PSA uptick

[mediocra]

Quick background, my dad was diagnosed with metastatic PCa in 2018. Initially treated with docetaxel + ADT. His PSA has been at/near undetected (<0.01-0.02) for several years, but recently there has been an uptick to 0.08 (similar on a recheck, so not lab error).

Obviously still low-level, but concerning signal. Other labs are stable and bone scan a few months ago was stable. His oncologist wasn't too concerned and recommended just the regular 3-month interval labs and seemed to suggest we could do a PSMA PET when PSA reaches 0.2 and radiate any new spots.

Does that sound like best plan of action? I thought metastasis-directed therapy was not evidence-based? Should he just start one of the newer antihormonals?

[Boywonder56]

i think onc right wait 3 mos...if it goes to 1.6.......do one more 3mo. and youll have your answe as it would be >.2 ....and psma might be fruitful....hang in there....breathe....live.....bw

[Tall_Allen]

No need for action until PSA reaches 2.0. He had too many metastases to debulk his prostate? You are right that there is no convincing evidence that MDT has any survival benefit. But if safe, why not? As long as systemic therapy is given too.