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  • Quest Psa users

    Hubby went for his 3 year Psa test.. We used Quest. Normally his reading comes back at <0.02.. This is due to he would get the psa post prostatectomy Hama test done. They normally have to send blood out to CA lab. And it would take like 3-4 days for results.. If they do the normal psa total test it comes back at <0.1..Well per the results we got today. His came back as <0.04 and a psa total test was done and not the Post psa Hama one. So I curious does this mean his psa went up or maybe their new lower limits for a regular psa is more sensitive now. He did have a uPsa test in Jan and it was 0.009.. Anyone know is Quest lower limits changed?
    Wife posting - DOB 5/76- Black Male

    PSA Hist:
    1/2018 2.66
    1/2019 3.39
    Retest 2/019 3.04

    MRI 3/2019: 3 Lesions identified (1) Pirads 4 & (2)Pirads3
    MRI Guided Biopsy 4/11/2019: G6(3+3)

    RMB: 10% of 1 core
    RMM: 10% of the tissue (fragmented specimen).
    RMA: High-grade prostatic intraepithelial neoplasia.
    RLB: 25% of 1 core.
    RLM: 70% of tissue
    RLA: 50% of 1 core.
    LMB: 80% of 1 core.
    Lesion #2, in 3 of 3 cores, 80% of total tissue

    RALP 6/5/19 USMD Arlington Dr. R. Parham
    Cath 6 days, bladder spasms, cath back in for 5 days
    No incontinence/Minimum ED (using Sildenafil as needed)

    Final Path 6/11/19: G6(3+3)
    SV, BNI, Adipose Tissue, ECE, Margins, PNI, LVI, LNI(0of8) All Negative

    PT2N0 ~10% involved by tumor

    Quest Diagnostics uPSA:
    9/7/19 (3mths) <0.02
    1/4/20 (7mths) <0.1 & <0.02
    1/20/20 Annual physical <0.02
    6/6/20 (1yr) <0.02
    12/5/20(18mths) <0.02
    6/5/21(2Yr) <0.1
    1/17/22(31mths) 0.009-Clinical Path Lab ultrasensitive
    6/9/22(3 years)<0.04


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  • #2
    I'm also thinking if there is a "<" sign that must be the lowest that test goes.
    Wife posting - DOB 5/76- Black Male

    PSA Hist:
    1/2018 2.66
    1/2019 3.39
    Retest 2/019 3.04

    MRI 3/2019: 3 Lesions identified (1) Pirads 4 & (2)Pirads3
    MRI Guided Biopsy 4/11/2019: G6(3+3)

    RMB: 10% of 1 core
    RMM: 10% of the tissue (fragmented specimen).
    RMA: High-grade prostatic intraepithelial neoplasia.
    RLB: 25% of 1 core.
    RLM: 70% of tissue
    RLA: 50% of 1 core.
    LMB: 80% of 1 core.
    Lesion #2, in 3 of 3 cores, 80% of total tissue

    RALP 6/5/19 USMD Arlington Dr. R. Parham
    Cath 6 days, bladder spasms, cath back in for 5 days
    No incontinence/Minimum ED (using Sildenafil as needed)

    Final Path 6/11/19: G6(3+3)
    SV, BNI, Adipose Tissue, ECE, Margins, PNI, LVI, LNI(0of8) All Negative

    PT2N0 ~10% involved by tumor

    Quest Diagnostics uPSA:
    9/7/19 (3mths) <0.02
    1/4/20 (7mths) <0.1 & <0.02
    1/20/20 Annual physical <0.02
    6/6/20 (1yr) <0.02
    12/5/20(18mths) <0.02
    6/5/21(2Yr) <0.1
    1/17/22(31mths) 0.009-Clinical Path Lab ultrasensitive
    6/9/22(3 years)<0.04


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    Comment


    • #3
      DjinTonic I need your help again. Duck2 yall see above. I'm still learning these lower limits and such.
      Wife posting - DOB 5/76- Black Male

      PSA Hist:
      1/2018 2.66
      1/2019 3.39
      Retest 2/019 3.04

      MRI 3/2019: 3 Lesions identified (1) Pirads 4 & (2)Pirads3
      MRI Guided Biopsy 4/11/2019: G6(3+3)

      RMB: 10% of 1 core
      RMM: 10% of the tissue (fragmented specimen).
      RMA: High-grade prostatic intraepithelial neoplasia.
      RLB: 25% of 1 core.
      RLM: 70% of tissue
      RLA: 50% of 1 core.
      LMB: 80% of 1 core.
      Lesion #2, in 3 of 3 cores, 80% of total tissue

      RALP 6/5/19 USMD Arlington Dr. R. Parham
      Cath 6 days, bladder spasms, cath back in for 5 days
      No incontinence/Minimum ED (using Sildenafil as needed)

      Final Path 6/11/19: G6(3+3)
      SV, BNI, Adipose Tissue, ECE, Margins, PNI, LVI, LNI(0of8) All Negative

      PT2N0 ~10% involved by tumor

      Quest Diagnostics uPSA:
      9/7/19 (3mths) <0.02
      1/4/20 (7mths) <0.1 & <0.02
      1/20/20 Annual physical <0.02
      6/6/20 (1yr) <0.02
      12/5/20(18mths) <0.02
      6/5/21(2Yr) <0.1
      1/17/22(31mths) 0.009-Clinical Path Lab ultrasensitive
      6/9/22(3 years)<0.04


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      Comment


      • #4
        <0.04 is undetectable with that limit. It means the PSA could be from 0.039 down to 0.000, but the test won’t test that low. Have no worry.
        YOB 1957

        DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM &lt;5%, Right side negative.

        3/6/19. Post surgery Pathology Report - Grade Group 4 Intraductal Carcinoma
        T3aNO, <1 mm non focal EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.
        7 Nodes, SV, SM, PNI, and BNI were negative.
        LVI and Cribriform pattern present.
        Decipher .86 High Risk.

        Post Surgery PSA
        3/25/19 .03. (25 days)
        4/25/19 <.03. (2 months)
        5/25/19 <.02 (3 months)
        9/10/2019. <.02 (7 months)
        11/27/2019. <.02. T < 3 (9 months)
        5/19/2020. <.02 (15 months)
        11/2/2020. <.02 (21 months)
        5/11/2021. <.02 T <3 (27 months)
        8/25/2021. <.02 T <3 (30 months)
        12/6/2021. <.02 T <3 (33 months)
        6/14/2022. <.02 T <3 (39 months) T=37

        3 Part Modality Treatment Completed

        2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
        ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
        ADT - 5/19- 5/21 Eligard and Casodex.



        3 Part Modality Treatment Completed

        2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
        ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
        ADT - 5/19- 5/21 Eligard and Casodex.

        Comment


        • #5
          I can't speak to why any one test was done instead of another (or if the same test was used but the lower limit of detection was changed), but the principle is very simple: if you have a < sign, you know only that your value is something below the value after the < sign. Just read the < sign as "below" and think about the meaning.

          So if you go from, say, <0.02 to <0.04 you know only that your current value is less than 0.04, but you don't know if you had no change, went up, or went down. But you have lost information, because before you knew your PSA was below 0.02 and now you know only it is below 0.04. It may or may not still be below 0.02; you don't know.

          If you go from <0.04 to <0.02 you also do not know if or how your PSA changed, but you have gained information because you know it is now below 0.02, whereas before you knew it was below 0.04.


          Djin
          Last edited by DjinTonic; 06-05-2022, 05:55 AM.
          69 yr at diagnosis, BPH x 20 yr, 9 (!) negative biopsies, PCA3-
          7-05-13 TURP for BPH (90→30 g) path negative for PCa, then 6-mo. checks
          6-06-17 Nodule on right + PSA rise on finasteride: 3.6→4.3
          6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
          Nodule was negative for PCa
          Bone scan, CTs, X-rays: neg.
          8-7-17 Open RP, negative frozen sections, Duke Regional Hosp.
          SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
          pT2c pN0 pMX, G9 (4+5) acinar adenocarcinoma
          5% of prostate (4.5 x 5 x 4 cm, 64 g) involved
          Dry; ED OK with sildenafil
          11-10-17 Decipher score: 0.37, Low Risk:
          5-yr met risk: 2.4%, 10-yr PCa-specific mortality: 3.3%
          9-16-17 (5 wk) PSA <0.1
          LabCorp uPSA:
          11-28-17 (3 m ) 0.010
          02-26-18 (6 m ) 0.009
          05-30-18 (9 m ) 0.007 (nadir)
          08-27-18 (1 yr.) 0.018 (huh?)
          09-26-18 (13 m) 0.013 (retest)
          11-26-18 (15 m) 0.012
          02-25-19 (18 m) 0.015
          05-22-19 (21 m) 0.015
          08-28-19 (2 yr. ) 0.016
          12-18-19 (28 m) 0.015
          06-30-20 (34 m) <0.014
          12-30-20 (40 m) 0.037 (?)
          03-31-21 (43 m) 0.020
          07-13-21(46 m) 0.018
          01-25-22(52 m) 0.023

          Comment


          • #6
            Ok. Thanks guys so much for responding. I appreciate it.
            Wife posting - DOB 5/76- Black Male

            PSA Hist:
            1/2018 2.66
            1/2019 3.39
            Retest 2/019 3.04

            MRI 3/2019: 3 Lesions identified (1) Pirads 4 & (2)Pirads3
            MRI Guided Biopsy 4/11/2019: G6(3+3)

            RMB: 10% of 1 core
            RMM: 10% of the tissue (fragmented specimen).
            RMA: High-grade prostatic intraepithelial neoplasia.
            RLB: 25% of 1 core.
            RLM: 70% of tissue
            RLA: 50% of 1 core.
            LMB: 80% of 1 core.
            Lesion #2, in 3 of 3 cores, 80% of total tissue

            RALP 6/5/19 USMD Arlington Dr. R. Parham
            Cath 6 days, bladder spasms, cath back in for 5 days
            No incontinence/Minimum ED (using Sildenafil as needed)

            Final Path 6/11/19: G6(3+3)
            SV, BNI, Adipose Tissue, ECE, Margins, PNI, LVI, LNI(0of8) All Negative

            PT2N0 ~10% involved by tumor

            Quest Diagnostics uPSA:
            9/7/19 (3mths) <0.02
            1/4/20 (7mths) <0.1 & <0.02
            1/20/20 Annual physical <0.02
            6/6/20 (1yr) <0.02
            12/5/20(18mths) <0.02
            6/5/21(2Yr) <0.1
            1/17/22(31mths) 0.009-Clinical Path Lab ultrasensitive
            6/9/22(3 years)<0.04


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            Comment

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