Another test?

[Jvaughan0]

It has been three months since my PSA climbed from undetectable in 2017 to .2 last March. My MO has suggested that it reach .5 before getting scans and deciding on the next step. Up for a routine checkup with my family doctor next week. I will ask for a PSA and maybe a T test then. Any suggestions for other blood tests that might be helpful?

[dac500]

Did you have surgery?

[Jvaughan0 in reply to dac500]

Removal in 2014, Salvage radiation in 2017.

[Justfor_ in reply to Jvaughan0]

DHT, Estradiol, vit. D3(25OH), CRP and Alcaline phosphatase.

[NecessarilySo]

I may be on a different cloud, but I think you have not established a "biochemical recurrence" yet. My PSA tests come with the following:

"According to the American Urological Association, Serum PSA should

decrease and remain at undetectable levels after radical

prostatectomy. The AUA defines biochemical recurrence as an initial

PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory

PSA value 0.2 ng/mL or greater."

So it seems you have yet to have the subsequent confirmatory PSA.

Furthermore, in my own case, my RO didn't worry until the PSA reached 4. So here you are at .2 and worried what to do. Confirm PSA over .2. Then worry.

[Jvaughan0 in reply to NecessarilySo]

Your reasoning is noted and my cloud is lined with "what if" anxiety. I have had two "month apart" PSA tests since March. Both were .2. Back in 2016, a year and a half after removal and before salvage radiation, my PSA rose from 1.7 to 2.6 in a month. Radiation and ADT brought the level to undetectable until last March. Every provider I have seen since 2014 has either given me partial or wishful thinking information. Worry is pointless; information offers options.

[Justfor_ in reply to Jvaughan0]

Switch to a lab that reports PSA with 2 (or 3) decimal digits.

[NecessarilySo in reply to Jvaughan0]

I suggest you put your anxiety towards carefully measuring and charting your PSA. I think your doctor is more towards my cloud but check out my PSA chart below. I am now nine years since "biochemical recurrence" and my PSA is now <0.1 thanks to hormone therapy.

PSA 2008-2021

[Jvaughan0 in reply to NecessarilySo]

You certainly have an interesting history. I guess I will have a better idea this week after my third PSA results since March.

[Poowater]

You need to be on hormone deprivation therapy to wipe out active cancer. What you have is biochemical recurrence. A PSA test every month is warranted. Also, you need a Pet Scan Get second opinion from another MO..

[Bcgkelly]

Our cases appear similar. I had an RP in 2918 followed by stereotactic radiotherapy in 2019 for my first biochemical reoccurrence. I wasn’t suitable for pelvic wide radiotherapy. My PSA went down to 0.013 and over 18 months has increased to 0.068. My consultant considers anything above 0.05 to be a biochemical reoccurrence but wants to wait until it gets to 0.5, get a PSMA scan before treatment. He says the treatment will include hormone, more radiotherapy and possibly chemotherapy. I would be interested in following you to see how you get on. Bill

[Jvaughan0]

I understand. It seems our physicians have even more in common. I am still uneasy about waiting for .5. Part of me says I don't need lite tourist destinations to know I have prostate cancer, bring on the ADT and let's try and turn off the street lights.