I am starting chemo next week after Zytiga and Xtandi failed to lower my PSA. My physical done last year showed a PSA at 3.1 and 7 months later the PSA was at 39.1 and i was diagnosed with met PCa. I looked back at 5 years of PSA readings, and each time the PSA was increasing. Talking to my internist he said the rate of change of the PSA did not concern him, but as you can see I was on a trajectory that was going to have a reading greater than 4. That reading would have concerned him. To my fellow community members, i am telling everyone I know that they should keep track of the rate of change of the PSA, and maybe, they can nib this damn disease in the bud.