Rising PSA

[John347]

Hi all,I had RT about 2 years ago and have been having 3 monthly Lupron jabs. My PSA has been rising steadily from a low of 0.02 ug/l (May, 2024) to 0.04 ug/l (August, 2024) The result of my blood test today is 0.09 ug/l (Nov, 2024).

My PSA seems to be doubling every 3 months. Is this cause for concern? Or, are the readings normal considering my prostate is still intact? Or, is the Lupron starting to fail?

Thanks for any advice.

[Justfor_]

They will tell you that BCR post RT is nadir +2. So, you will have to wait until 2.02 which is absolutely nonsense as this 0.02 was achieved under ADT. IMO your RT has failed to the degree that ADT isn't enough to mask it up. Only way to know more than wait-and-see would be a PSMA PET/CT. Sorry if I brought you bad news.

[John347 in reply to Justfor_]

Thank you Justfor for your input. I will consult with my MO next Wednesday then consider what to do.

[Mgtd]

Just to confirm are you still getting Lupron shots or have you stopped getting them?

[John347 in reply to Mgtd]

The Lupron shots are still ongoing. Next shot is next week after consultation with MO.

[Mgtd in reply to John347]

Thanks for the reply. I am almost in the identical situation except I am off the Lupron and my T has returned to my normal range of around 700. My MO told me as my T rises I can expect the PSA to increase also. However in your case your T should still be low in the castration range.

Have you had your T tested recently to see if Lupron is working as advertised?

[John347 in reply to Mgtd]

Thanks for sharing Mgtd. I have not tested my T level recently but should still be low as evidenced by the usual side effects of low T.

[Fiddler2004]

Hi John, has your MO suggested adding another med to the Lupron injections? (i.e. Zytiga w/ Prednisone or Xtandi? Could help augment the Lupron. Are your Lupron injections every 3 months or monthly every month? Have you missed any injections? You're still in a good place IMHO but I wouldn't wait for it to climb too high...

[John347 in reply to Fiddler2004]

Thank you Fiddler for your reply. Yes, my Lupron jabs are 3 monthly and my next jab is on Wednesday. I will also consult with the MO on that day and see what he says about the psa rise.

[petabyte]

Maybe just a PSA bounce?

My RO warned me this was a possibility.

sperlingprostatecenter.com/...

[John347 in reply to petabyte]

Thank you petabyte for the link. I hope that is what I'm having...a PSA bounce.

[Tall_Allen]

Your PSA test is the cause of your anxiety. Switch to a conventional PSA test (lowest reading=0.1) and you will be fine.

[John347 in reply to Tall_Allen]

Thanks Tall_Allen for your advice.

So, are you saying that under a conventional PSA test, all my last few readings would just show up as 0.1? And the rises are too small and I should not be too concern?

[Tall_Allen in reply to John347]

Lupron should be preventing testosterone from being produced. If it is at castration level, you have no worries until your PSA reaches 2.0. There is no need for the ultrasensitive test you are using.

[John347 in reply to Tall_Allen]

Thanks Tall_Allen, that's reassuring. 😊