Dad 2nd BCR. Advice needed...

[MsBoBo]

After a very late salvage radiation + 1 year Lupron. He has been off ADT for 1 year when PSA began to rise again. From 0.01 to 0.03 in less than 2 months then 0.05 after another 3 months. Is this indicative of an aggressive progression and metastasis? The oncologist said that the doubling time is not really considered below a certain value and brushed that off. I have not seen info anywhere that this is the case. What should we do next? His details are in my profile. Thank you so much for any advice. 🙏

[Cackalacky_cyclist]

The PSA numbers you’ve posted only indicate the presence of PCa, not its aggressiveness nor its location. PSADT is only calculated after reaching 0.1 based on current understanding of the science. I also had a hard time with this and wanted to treat as early as possible, but found no Dr. would do anything before I went above 0.1. Since your father has already had whole pelvic radiation, I would expect your team to wait until at least 0.5 ( or more) before doing a PSMA PET scan to locate the sucker. As far as metastasis, yes, you can consider him metastatic at this point unless scans prove otherwise, since he’s had all the local radiation possible.

Knowing what you already know, it’s difficult to just wait; but the best thing you can do is enjoy the next few months or hopefully years before whatever treatments start again. Live your best life, so your father can too.

[God_Loves_Me in reply to Cackalacky_cyclist]

Agree with you

[Tall_Allen]

The oncologist is right. PSADT is not defined for numbers less than 0.1 and you need at least 3 readings.

[Justfor_]

The oncologist is either old school, lazy, measurements ignorant or plainly silly. The up to now PSA readings are suggestive of salvage RT failure. Sorry to be that blunt, but I am not posting in support to bad practices.

[Mgtd]

I am not a doctor but I have very similar results after almost identical treatment. I was told there is no need to take action except monitor PSA at this time. Next PSA test next week and meet with my RO.

Tall _Allen’s advice is identical to what my MO said and besides I am not rushing to do ADT etc until it is necessary. I assume next step is a scan and perhaps some spot radiation and play the wack a mole game for awhile.

[j-o-h-n]

Which Bo is your first name and which Bo is your last name?

Good Luck, Good Health and Good Humor.

j-o-h-n