One particular of my fortunate numbers expanding up was 7. Ironically, 7 many years right after my cancer therapy, a little something pulled me back again in and gave me a scare. This hottest growth began back again in 2014. As you may possibly remember in a previous short article, I talked about the screening methods applied to do PSA assessments. I had indicated that the finest issue to do, in my view, was to make sure the identical approach was applied just about every and every time my PSA was examined. These tests strategies would guide me to my most recent scare.
From 2007 through 2013, my doctor, Dr. Joseph Wagner, purchased a typical PSA examination for me, which makes use of the Bayer chemiluminescence process. This method has a sensitivity limit of <0.1 ng/mL. My results throughout that period were consistently <0.1 ng/mL. This level was considered to be a negative result, in other words, not present.
A wise person once said that a little information can be dangerous. Having over 30 years of analytical experience looking at water discharge permit effluent results for many pollutants, I was well aware of testing sensitivity problems related to detection limits and minimum levels for pollutants. There are many variables that can affect the results, including but not limited to, lab errors, sample or testing equipment contamination, and using different testing methods. I knew one thing for sure though. I knew that results of < 0.1 ng/mL meant my result was somewhere between 0.0 and less than 0.1 ng/mL. Just prior to 2014, Dr. Wagner had been encouraging me to seek out another doctor to monitor my PSA since my results had been good through 2013. I told him that I preferred to stay with him since he was the one that operated on me.
In 2014, Dr. Wagner decided to switch the method used to test my PSA from the Bayer chemiluminescence method to the Roche Chemiluminescence Immunoassay, which is a more sensitive test method, with a sensitivity limit of <0.02 ng/mL. The test order paperwork that Dr. Wagner filled out and gave me to bring to the testing laboratory for PSA analysis even lists the test on the form as "Hypersensitive PSA". When I asked him why did he decide to switch, he said "why not use a more sensitive method when it is available?". The odd thing is that this more sensitive method has been around for a while.
My PSA result for June, 2014 was 0.04 ng/mL. One week before my scheduled annual check-up, his office called me and requested that I switch my appointment because of a conflict in Dr. Wagner’s schedule. They give me an appointment 3 or 4 days earlier and my PSA results didn’t reach his office until the day after my appointment. This was not good because he wasn’t able to discuss the result with me. Well, upon receiving a copy of the report, I read the fine print at the bottom of the laboratory result sheet and started to get nervous. The minimal level was <0.02 ng/mL and my result was 0.04, twice the minimum level. I knew the Bayer test was only sensitive down to 0.1 ng/mL, but was my level increasing? I didn't know.
The next day, I called Dr. Wagner’s office to express my concern. I ended up leaving a message, which was returned later that day. An employee, possibly a nurse or a office person, called me back and said that there was nothing to worry about and that my results were still less than 0.1 ng/mL. Less than 24 hours later, I received another call with quite a different story. This time the office employee said that Dr. Wagner wanted me to redo the test and switch from yearly back to every six month appointments. I persisted and called back his office several days later. Eventually, Dr. Wagner called me back and reiterated what his staff had said. He did say that he wanted to see me every 6 months going forward to keep an eye on my PSA. For some reason, I felt better after talking to him even though I really knew nothing more than before I called him.
My PSA results for October, 2014 and January 2015 were 0.04 ng/mL, the same as back in June, 2014. I was happy with these results for obvious reasons, no increase in my PSA levels. Now I just had to wait for my next appointment and PSA test, which was scheduled in July to see if my PSA levels had remained constant for over one year.
