Re: Re: Elevated PSA--Another Question

[Guest guest]

Thanks,

Sammy.

I’ll

be going in tomorrow for the CT, I should find out what the results of my PSA,

bone scan, and MRI are at the same time.

I’m

still unsure about the standard PSA and sensitive PSA. How accurate is the

standard at lower levels compared to the sensitive? When the level is down to

0.1 to 0.3, is the standard test accurate? I still don’t quite understand

when to use the standard or when to use the sensitive. Can someone give a

little more information?

Tks-Dennis

Dennis J

dennisp42@...

Seffner, FL 33584

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of sammy_bates

Sent: Monday, September 27, 2010 19:06

To: ProstateCancerSupport

Subject: Re: Elevated PSA--Another Question

'Scuse me guys, but there is a difference

between doubling 0.1 to 0.2 in a month and incrementing from ~ 50 to 51 in the

same time period.

Whoever is concerned about the former should keep a close watch on the next

month's numbers. This is what 'active surveillance' is all about.

Sammy.

" Prostrate men need helping to their feet, not sending to sleep. "

[Guest guest]

(snip)

> I still don’t quite understand when to use the

> standard or when to use the sensitive. Can someone give a little

> more information?

The " standard " was once the best we had. Then the

" ultrasensitive " tests were developed.

Although, as usual in this business, there is no uniformity of

opinion, this is the way it looks to me:

The " standard " test reports only to 0.10 ng/mL. Often, we see

folks reporting their PSA as " <0.01. " But they do not know how

far below 0.01 their PSA actually is.

The " ultrasensitive " tests report to " <0.01 " and some even lower.

" Undetectable " PSA is =/< 0.05. I and others better-qualified

(such as Dr. B. Strum, PCa specialist med onc) believe

that the ability to track what, if anything, the PSA is doing is

extremely valuable information. For example, if the PSA is rising

from, say, 0.03 to (last test) 0.09, that alerts the patient and

his medic to something that potentially requires attention. Using

the minimum 0.10 will not detect that rise.

Whether to take action in the above situation is not up to me nor

anyone else but the patient and his medic. But if one has elected

to use only the cruder " standard " PSA test, he has burned some

very important bridges.

Rant over.

Regards,

Steve J

" With all of the talk about the hazards of PC diagnosis and

unnecessary treatment, the PSA remains, without any doubt, the best

and most useful biomarker for a common malignancy in the history of

medicine. The problem, dear Brutus, lies within the lack of

perspective of the physicians who abuse the tool or are not

sensitive

to the understanding of biology and whether or not invasive

interventions are called for. It is the typical " bull in the China

shop " approach of many of the " scientific " community that screws up

the distinction between the message and the messenger.

The key is to use this outstanding biomarker in the CONTEXT of the

patient's biological milieu. This is not something that is

common in

the American landscape. Context is a foreign phenomenon. "

-- B. Strum, MD

Medical Oncologist

PCa Specialist