Your father's doctor is right on.  There is too little information to
tell if this jump to .08 is significant or not.  The next PSA in three
months will be much more informative.  Lots of people in this
newsgroup have the ultrasensitive PSA test and get concerned when the
PSA bounces around down in that low level.  Only a definite trend
upward is something to be concerned about as his doctor indicated.
Good luck with the next test.
Dave Perry

Those of us who have ultra-sensitive PSA tests should be aware that
small "twitches" are not uncommon. I know of a fellow who, as an
experiment, had daily PSA tests for about a month. The results varied
all over the place.

But: If the patient's PSA tests are done by a Quest Diagnostics lab,
they might very well have changed the test protocol as of January. The
received wisdom is that results from protocol A cannot reliably be
compared to protocol B.

In my case, the local (Scottsdale, Arizona) Quest lab changed from the
DPC Third Generation ICMA protocol to the Roche Elecsys protocol. My
results changed from 0.01ng/mL to 0.06 ng/mL.

They say that, "Values obtained with different assay methods or kits
cannot be used interchangeably."

I don't quite grasp that, as each assay/protocol is measuring PSA in
ng/mL units. More study is required, I reckon.

Quest does offer "rebaseline testing testing by the previous method"
until March 3. I called the lab and was treated like an idiot child (and
nuisance). They claim that "the law" forbids them from dealing directly
with patients regarding testing orders; I must have some clerk at my
medic's office do so.

I have read what they claim is "the law" and it says no such thing. Try
telling that to them, though. They cannot hear you. All we are is
objects from which they remove specimens. Their customers are the
medics, not us.

Enough ranting.

I recommend checking on the test protocols; the answer may lie there.
Otherwise, I recommend more frequent tests and NOT acting upon a single
result.

BTW, I was never informed of the changed protocol. I learned of it
because it is documented in my copy of the test report. I would not have
known of it if I did not get copies. I have always recommended that we
insist on copies, and that recommendation is now reinforced.

Regards,

Steve J, who hates to be patronized

"You must pay for conformity. All goes well as long as you run with
conformists. But you, who are honest men in other particulars, know that
there is alive somewhere a man whose honesty reaches to this point also,
that he shall not kneel to false gods, and, on the day when you meet
him, you sink into the class of counterfeits."
-- Ralph Waldo Emerson

Jey,

I agree with what others have said.  As I understand it, the
consensus of experts is that PSA failure after surgery should
not be declared until a clear trend of 3 rising PSA tests has
been seen, and then I believe only after the PSA passes 0.2.

There are people on this newsgroup who have reported results
just like your Dad's, or worse, and then had their PSA come
down again.  This has happened even when using the same test
technology for all tests.  Steve J's point about possible
changes in test technology makes it all the more possible that
this is a false alarm.

There are other people whose PSA hovered at some low
but not undetectable value for years without ever going up.
That is unnerving perhaps, but not dangerous.

I don't blame you for being concerned.  How could you help
but be?  But your Dad has not yet shown definite evidence
of recurrence.

Best of luck.

   Alan

Concerned?  Sure.  Worried?  No, not yet.  Right now, you're talking about
8/100ths of a nanogram (1/millionth of a gram).  He needs to wait three
months and maybe three months more to establish failure.

Not to worry. I had an RRP in Jun 2004 and my PSA went from .03 to .08
after 6 months. It has held at .08 ever since. My Uro believes he left
a slice of benign prostate tissue which will keep generating a PSA of .
08 from now on.