> > Hi Ralph...I assume you are talking about the ultrasensitive PSA test,
> > there would be no "additional" information to report if it were the
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>
> What is IHT?
Intermittent hormone therapy, where you stay off the hormones until
the PSA starts to rise again. Comparing the nadirs during subsequent
off periods is also informational.
> If that is some kind of hormone therapy, it seems to me
> that such patients should be in regular communication with their
> oncologists about the meaning of any PSA testing and they shouldn't be
> interpreting the results themselves.
I'd say it depends on the individual and the oncologist. From reading
the posts of advanced men, I've drawn the conclusion that many
advanced men (or at least many that participate in various PCa
discussion groups, know quite a bit more than their oncologist,
unfortunate but true. The oncologists often support the plans /
recommendations that the men have researched out, after reviewing
them. I suspect some men with early stage disease know more than
their radiologist, urologist, etc. I fully support such men
evaluating their PSA results and then comparing notes / thoughts with
their doc.
> For radiation therapy, ultrasensitive tests are not very useful since
> the nadir is seldom below 0.1 ng/mm.
Yes, ultra-sensitive testing wouldn't make sense here.
> For RP patients, whether or not ultrasensitive tests provide any useful
> information is a matter of dispute among experts.
I suspect current thinking amongst most experts has shifted to seeing
value in the ultra-sensitive test as the test error / reproducibility
has been validated. Dr. Strum for one, comments on its value
regularly. I wonder what Dr. Walsh would say in a conversation today.
I've listed 3 advantages to the test, what negatives offset them?
PSA anxiety is a different issue, as we both noted, some men do not
want this information. That's fine, but it doesn't lessen the
informational value of the test.
> I agree that the
> results of such tests should be made available, without too much
> difficulty, to patients who demand it. On the other hand, many men
> will experience unwarranted "PSA anxiety" if routinely presented with
> such information, so it makes sense not to divulge it unless requested.
Leonard, I disagree again. I believe the test lab should release all
information to all qualified requesting parties. If someone has PSA
anxiety, then others should do like you do and have their doc serve as
a filter, rather than the lab having to keep track of the preferences
of thousands of patients.
> My doctor reports the results to me as "undetectable", and although I am
> probably more sophisticated than most in matters of measurement science,
> I leave it at that and don't question him further about what it means.
> I figure that I am paying him to worry about what is significant and
> what isn't, and I trust his judgement. If I didn't trust him, I would
> get another doctor.
I trust my doc too, but my mom always told me that two heads are
better than one.
> > The ultra-sensitive PSA is not for everyone, but for those who select
> > it, the information should be made available. I would encourage you
> > to "educate" the hospital personnel who have made this decision and
> > work for a change in policy...Best wishes and good health, Ron