Is this 1-month PSA “plateau” significant?

[happycamperguy]

Is this 1-month “plateau” of PSA Ultrasensitive significant?

My March 11, 2021, PSA Ultrasensitive was 0.342 compared to a month earlier when it was 0.341.

Prior to that, my PSA Ultrasensitive had been dropping for months:

-4 Sept 2020 PSA = 3.210

-30 Oct. 2020 PSA = 1.610

-4 Nov 2020 Started Abiraterone 1000 mg daily in addition to Firmagon monthly.

-19 Nov 2020 PSA = 1.89 (an increase).

-17 Dec. 2020 PSA = 0.751

-14 Jan 2021 PSA = 0.596

-11 Feb. 2021 PSA = 0.341

-11 March 2022 PSA = 0.342

Is that last slight increase significant? Is this 1-month “plateau” significant?

Thanks in advance for your perspectives.

[Tall_Allen]

Why are you getting PSA tests every month, and what is it that you would do because of it?

[happycamperguy in reply to Tall_Allen]

I realize we’re not treating the PSA. I get monthly PSA tests since it’s the only indicator we have as we work using ADT on getting PSA down to undetectable during this 6-month initial phase of Abiraterone. Nearest Axumin Scan is 5 hours away in Boise. We’re also looking for a recurrence or PSA doubling if it occurs.

Why wouldn’t we want to see if PSA falls or rises each month, then consider treatments or imaging going forward?

This monthly MO visit includes multiple lab tests such as Comprehensive Metabolic Panel (to see how I’m tolerating Abiraterone, I believe), 90-day Hemoglobin A1C since I’m diabetic, and any other needed lab tests. Then I see the MO. Then I get my Firmagon (now Lupron) injection. I’ll be looking at multi-month Lupron injections in the future.

[Justfor_ in reply to happycamperguy]

Don't apologize for not being part of the "Ignorance equals happiness" movement. It is there because it serves a reason, that of not burdening docs with questions they can't respond to. Re your query now, just a pair of samples is not enough evidence that your descending trend was halted, not to mention reversed.

[Tall_Allen in reply to happycamperguy]

My point is that at your low PSA and monthly tests, you are looking for meaning in inconsequential fluctuations. There is no meaning. The only thing that is important is if your PSA rises to the point that it is time to do something about it. That point will occur when your PSA reaches over 2.0 or a PSADT<9 months. At that point a bone scan/CT can reveal progression and you may wish to change medications.

Monthly PSA tests for someone in your situation seem like torture to me. (I can't imagine why you are getting ultrasensitive PSA tests to boot). Why create more anxiety in your life? It encourages you to focus your life on your disease.

[happycamperguy in reply to Tall_Allen]

Thanks for pointing out this PSA variation is “inconsequential.” What is “...PSADT<9 months” meaning?

[Tall_Allen in reply to happycamperguy]

PSA Doubling Time

[Magnus1964]

Rises in the third decimal are not significant. Your doing great.