Rising PSA Again! What Next? Any Thoughts?

[MGBman]

Prostatectomy 2015. Radiation x 32 tx. Zoladex x 8 with PSA nadir Oct 2017 - 0.01. Since then PSA climbed to 7.73 Jan 2022. Then had 9 degarelix injections ending Aug 2022. PSA down to 0.31. By Oct PSA was rising and by mid Dec was 2.0. Over the past two yrs have had PSMA Pet and internal MRI - no identifiable mets, just one 2cm tumour residing along vas deferens. Appears as though degarelix has had no lasting effect and my PSA now seems to be going into overdrive. I’ll have to go back on ‘something’ probably by spring or summer. Have appointment with Oncologist 9 Jan 2023. As I live in Canada, Lu177 probably not an option. Go back on Zoladex? Try to get on a drug such enzalutamide, apalutamide, etc.? Any thoughts that I could discuss with my Oncologist?

[Tall_Allen]

Yes, of course go back on Zoladex. But also ask for treatment (radiation or surgery) of your vas deferens tumor:

ncbi.nlm.nih.gov/pmc/articl...