PSA up again after 30 days

[Armywifedublin]

Husbands second PSA in 30 days went up again but not by much but went up.

July he went from undetectable to 0.15 they MSK asked him to repeat in 30 days results now 0.18 still under 1.

The ADT has been out of his system since July and his Testerone came back from 39 to 250. Same month as the PSA test in July.

Just very worried.. I know that there are no scans to do as of yet. And we did have the genetic testing done because at first they thought this was very aggressive type since only 20 percent was in the gland the cancer spread outside the gland to 6 lymph nodes right side none on the left and he did radiation 40 rounds last year in June and was on ADT last shot was April last year.

The genetic test came back it was not the aggressive type. And his Gleason was a 3+4, PSA prior to radical prostatectomy was 2.4. Scans also were clear prior to prostate removal.

He’s doing well lifts and works out 5 days a week he’s plant based

Can anyone tell me is this still slow growing?

Do you know of a scan that can detect even if PSA is under 1?

I’m worried and so is he

Do you think they’ll put him back on ADT?

[Tall_Allen]

No scans to do. PSA is still low, which is a good thing.

[Armywifedublin in reply to Tall_Allen]

Thank you for confirming what I believed to be the case, and for the insight you so often provide us all. My wife at times makes these inquiries. When you and Nalakrats respond, I take careful note.

[j-o-h-n in reply to Armywifedublin]

"When you and Nalakrats respond, I take careful note."

SO WHAT AM I? CHOPPED LIVER?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 08/18/2019 1:02 PM DST

[monte1111 in reply to j-o-h-n]

I know you are, but what am I?

[j-o-h-n in reply to monte1111]

A tuna fish sandwich...

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 08/19/2019 2:59 AM DST

[Tall_Allen in reply to Armywifedublin]

I'm not sure what we carefully note, since I believe in evidence based medicine and he doesn't. I consider naturopathy to be right up there with voodoo.

[Armywifedublin in reply to Tall_Allen]

My apologies to all. I appreciate that my first post on this site was rather insulting. My wife and appreciate ALL who have responded to our inquiries. We are so grateful to have found this site and have learned so much from all who post on it. Forgive a “newbie.”

[tango65]

He could have a PSMA PET/CT scan (Ga 68 or DCFPyl) when the PSA is higher than 0.5 (detection rate around 50 to 60%). They could detect lymph nodes with cancer or metastases which could be treated with radiotherapy. This approach could delay starting ADT again and he could gain some time before exposing the cancer to more ADT and the new anti androgens. This is an article posted by Patrick today:

ncbi.nlm.nih.gov/pubmed/314...

[Hidden]

A PSA of .18 is still very low and going from .15 to .18 would not be considered a trend. You just have to keep watching and also watch how fast it's rising. If it's moving very slowly, there's time to decide what to do.

If he does have go back on ADT, he could add Erleada (Apalutamide). It's approved for non-metastatic hormone sensitive prostate cancer and has been shown to delay progression when added to ADT (See SPARTAN trial).

ascopost.com/News/58568

[garyi]

At this point you have nothing to worry about, except maybe worrying too much

Relax...you're in very good hands at MSK.

[Armywifedublin in reply to garyi]

Thank you. Yes we love MSK and our radiologist oncologist at the James here is in contact with them. Since if he needs radiation we can get it here

[Hidden]

At this point I would worry more about who gets the last slice of pizza.

[Alinur]

To my experience 0.4 is the best time to have PSMA PETCT ,Whatever kind. I have done six so far.

Good luck

[Magnus1964]

Which ADT drugs has he taken at this point in time? Plus has he had radiation treatment? If not this may be the best option.

[Armywifedublin in reply to Magnus1964]

He has done radiation to pelvic bed last June at The James at Ohio State 40 Rounds he also had firmagon for thirty days then Lupron for nine months.. which st that time he was undetectable till this past July from March of 2018. He is now on Avodart and metformin to slow things down

[CaryOn]

I am in month nine of a six month lupron depot injection, and I am still having side effects (joint pain, hot flashes, etc.). My last two ultra sensitive PSA tests have come back undetectable, but my doctor has warned me that I might see a little bump up in PSA as I come off the lupron, and that I should not worry about that, as it should fall again. Maybe that is the case with your husband.

By the way, I have had a prostatectomy, after which my PSA was undetectable for eight months, then it climbed back up. At that point I had 38 sessions of radiation therapy to go along with the lupron.

I agree with others that you should not worry., just keep on top of it.

[Xiang]

After my prostatectomy Psa was 0.34,rising till 2.43, 18 months later, I did a imrt 35 rounds. I had twice PSMA, one @1.03 & 2.03. Both undectable. Also 2 bone scan, negative. My Psa 8.34 & Gleason 3+4 with extrapucate prior surgery. Would recommend that you try imrt. Should you have a recurrence, then ADT, giving you better quality life

[tallguy2]

Why is he discontinuing ADT given all the mets? An "ADT holiday?" I urge caution.