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  • False alarms with ultrasensitive PSA test?

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    Old 10-13-2009, 02:16 PM   #1
    laughagain
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    False alarms with ultrasensitive PSA test?

    Has anyone experienced false detectable levels of PSA using the ultrasensitive test following nerve sparing radical prostatectomy?

    My father had this surgery 2/08. He had undectable psa (<.01) in3/08, 10/08, and 4/09. Last week his test showed .01. I understand: 1) some upstanding medical institutions disagree with using the ultra-sensitive test due to the anxiety it can cause. However, it seems useful to follow-up on a recurrence at a much more treatable point. 2) I also realize that .01 is very low, and that only time will tell if the PSA is on an upward trend. I would simply like to hear from anyone who has experienced an occasional detectable psa and then back to non-detect using the ultrasensitive test.

    I have been dealing with/managing many health issues in the family over the last few years, and just started to laugh again, and then this result. I don't think I can do this again. THanks.

    Last edited by laughagain; 10-14-2009 at 07:20 PM. Reason: typo should have been 4/09 instead of 4/08

     
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    Old 10-14-2009, 06:34 PM   #2
    IADT3since2000
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    Re: False alarms with ultrasensitive PSA test?

    Hi laughagain,

    I've used this ultrasensitive technology for years to monitor the success of my hormonal blockade therapy, twice achieving a nadir of <0.01 and apparently nearing that point again (, but praying) but never had surgery. However, I did have a friend who went through the anxiety you describe, and have some familiarity with the issues. I'll add thoughts in green, and one clarification question: did you mean 2/8 instead of 2/9 for your father's surgery? That would make sense.


    Quote:
    Originally Posted by laughagain View Post
    Has anyone experienced false detectable levels of PSA using the ultrasensitive test following nerve sparing radical prostatectomy?

    My father had this surgery 2/09. He had undectable psa (<.01) in3/08, 10/08, and 4/09. Last week his test showed .01.

    I believe it could be an artificial increase just due to testing or to a slight daily difference for your father's PSA that just happened to tip the scale. For instance, suppose that your father's true average PSA was 0.0048, which would be rounded to <0.01. (I'm not aware of any ultrasensitive test that gives reliable results to the fourth or fifth decimal places, but thinking about it will help through light on the issues.) Let's say that the daily swing in PSA is 15%, which is supportable for normal PSA as I recall, making the range of his daily PSAs extend from 0.00408 (based on 0.0048 X 85%) to 0.00552 (based on 0.0048 X 115%). Now, 0.00552, instead of being reported as "<0.01", would be rounded to "0.01" and so reported. Of course we don't know what your father's true average PSA is, or that it is not increasing, but the numbers show what could be happening. Do you see what I'm driving at?

    I understand: 1) some upstanding medical institutions disagree with using the ultra-sensitive test due to the anxiety it can cause. However, it seems useful to follow-up on a recurrence at a much more treatable point.

    Amen! Also, the follow-up "treatment" could be as simple as following more of the lifestyle tactics for prostate cancer, such as consuming 8 oz of quality pomegranate juice or equivalent extract, which looks promising. With the aid of the ultrasensitive results, you would be able to tell quickly if the tactics were working as the rising PSA would rise more slowly, stabilize, or decline.

    2) I also realize that .01 is very low, and that only time will tell if the PSA is on an upward trend. The doctor is probably comfortable waiting another few months before doing the next ultrasensitive PSA. That makes sense to me.

    The great beauty of the ultrasensitive test is that it reveals any trend at a very early point when the cancer is still tiny.

    I would simply like to hear from anyone who has experienced an occasional detectable psa and then back to non-detect using the ultrasensitive test.

    My friend was upset when his PSA, while <0.01, was going up in the third decimal place, for example, from 0.003 to 0.004. However, that third place is not accurate unless special testing processes are used with close attention, and not all brands of ultrasensitive PSA tests are even capable of accurate readings to the third decimal place even with strict processing. My friend's PSA did come back down, and he relaxed. We were diagnosed about the same time, and we keep in touch at least once a year. He is doing fine, and his tests are still <0.01 at nearly the ten year point.

    I have been dealing with/managing many health issues in the family over the last few years, and just started to laugh again, and then this result. I don't think I can do this again. THanks.

    It's not for nothing that a lot of us know the PSA test as the Prostate Specific Anxiety test. Hopefully, future tests will be reassuring. I think there is an excellent chance of that.

    Good luck to you, your family, and especially to your father!

    Take care,

    Jim

     
    Old 10-14-2009, 07:20 PM   #3
    laughagain
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    Re: False alarms with ultrasensitive PSA test?

    Quote:
    Originally Posted by IADT3since2000 View Post
    Hi laughagain,

    I've used this ultrasensitive technology for years to monitor the success of my hormonal blockade therapy, twice achieving a nadir of <0.01 and apparently nearing that point again (, but praying) but never had surgery. However, I did have a friend who went through the anxiety you describe, and have some familiarity with the issues. I'll add thoughts in green, and one clarification question: did you mean 2/8 instead of 2/9 for your father's surgery? That would make sense.
    Jim:
    Thank you so very much for your reply! Yes, my dad's rp was 2/08.

    We saw the oncologist today. He re-tested the PSA, and again it was .01. However, he is not concerned at all. He is familiar with "dozens of cases" of PSA being undetectable then to .01, .02, back to <.01, etc. without recurrence. He will re-test every 2 months for the next 6 months for our peace of mind. We are keeping the faith.

    Thank you for the nutritional info as well. My dad eats an all organic vegetarian whole foods diet, with the addition of Wild Alaskan Salmon. He includes Pomengranate extract, Green Tea, Grapeseed extract, Curcumin, VitaminD3, fish oil, etc as part of his supplement routine. Diet is critical in the fight against cancer and disease in general. I hope all who read this will take this information to heart.

    Thank you Jim, and to everyone else who provide not only excellent information, but for the encouragement and support of one another fighting cancer. It takes a village!

    Best of luck to you, too. Positive thoughts for your next undetectable PSA!! -Blessings

     
    Old 10-14-2009, 07:51 PM   #4
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    Re: False alarms with ultrasensitive PSA test?

    Jim -

    What is a "quality" pomegranate juice? How does a consumer know whether a pomegranate juice is good quality or not? I drink a glass every day -- have tried several different brands -- often whichever is on sale.

    Thanks,

    Medved

     
    Old 10-16-2009, 02:19 PM   #5
    IADT3since2000
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    Re: False alarms with ultrasensitive PSA test?

    Hi Medved,

    Here's what I know about quality pomegranate juice, responding to your question:


    Quote:
    Originally Posted by medved View Post
    ...

    What is a "quality" pomegranate juice? How does a consumer know whether a pomegranate juice is good quality or not? I drink a glass every day -- have tried several different brands -- often whichever is on sale.

    ...
    I like your style - picking the least expensive. That's what I did too until I got more into the research.

    The brand used in the study was PomWonderful, so at least that brand is known to be effective.

    Dr. Myers has commented that both heat and light can decrease the effectiveness of the juice, and PomWonderful is the only brand I know of that refrigerates its juice (though it does not have a dark container that would reduce light).

    I've tried to find out about quality and effectiveness of other brands, and to learn more about the light and heat angles, but haven't come up with anything.

    One acid test of effectiveness is whether your PSADT after a recurrence is lengthened by drinking a brand of the juice.

    The leading experts also appear confident that good quality pomegranate extract pills will work. Based on research I have heard reported, if the Pomela company supplies the main ingredient for the extract, it should be a good one. Their mix of ingredients is based on how specific elements (the juice, the rind, the white stuff, the seeds) affected arrays of genes that are relevant to prostate cancer. The Life Extension Foundation also appears to have a good pill.

    Hope this helps,

    Jim

     
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