PSA doubled in last 30 days after 4 months stable since Provenge. What's next?

[SViking]

Update: PSA remained roughly 1.7 to 1.8 for last 4 months after Provenge but yesterday's 30-day PSA test revealed a jump to 3.190 so something is growing quick. I have been off of all ADT since finishing fourth LU-177 injection five months ago and one SBRT treatment 4 months ago.

After LU-177, PSA had been climbing quick until leveling off at 1.77 even as testosterone slowly returned.

New PSMA scan scheduled for next week but I have a feeling tumors won't show up.

What's next?

[cesces]

Take another PSA test just for the heck of it.

Do that before taking a PSMA.

[SViking in reply to cesces]

Thank you. I’m not sure what another PSA test will reveal. The day before SBRT my PSA was 2.2 and it only went down to roughly 1.80 for the last several months. This made me assume that those two tumors that showed up on my PSMA scan were not the only tumors, just the ones visible.

So basically, whatever cancer is left is either a large amount of micro metastasis or not PSMA avid. That’s why I suspect the PSMA test next week might not reveal any new tumors even though they exist. If that was the case what other type of scan could I try?

[cesanon in reply to SViking]

After a second verifying PSA test, along with the psma scan you need an FGD scan to look for cancer that the psma scan won't light up.

And while you are at it maybe look for another care team while seeking a few second opinions.

[SViking in reply to cesanon]

Thanks. Is the purpose of another PSA test to determine if the previous test was incorrect?

[cesanon in reply to SViking]

Why not. See which test is the anomaly. Simple, cheap and quick. Something you cannot say about a psma scan.

[God_Loves_Me]

time for Xtandi or apalutamide or darolutamide. Start immediately

[rick8637]

I had a similar increase this month. After 6 months at 1.4 it went to 2.5. I am on orgovyx and ubeqa currently. I am wondering if physical condition at the time can play a part. I was very busy and anxious with work related issues and had spent some time snowmobiling which is serious exercise. Plus I was having slight UTI issue which since went away after the PSA test(of course). all these things can have an effect on psa readings. I am gonna have a retest under normal conditions and I think you should too before you adjust care.

[SViking in reply to rick8637]

The only thing I did different was doing a 4-day water-only fast. I've been training like crazy my whole life.

[Worked_the_World]

You understand your condition better than I. Keep me in your loop brother.

[SViking in reply to Worked_the_World]

Will do