultrasensitve assay. At RP I had a Gleason of 9, focal established extra-capsular invasion, nerve invasion, 4 lymph nodes positive, and a PSADT of ~7½ months. My doctors called my cancer aggressive and did not expect a post RP PSA test result <0.2. I do believe that once it is in the lymphatic system, there is virtually no possibility of it being excised and that it will develop further. My miracle is that I am now at 4 years after RP and still at such low PSA readings. Those with less aggressive cancer may, indeed, be quite comfortable with using standard PSA testing instead of considering the ultrasensitive option.
So far, my PSA readings have meandered between <0.003 and 0.008. This, I think, represents either a PSA which actually gives these different readings, or - more likely - an error tolerance in the test of around (+ or -) 0.005ng/ml. Of course the error tolerance may be greater than that - which I should be able to see going forward with more data points. In any case, some studies question the accuracy of Ultrasensitive PSA testing in ranges < 0.01ng/ml. However, there is ample evidence of Ultrasensitive PSA testing accuracy above that level. Should anyone be interested in a listing of papers dealing with that issue, I would be pleased to send - or to post.
My last reading was 0.012ng/ml which I hope was either a testing error (I believe they do occur) or it could simply be the error tolerance of the test (my testing is by Siemens Immulite Chemiluminescent Assay) which I have already worked out - maybe expanded by 0.002. I should have some idea about that after a few more data points. It seems to me it makes the most sense to work on these kind of questions with each individual case history rather than to focus on broad generalized statements each of which would be taken to apply to each person - and that is what I am doing.
If anyone would care to contribute ideas about this topic, I would be pleased to hear them. Perhaps my thinking may continue to evolve with your help!
A special thanks to Terry who has struggled and agonized and put up with me (!) as I have worked on and refined my thinking about ultrasensitive PSA testing!
Re: MY EVOLVING THINKING ON ULTRASENSITIVE PSA TESTING
I think "struggled and agonized" might be a little strong:-)
I'm trying to find time to read all the relevant material - both that sent by Pete and from other sources to make some sense of the current position.
As ever, I believe we must all make our own decisions. My current view of ultra-sensitive PSA tests is that there may be a gap between a theoretical accuracy and consistency and that achieved in a working environment outside the laboratory.
My current views are here ULTRA SENSITVE PSA. As I say will hopefully be clarified within the week (there's a lot of reading to be done and George Hardy and I are still working through the backlog of updates. Don't know where I'd be without him, but I certainly wouldn't have time to catch up on this subject!!)
