Re: Elevated PSA--Another Question

[Guest guest]

Dennis,

Some doctors do not believe that ultra

sensitive tests have much value, given the issues involved – see http://www.yananow.net/UltraPSA.htm

for some information that might be relevant

All the best

Prostate men need enlightening, not

frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of D

Sent: Friday, 24 September 2010

9:40 AM

To: ProstateCancerSupport

Subject:

Elevated PSA--Another Question

I went to draw blood for my PSA today at Quest. I have been

going to them for over a year and understand the it’s best to use the

same lab so the test is consistent. I asked if the test the radiation

oncologist wrote the script for was for the standard or the sensitive test. I

was told it was for the standard. Question…since I’ve had my

prostate removed, shouldn’t it have been for the sensitive? I called the

doctor’s office as I was leaving and questioned the assistant. She said

the doctor usually prescribes the standard. I questioned her stating that since

I don’t have my prostate, will it measure accurately. As a refresher, my

test have been 0.11, 0.19 and the last was 0.30. This is over a year span.

It’s making me think that something is wrong here. Am I correct in my

suspicion?

Any input would be appreciated.

Tks-Dennis

Dennis J

dennisp42@...

Seffner,

FL 33584

[Guest guest]

D wrote:

> ... will it measure accurately. As a refresher, my test have

> been 0.11, 0.19 and the last was 0.30. This is over a year

> span. It’s making me think that something is wrong here. ...

In scientific measurements, one is supposed to report results to

the nearest " significant digit " . So assuming that the lab has

done everything right, the full meaning of various numbers is as

follows:

PSA = 0.3 means PSA is between 0.25 and 0.35.

PSA = 0.30 means PSA is between 0.295 and 0.305

PSA = 0.300 means PSA is between 0.2995 and 0.3005

One could argue, as some of the people did in Terry's posting,

that the extra digit is bogus. Even if the extra digit were

measured perfectly, and we can question whether that's possible

or, if possible, knowable - PSA concentrations in the blood are

probably not constant enough that two samples taken at the same

time from the same man on the same day are going to come out the

same at the third digit.

However, let's assume that the values are stable, the measurement

is perfect, the calibration of the machines is perfect, the

preparation of the reagents is perfect, the operator procedures

are perfect, the temperature, humidity, atmospheric pressure are

perfect, and there is not the tiniest speck of dirt in the

machine or the sample. The reported values are exactly dead on

and accurate out to 3, 4, 5, or as many digits as you choose.

What extra information would the extra digits give us?

When we're talking about values above 0.10, it's hard to think of

a scenario in which any decision might depend on a third digit of

precision to the right of the decimal point. What would you do

differently if the actual value were not 0.300000 but 0.295 or

0.305? I can't think of any practical value of getting the

additional digits.

So I'll give a break to the doc here.

Alan

[Guest guest]

Terry

I agree, what really counts is the doubling time over a reasonable period and over a significant minimum.

To worry about a doubling of 0.1 to 0.2 in one month is not worthwhile, next month it could be back down to 0.1.

I had a PSA of 53.6 in April and a 52.8 in August - I call that the same.

RE: Elevated PSA--Another Question

Dennis,

Some doctors do not believe that ultra sensitive tests have much value, given the issues involved – see http://www.yananow.net/UltraPSA.htm for some information that might be relevant

All the best

Prostate men need enlightening, not frightening

Terry Herbert - diagnosed in 1996 and still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

[Guest guest]

Terry

I agree, what really counts is the doubling time over a reasonable period and over a significant minimum.

To worry about a doubling of 0.1 to 0.2 in one month is not worthwhile, next month it could be back down to 0.1.

I had a PSA of 53.6 in April and a 52.8 in August - I call that the same.

RE: Elevated PSA--Another Question

Dennis,

Some doctors do not believe that ultra sensitive tests have much value, given the issues involved – see http://www.yananow.net/UltraPSA.htm for some information that might be relevant

All the best

Prostate men need enlightening, not frightening

Terry Herbert - diagnosed in 1996 and still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

[Guest guest]

" You can tell a little thing from a big thing. What's very hard to do is

tell a little thing from nothing at all " Thun Epidemiologist

" Il faut d'abord durer " Hemingway

Re: Elevated PSA--Another Question

D wrote:

> ... will it measure accurately. As a refresher, my test have

> been 0.11, 0.19 and the last was 0.30. This is over a year

> span. It’s making me think that something is wrong here. ...

In scientific measurements, one is supposed to report results to

the nearest " significant digit " . So assuming that the lab has

done everything right, the full meaning of various numbers is as

follows:

PSA = 0.3 means PSA is between 0.25 and 0.35.

PSA = 0.30 means PSA is between 0.295 and 0.305

PSA = 0.300 means PSA is between 0.2995 and 0.3005

One could argue, as some of the people did in Terry's posting,

that the extra digit is bogus. Even if the extra digit were

measured perfectly, and we can question whether that's possible

or, if possible, knowable - PSA concentrations in the blood are

probably not constant enough that two samples taken at the same

time from the same man on the same day are going to come out the

same at the third digit.

However, let's assume that the values are stable, the measurement

is perfect, the calibration of the machines is perfect, the

preparation of the reagents is perfect, the operator procedures

are perfect, the temperature, humidity, atmospheric pressure are

perfect, and there is not the tiniest speck of dirt in the

machine or the sample. The reported values are exactly dead on

and accurate out to 3, 4, 5, or as many digits as you choose.

What extra information would the extra digits give us?

When we're talking about values above 0.10, it's hard to think of

a scenario in which any decision might depend on a third digit of

precision to the right of the decimal point. What would you do

differently if the actual value were not 0.300000 but 0.295 or

0.305? I can't think of any practical value of getting the

additional digits.

So I'll give a break to the doc here.

Alan

------------------------------------

There are just two rules for this group

1 No Spam

2 Be kind to others

Please recognise that Prostate Cancerhas different guises and needs

different levels of treatment and in some cases no treatment at all. Some

men even with all options offered chose radical options that you would not

choose. We only ask that people be informed before choice is made, we cannot

and should not tell other members what to do, other than look at other

options.

Try to delete old material that is no longer applying when clicking reply

Try to change the title if the content requires it

[Guest guest]

" You can tell a little thing from a big thing. What's very hard to do is

tell a little thing from nothing at all " Thun Epidemiologist

" Il faut d'abord durer " Hemingway

Re: Elevated PSA--Another Question

D wrote:

> ... will it measure accurately. As a refresher, my test have

> been 0.11, 0.19 and the last was 0.30. This is over a year

> span. It’s making me think that something is wrong here. ...

In scientific measurements, one is supposed to report results to

the nearest " significant digit " . So assuming that the lab has

done everything right, the full meaning of various numbers is as

follows:

PSA = 0.3 means PSA is between 0.25 and 0.35.

PSA = 0.30 means PSA is between 0.295 and 0.305

PSA = 0.300 means PSA is between 0.2995 and 0.3005

One could argue, as some of the people did in Terry's posting,

that the extra digit is bogus. Even if the extra digit were

measured perfectly, and we can question whether that's possible

or, if possible, knowable - PSA concentrations in the blood are

probably not constant enough that two samples taken at the same

time from the same man on the same day are going to come out the

same at the third digit.

However, let's assume that the values are stable, the measurement

is perfect, the calibration of the machines is perfect, the

preparation of the reagents is perfect, the operator procedures

are perfect, the temperature, humidity, atmospheric pressure are

perfect, and there is not the tiniest speck of dirt in the

machine or the sample. The reported values are exactly dead on

and accurate out to 3, 4, 5, or as many digits as you choose.

What extra information would the extra digits give us?

When we're talking about values above 0.10, it's hard to think of

a scenario in which any decision might depend on a third digit of

precision to the right of the decimal point. What would you do

differently if the actual value were not 0.300000 but 0.295 or

0.305? I can't think of any practical value of getting the

additional digits.

So I'll give a break to the doc here.

Alan

------------------------------------

There are just two rules for this group

1 No Spam

2 Be kind to others

Please recognise that Prostate Cancerhas different guises and needs

different levels of treatment and in some cases no treatment at all. Some

men even with all options offered chose radical options that you would not

choose. We only ask that people be informed before choice is made, we cannot

and should not tell other members what to do, other than look at other

options.

Try to delete old material that is no longer applying when clicking reply

Try to change the title if the content requires it

[Guest guest]

Thanks

for the clarification. What my concern was whether or not the standard test

could detect accurately at these low levels, or if it would take the sensitive test

to accurately measure these small amounts. To what digit would the regular test

measure vs the sensitive test? For example, does the standard test accurately

measure to the tenth, and the sensitive test needed to measure the lower

levels?

Dennis J

dennisp42@...

Seffner, FL 33584

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Alan Meyer

Sent: Thursday, September 23, 2010 23:41

To: ProstateCancerSupport

Subject: Re: Elevated PSA--Another Question

D wrote:

> ... will it measure accurately. As a refresher, my test have

> been 0.11, 0.19 and the last was 0.30. This is over a year

> span. It’s making me think that something is wrong here. ...

In scientific measurements, one is supposed to report results to

the nearest " significant digit " . So assuming that the lab has

done everything right, the full meaning of various numbers is as

follows:

PSA = 0.3 means PSA is between 0.25 and 0.35.

PSA = 0.30 means PSA is between 0.295 and 0.305

PSA = 0.300 means PSA is between 0.2995 and 0.3005

One could argue, as some of the people did in Terry's posting,

that the extra digit is bogus. Even if the extra digit were

measured perfectly, and we can question whether that's possible

or, if possible, knowable - PSA concentrations in the blood are

probably not constant enough that two samples taken at the same

time from the same man on the same day are going to come out the

same at the third digit.

However, let's assume that the values are stable, the measurement

is perfect, the calibration of the machines is perfect, the

preparation of the reagents is perfect, the operator procedures

are perfect, the temperature, humidity, atmospheric pressure are

perfect, and there is not the tiniest speck of dirt in the

machine or the sample. The reported values are exactly dead on

and accurate out to 3, 4, 5, or as many digits as you choose.

What extra information would the extra digits give us?

When we're talking about values above 0.10, it's hard to think of

a scenario in which any decision might depend on a third digit of

precision to the right of the decimal point. What would you do

differently if the actual value were not 0.300000 but 0.295 or

0.305? I can't think of any practical value of getting the

additional digits.

So I'll give a break to the doc here.

Alan

[Guest guest]

Thanks

for the clarification. What my concern was whether or not the standard test

could detect accurately at these low levels, or if it would take the sensitive test

to accurately measure these small amounts. To what digit would the regular test

measure vs the sensitive test? For example, does the standard test accurately

measure to the tenth, and the sensitive test needed to measure the lower

levels?

Dennis J

dennisp42@...

Seffner, FL 33584

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Alan Meyer

Sent: Thursday, September 23, 2010 23:41

To: ProstateCancerSupport

Subject: Re: Elevated PSA--Another Question

D wrote:

> ... will it measure accurately. As a refresher, my test have

> been 0.11, 0.19 and the last was 0.30. This is over a year

> span. It’s making me think that something is wrong here. ...

In scientific measurements, one is supposed to report results to

the nearest " significant digit " . So assuming that the lab has

done everything right, the full meaning of various numbers is as

follows:

PSA = 0.3 means PSA is between 0.25 and 0.35.

PSA = 0.30 means PSA is between 0.295 and 0.305

PSA = 0.300 means PSA is between 0.2995 and 0.3005

One could argue, as some of the people did in Terry's posting,

that the extra digit is bogus. Even if the extra digit were

measured perfectly, and we can question whether that's possible

or, if possible, knowable - PSA concentrations in the blood are

probably not constant enough that two samples taken at the same

time from the same man on the same day are going to come out the

same at the third digit.

However, let's assume that the values are stable, the measurement

is perfect, the calibration of the machines is perfect, the

preparation of the reagents is perfect, the operator procedures

are perfect, the temperature, humidity, atmospheric pressure are

perfect, and there is not the tiniest speck of dirt in the

machine or the sample. The reported values are exactly dead on

and accurate out to 3, 4, 5, or as many digits as you choose.

What extra information would the extra digits give us?

When we're talking about values above 0.10, it's hard to think of

a scenario in which any decision might depend on a third digit of

precision to the right of the decimal point. What would you do

differently if the actual value were not 0.300000 but 0.295 or

0.305? I can't think of any practical value of getting the

additional digits.

So I'll give a break to the doc here.

Alan

[Guest guest]

Post surgery the ultra sensitive is the way to go.  If after surgery your PSA begins to rise you must catch it very quickly in order to still have a shot at permanently stopping the disease.  PSA rises post surgery are NOT comparable to PSA changes prior to surgery, do not confuse the significance of small changes post surgery.

 

I

went to draw blood for my PSA today at Quest. I have been going to them for

over a year and understand the it’s best to use the same lab so the test

is consistent. I asked if the test the radiation oncologist wrote the script

for was for the standard or the sensitive test. I was told it was for the

standard. Question…since I’ve had my prostate removed, shouldn’t

it have been for the sensitive? I called the doctor’s office as I was

leaving and questioned the assistant. She said the doctor usually prescribes

the standard. I questioned her stating that since I don’t have my

prostate, will it measure accurately. As a refresher, my test have been 0.11,

0.19 and the last was 0.30. This is over a year span. It’s making me

think that something is wrong here. Am I correct in my suspicion?

 

Any

input would be appreciated.

 

Tks-Dennis

 

Dennis J

dennisp42@...

Seffner, FL 33584

-- T Nowak, MA, MSWDirector for Advocacy and  Advanced Prostate Cancer Programs, Malecare Inc. Men Fighting Cancer, TogetherSurvivor - Recurrent Prostate, Thyroid, Melanoma and Renal Cancers

www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.com - information and support about prostate cancer

http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer

[Guest guest]

I have been trying to find out just how these PSA tests are run, what is used, what may cause a false reading for quite a while now. Haven't been able to get any reliable info. I've read of a color comparison, machine testing, etc. I really wonder how accurate the standard testing is for very low readings. At an annual checkup they are looking for results in a much higher range where a tenth of a ng/ml is of no real importance. Looking at 2.0 compared to 2.1 is not a big deal. For a post surgery test the difference between .04 to .14 is the difference between nothing and something. I'd like to see a comprehensive article about PSA testing that really digs into it.

[Guest guest]

Also during my last visit my Doc. prescribed a PAP test along with the PSA test.

A little research shows that this PAP is useful to look for a recurrence of the

cancer. I haven't had this yet, go next month, but maybe this will help nail it

down? snip >>prostatic acid phosphatase (PAP), an antigen expressed in most

prostate cancers<<

[Guest guest]

'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. "

>

> Terry

>

> I agree, what really counts is the doubling time over a reasonable period and

over a significant minimum.

>

> To worry about a doubling of 0.1 to 0.2 in one month is not worthwhile, next

month it could be back down to 0.1.

>

> I had a PSA of 53.6 in April and a 52.8 in August - I call that the same.

>

>

> RE: Elevated PSA--Another Question

>

>

>

>

> Dennis,

>

>

>

> Some doctors do not believe that ultra sensitive tests have much value,

given the issues involved - see http://www.yananow.net/UltraPSA.htm for some

information that might be relevant

>

>

>

> All the best

>

> Prostate men need enlightening, not frightening

>

> Terry Herbert - diagnosed in 1996 and still going strong

>

> Read A Strange Place for unbiased information at

http://www.yananow.net/StrangePlace/index.html

>

[Guest guest]

'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. "

>

> Terry

>

> I agree, what really counts is the doubling time over a reasonable period and

over a significant minimum.

>

> To worry about a doubling of 0.1 to 0.2 in one month is not worthwhile, next

month it could be back down to 0.1.

>

> I had a PSA of 53.6 in April and a 52.8 in August - I call that the same.

>

>

> RE: Elevated PSA--Another Question

>

>

>

>

> Dennis,

>

>

>

> Some doctors do not believe that ultra sensitive tests have much value,

given the issues involved - see http://www.yananow.net/UltraPSA.htm for some

information that might be relevant

>

>

>

> All the best

>

> Prostate men need enlightening, not frightening

>

> Terry Herbert - diagnosed in 1996 and still going strong

>

> Read A Strange Place for unbiased information at

http://www.yananow.net/StrangePlace/index.html

>

[Guest guest]

I think the standard test is fine for routine screening, looking for a value of

1.0 or greater. The lower levels are not that important for this function. For a

recurrence of the cancer the rate of increase in the very small amounts that may

first be detected are very important for diagnosis. The more sensitive test is a

critical tool for this. The PSA test has had two or three major improvements

over the years and is getting much more accurate in the low numbers. Also there

is the " free PSA " test that is a good tool to screen for PCA at initial testing.

>

>

> 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. "

>