December 2018 diagnosed. Gleason 7 PSA peak 3.86.
Prostatectomy April 2019. Confirmed all diagnostics. T2N0M0. Two actual lessons. 4+3/3+4. 1st lesion did contain cribriform cells.
PSA nadir post op 0.04. Never undetectable. By October 2019 PSA up to 0.13. The decision was made to do 34 68 Gy salvage radiation to fossa bed with 6 months of Lupron in January 2020.
Decipher came back 0.71
PSA undetectable until now.
My institution only goes down to <0.03.
Current PSA is 0.03 so technically detectable as per conversation with RO.
Radiation Oncologist wants to just do another PSA in 3 months and potentially wait until it rises to a point where imaging can be done to see exactly where it is.
Thoughts? Should I have a PSA more frequently? She feels we need to wait to even talk with a Medical Oncologist.
How aggressive should I be pushing for at this juncture? Thoughts about waiting vs some sort of aggressive treatment now?
Obviously quite anxious...
Everything looks good - I don't understand what you are anxious about. Every 3 months is fine - random fluctuations of more frequent tests will drive you crazy. In fact, try to get a PSA test whose lowest value is 0.1.
I understand random fluctuations. I am anxious because my RO stated she feels I am detectable even at such a low PSA and where we should go from here. I was hoping to stay NED for a bit longer and while the PSA is extremely low at this juncture I don't feel I am wrong for being concerned. I just don't know where to go from here.
detectable on a test is not the same as significant. When you are at the bottom of detectability of a test, there is a great deal of error (in statistical terms, the standard error of the test is greatest at its lowest limit). Therefore, random fluctuations of error should not be a concern.