One of my lucky numbers growing up was 7. Ironically, 7 years after my cancer treatment, something pulled me back and scared me. This latest development started in 2014. As you may recall in a previous article, I mentioned the test methods used to perform PSA testing. I had indicated that the best thing to do, in my opinion, was to make sure the same method was used each and every time my PSA was tested. These test methods would lead to my last scare.

From 2007 to 2013, my doctor, Dr. Joseph Wagner, ordered a standard PSA test, which uses Bayer’s chemiluminescence method. This method has a sensitivity limit of <0.1 ng / mL. My results during that period were consistently <0.1 ng / mL. This level was considered a negative result, that is, not present.

A wise person once said that a little information can be dangerous. With over 30 years of analytical experience analyzing discharge permit effluent results for many contaminants, he was well aware of the test sensitivity issues related to detection limits and minimum levels of contaminants. There are many variables that can affect results, including but not limited to laboratory errors, contamination of samples or test equipment, and the use of different test methods. However, he knew one thing for sure. I knew that results of <0.1 ng / mL meant my result was between 0.0 and less than 0.1 ng / mL. Just before 2014, Dr. Wagner had been encouraging me to find another doctor to monitor my PSA as my results had been good until 2013. I told him that I preferred to stay with him since he was the one doing the surgery.

In 2014, Dr. Wagner decided to change 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 take to the testing lab for PSA analysis even lists the test on the form as "hypersensitive PSA." When I asked him why he decided to change, he said "why not use a more sensitive method when available?" The funny thing is that this more sensitive method has been around for a while.

My PSA result for June 2014 was 0.04 ng / mL. A week before my scheduled annual checkup, his office called me and asked me to reschedule my appointment due to a conflict in Dr. Wagner’s schedule. They give me an appointment 3 or 4 days before and my PSA results did not arrive in their office until the day after my appointment. This was not good because he could not discuss the result with me. Well, upon receiving a copy of the report, I read the fine print at the bottom of the lab results sheet and started to get nervous. The minimum 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 did not know, I did not know it.

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 office worker, 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 a quite different story. This time, the office worker said that Dr. Wagner wanted me to retest and switch from an annual appointment to an appointment every six months. I insisted and called his office several days later. Finally, Dr. Wagner called me back and reiterated what his staff had said. He said he wanted to see me every 6 months in the future to monitor my PSA. For some reason, I felt better after talking to him, even though I didn’t really know anything other than before I called him.

My PSA results for October 2014 and January 2015 were 0.04 ng / mL, the same as June 2014. I was happy with these results for obvious reasons, with no increase in my PSA levels. Now I just had to wait for my next appointment and the PSA test, which was scheduled for July to see if my PSA levels had stayed constant for over a year.