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    To Mikeraphone
    az4peaks2 posted:
    Hi Mike, - Let me respond to the questions that you have posed and to which the answers, in my opinion, have been confusing, to say the least.

    For years, the Clinical Standard for "undetectable PSA" in routine monitoring situations following surgery has been LESS THAN 0.1 ng/ml, which is usually depicted as < 0.1 on Laboratory Reports. Although there are RARE individual situations where this may not be the standard used by an individual Physician, it remains the most widely accepted definition of "undetectable PSA', BY FAR.

    So, in nearly every case of ROUTINE monitoring following surgery this still remains the criteria for the use of the term, "undetectable" in reference to post-treatment PSA. The figures you cite in your Posts are all below this Standard if the decimal points are accurately reflected.

    Obviously, accuracy of the decimal point placement is critically important in judging PSA significance in the post-treatment monitoring, as is the understanding of the metric system in use. The 0.1 ng/ml threshold, referred to above, represents 1/10th of a BILLIONTH of a Gram of PSA found in 1 milliliter of blood. The finding of 0.01 ng/l is 1/100th and 0.001 is 1/1000th of a BILLIONTH of a gram, so these are "minute" (my-noot) amounts of PSA that are present.

    Again, anything below 0.1 ng/ml (<0.1) is therefore considered clinically undetectable in routine monitoring of low and/or moderate risk, post-treatment results.

    The < icon always identifies the term "LESS THAN" and reflects the fact that any PSA present, IF ANY, is BELOW the known reliability of the assays (the test's) known sensitivity and so is reported thusly.

    As long as PSA results remain below the 0.1 ng/ml level, you usually need not initiate any aggressive secondary treatment, in low or moderate risk patients. I hope this helps your understanding. - (aka) az4peaks

    MIKERAPHONE responded:
    Thanks for explaining John ! Does benign prostate tissue left behind after surgery cause the psa to rise or just cause the psa to become detectable without any increase ? If the answer to the question is yes then this may be the case with me ( nerve sparing ) if my psa is stable at this level after my next psa test !
    dab60 responded:
    Thanks for that explanation. My PSA was reported as less than 0.1 for the two years after surgery. Biopsy 3 3, pathology 3 4. One year ago they reported it as 0.01 with a new more sensitive testing procedure. Last week using the same lab it measured 0.05 (this is four years after surgery).

    I know this is considered undetectable but is this showing the start of a rising PSA trend?

    My urologist said to not worry about it but I am having a little PSA anxiety and might have a hard time waiting a year for the next test.
    MIKERAPHONE replied to dab60's response:
    I wouldn't be too worried about the change as you say it is still undetectable , but I would suggest another psa test in six months , waiting another year seems extreme plus all the anxiety having to wait that long !
    marinemustangpa responded:
    John - Glad to see yoiu are still around and being helpful. Haven't visit the board much lately. But getting near deciding on hormone treatment. Now 9 years past radiation my psa had streadily gone up. Now sits at 15. Urologist and I have discussed the hormones when the psa gets near 20. I am trying to maintain quality of life foir as long as possibloe.,



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