Rise in PSA and extra Eligard Injection

[Brightman]

My psa has risen from <0.01 in Feb to 0.04 in April to 0.27 in July then 0.41 this week. I had a CT and full body scan on Tuesday, which according to my MO, who I saw today, showed no ‘hotspots’. Because my PCa metastasised to 4 places in 2016 when first diagnosed, I had radiation to the prostate followed by docetaxel and have been on ADT ever since. The MO can’t work out why my psa has risen. Could anyone suggest to me why this may have happened. She suggested maybe bladder infection ( had a urine test ), too much exercise ( I have been on rehabilitation programme in pool & gym for last few weeks since spinal fusion of 7 vertebrae on May 6 th) or because I hadn’t had my 6 monthly Eligard injection, which they gave me today. I checked my home records and I had an Eligard injection on May 3rd and another today, therefore shouldn’t affect psa levels. So I have had two in 16 weeks instead of two in 26 weeks. Does this matter? Any advice would be appreciated.

[Derf4223]

Did you mean you had a PSMA PET/CT scan?

[Brightman in reply to Derf4223]

I had a whole body bone scan ( WBBS) and a CT scan of neck, chest, pelvis and abdomen. I have never had a PSMA PET/CT scan, I thought because my psa has been too low. Before this year my psa has mainly been <0.01. Twice it increased slightly to 0.04 when tumours started to grow back on the 6th rib & T10/T11, which I had SBRT on. The 6th rib is now clear, but radiation on my T10/11 caused a compression fracture which led to a spinal fusion on 7 vertebrae ( T7- L1) in May this year, which I am recovering from now. But my psa has never gone up like it has this year since I was first diagnosed in 2016.

[Derf4223 in reply to Brightman]

You might ask your MO for a serial liquid biopsy. Guardant has one approved by medicare and AFAIK its in the NCCN playbook. GL

[Justfor_]

When on ADT test for PSA AND Testosterone together. Either of them alone dosn't provide a clear picture.