Rising psa

[BegalBoy]

My psa has been increasing slowly after 45 radiation treatments and ADT for 2 years. testing every 6 months : 0.211, 0.354, 0.596, 0.865. Should I be concerned? I was told doubling time was from 6 to 9 months.

[tango65]

If you still have the prostate and your PSA nadir was 0.2, a biochemical recurrence is considered when the PSA is 2.2 or higher. If that happens you could discuss getting a PET/CT, axumin or PSMA PET/CT (Ga 68 PSMA or 18F DCFPyl) to determine if there is local and/or metastatic recurrence and plan possible treatments.

auanet.org/guidelines/advan...

[Magnus1964]

Forget doubling time you have a definite progression . Time to move on to a new treatment. You should have a CAT scan and bone scan and go from there.

[Tall_Allen]

Doubling time doesn't apply to you (after RT). Those nubers look fine! It is expected that PSA will rise as testosterone comes back. It took me 4 years to reach my PSA nadir, There is nothing to be done right now - Just keep monitoring.

[noahware in reply to Tall_Allen]

Why would T be expected to rise if he is still on ADT, as it sounds?

[Tall_Allen in reply to noahware]

No, he was on ADT for 2 years

[Big_Mcc in reply to Tall_Allen]

Thk u 4 ur input. Not only do u help the person posting but many others in a similar situation who can only sit and worry alone especially in these covid lockdown times when access to oncologists and treatment can be limited or non existant. Much appreciate your comment

[billfenley2 in reply to Big_Mcc]

I second that completely.

[billfenley2 in reply to Tall_Allen]

T.A., would those observations hold true if brachytherapy were added to the mix?

[Tall_Allen in reply to billfenley2]

Yes. "Biochemical Recurrence (BCR)" after any kind of primary radiation is nadir+2. It is expected to rise a bit after ADT wears off, Even a BCR does not mean it's an actual clinical recurrence, it just means it's time to investigate further. With brachytherapy, it is important to rule out that the rise is from prostatitis or urinary retention.

[billfenley2 in reply to Tall_Allen]

Thanks, as always.

[noahware]

What are the details of your dx (PSA, Gleason, mets, etc.)? What are the details of your hormonal therapy? Have your T levels been checked along with PSA?

[pete0550]

My history is Gleason 3+4, seminal vesicle involvement dx November 2014 treated with ADT for 12 months and 37 rt sessions. My PSA has crept up since (as my oncologist warned me) but has 'plateaud' at 1.3 (again as he predicted). A PET scan in July 2019 was clear. Your PSA results seem to be increasing similarly to mine and i was reassured that doubling was not as significant at those low figures. I'm now on 6 monthly PSA testing with the promise of a further PET scan if/when it reaches 2. As Tall Allen says, just keep monitoring. I've had a great 5 3/4 years since I heard the dreaded words and am looking forward to covid19 being controlled so I can get back to travelling, concert going, attending sports events! I hope you find this reassuring BegalBoy. All the best and take care. Pete.

[pilot52]

12 cores Gleason 9 here....Post RP 2015 and Proton radiation...PSA rose as high as 13 as of late last two years Axumin PET negative for mets....last blood draw 3 weeks ago PSA doubled from 3.98 to 8.35...headed to LA for PSMA this Monday....Currently on Lupron and Xtandi past 18 months...will let you know how it goes...Blue Skies....

[Hidden]

You need to have a consultation with an oncologist. Please don't take the advice here regarding what you should do treatment wise. Let an oncologist recommend treatment if any. Don't play with fire.

[garyi]

In my experience, using the very valuable input offered here, and balancing that with the advise you get from a physician, is your best bet.

Good luck!

[j-o-h-n]

Tell us more info about yourself... Age? Location? Treatments to date? Treatment team? Doctor's namse(s)? All info is voluntary but it helps us help you and helps us too

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 08/05/2020 6:19 PM DST