I’m officially 4-years NED after prostate cancer surgery, and my PSA remains undetectable! NED means there is no evidence of disease, and undetectable means no PSA detected in the blood. I’m grateful my doctor recommended the PSA test. Without testing, I wouldn’t have known my PSA was rising. I was healthy, fit, with no family history or symptoms. And yet, cancer was already in the final stage before breaching the prostate. Regular PSA testing saved me from a terminal diagnosis.
Even though I’m NED, I fear recurrence partly because a few prostate cancer cells may have survived treatment. These cells could multiply, spread and cause the PSA to rise to detectable levels. The risk might be low, but it happened to a few close friends of mine. And unfortunately, I lost a good friend to prostate cancer recurrence. He was 10-years NED when his PSA started to rise uncontrollably. Secondary treatments failed him, and he died before his 70th birthday. And that’s the biggest reason for my anxiety and fear of recurrence. I understand this might be an exception, but it hits close to home as he was a good friend.
My fear of recurrence is at its highest during a follow-up PSA test. In my case, ever since surgery, my PSA results have been <0.008. The less than “<” sign indicates undetectable. The value of 0.008 represents the lowest level the lab equipment can detect. Therefore, levels below 0.008 are not detected and reported as undetectable. You can see how undetectable doesn’t necessarily mean zero. It just means results are below what the lab equipment can detect.
And I learned a lot more about this after I noticed a change in one of my PSA tests. The results were 0.008, but the less than sign was missing! I feared the worst and thought my PSA was now detectable! I panicked and immediately did some research. Including speaking with my doctor, a panel of doctors on Zoom, and a Clinical Biochemist from the lab! And I now feel much better about the missing less than sign.
The equipment at the lab I use can measure PSA down to 0.003. However, due to imprecision at that level, they cut it off at 0.008. At that level, there is an allowable analytical error of 30%. Therefore, results could vary by +/- 0.002. Meaning, even though the “<” is missing, it might not mean anything. All the experts I spoke to agreed there’s no need for concern unless the results rise to 0.1 or above.
What a relief! However, to be sure, I requested another PSA test. And I’m happy to see that the less than sign has returned, and my results continue to be <0.008. Although, I do feel a bit foolish for freaking out about the missing less than sign. But I’m finding the mental stress of cancer can be brutal. Even worst than the physical side-effects. I’m not sure I’ll ever lose my fear, and it’s essential to find healthy ways to cope. Please read my article, Prostate Cancer and My Coping Mechanisms, to learn about the ways that work for me.
And for now, I’m going to enjoy the moment of knowing that today, I remain NED!
Next PSA test in six months.
I’m grateful for the opportunity to share my prostate cancer diagnosis and lessons learned. You can listen to all my medical posts under Gogs’ Medical Testing.
If you’re newly diagnosed with prostate cancer and live in Canada please request a free Reef Knot Kit from Prostate Cancer Foundation BC. Each kit contains a copy of my book, Prostate Cancer Strikes: Navigating the Storm. For more details, please read the Announcement in my local paper.