Looking for anyone or anyone that knows someone with a post RP low but rising uPSA level?

[jronne]

Looking to engage with anyone or anyone that knows someone that has been or is in my situation

I am 4 years post RP with two years of rising uPSA from <0.006 to 0.012.

[leach234]

I wouldn’t call that rising. My lab doesn’t even detect ultra sensitive below 0.02. My results over the past year have always been <0.02. My PSA could be rising every 3 months and I wouldn’t even know it.

[jronne in reply to leach234]

thx

[marlins1]

jronne my case is similar. 3yrs after RP , pssa rose from .01 to .3. Elected for RT with boost 7/19. Lupron for 6mo. PSA presently .02.

It appears to me that you PSA is still very low and subject to variation. Just keep checking it every 3-6mo. Under .1 your good. You don't need to do anything presently. You can always op for RT or ADT later. Discuss with your MO.

[jronne in reply to marlins1]

thx, wishing you the best with the SRT

your PSA is low for now, may bounce up short term and then decline again

sometimes uPSA bounces high post SRT for 3 - 6 months

[Hawk56]

Similar, surgery in March 14, GS8, T2CNoMX, ECE, SV and margins negative,,,PSA undetectable for 18 months, SRT failed because we radiated only the prostate bed not the PLNS nor did we add short term ADT.

Because of the GS, short time to BCR, PSADT and PSAV we went to Mayo in Jan 17 and had the C11 Choline scan, four PLNs but no bone or organ. Did 18 months of ADT, 25 more radiation treatments and six cycle of taxotere. PSA has been "undetectable" since finishing treatment in May 18.

I say undetectable since in February 19 when my new urologist switched me to USPSA it came in at .36! I was ready to hit the panic button but relaxed. Why, the key is not one reading but the trend. Here's the subsequent labs.

2019

2 February 2019 Testosterone 481, USPSA .36

16 February 2019 USPSA .24

2 April 2019 USPSA .06 (

7 June 2019 (USPSA .124

19 August (USPSA .06

2020

3 January 2020 USPSA .07

So, it's a sine curve. My urologist looked at me and said "see you in four months."

I would consider doing nothing but continuing to monitor until such time there is a clear and upwards trend. My urologist and I do not have a specific PSA level to trigger treatment, rather we will evaluate the data and then decide.

Kevin

[jronne in reply to Hawk56]

wishing you the best, you had RP on 3/18 ?

when was SRT?

sometimes uPSA bounces high post SRT for 3 - 6 months

what is the explanation if any in the uPSA values bouncing around so much ?

[Hawk56]

SRT was March 2016, 39 Rapid ARC IMRT, 70.2 Gya. PSA was .3 to start, 99 days after we finished .07, 30 days later 1.0 and by January 2017 4.8.

Urologist is unsure why the bouncing around.

[jronne in reply to Hawk56]

thx, in the end doubling time is key for many doctors, I hope your PSA if it rises that it rises slow

[AlanMeyer]

Sorry I've taken so long to answer this. I've been out of the country and without Internet access for several weeks.

It seems reasonable to say that your current PSA doubling time is up to four years. I say that because your PSA was probably increasing during the first two years post RP, but remained below the test threshold of 0.006 and so was not visible on the test results.

If you were to stay at a four year doubling time for the long term, it would take about 25 years for you to reach 1.0, and another 20 years to reach 32. So it might not begin to be a threat to you until you reach the age of 104, and not a serious threat with symptoms until around age 116 - by which time we hope that new treatments will have ended the PCa problem. Of course doubling times can and do increase, but they don't always, or don't for a very long period.

I think I would work out a threshold PSA and a threshold doubling time either of which, when crossed, would trigger an examination of possible treatments. For example, if the PSA reaches 0.4 or the PSA doubling time reduces to one year. I don't know if those are the best thresholds or not. Others here may have informed opinions or if you've got a good oncologist he or she may have a good idea of what the numbers should be. Below those numbers, do your best not to worry about anything. Any new treatments always involve a risk and a hassle, so put them off until your plan indicates that it's time to do something. Enjoy life. Then see what the best available treatments are at that time. They may be different from and better than the best treatments available today.

Best of luck.

Alan