PSA increase, should I test again?

[Secretary_Bird]

I was diagnosed with oligometastatic PCa in Feb 2022 (see my profile). I had one met in my right iliac crest. I had 37 fractions of IMRT (including to the met) and completed 2 years of ADT which ended in April 2024.

My PSA has been undetectable (<0.025 ng/mL) in my three monthly tests since June 2022 but my test this week showed an increase to 0.051 ng/mL

Should I be concerned about this increase and get another test in, say, 6 weeks time? Or is this slight raise to be expected as I still have a prostate, albeit one that has been largely obliterated by radiation?

Any advice greatly appreciated. Incidentally, I know that stopping ADT for oligometastatic disease is controversial but I am following the advice of Dr Parker at Royal Marsden. I trust him.

Thanks again.

[Yokohama2023]

Your numbers seems very low… had the same question as I had brachytherapyand linac ADT・ After a year my numbers went to .3 a lot of discussion about doubling time etc but I only hear 2.0 where reoccurrence has happened .. like you said having a prostate means PSA happens. Feedback here is helpful .. strange that 2.0 is the only discussion point.

[Tall_Allen]

I think you can consider a vacation if you need one.

[God_Loves_Me]

I would do PSA every 4 week if you are planning to stop other treatments

[ron_bucher]

Since PSA trajectory is far more important than a couple absolute values, and since I was also in my 50's when first diagnosed, and since I prefer being as proactive as possible with treatments, I get monthly PSA tests whenever in doubt. When my PSA goes undetectable or stabilizes, I switch to every 2 or 3 months or more but not more than 6 months.

[Secretary_Bird in reply to ron_bucher]

Thanks. That sounds like a good approach. I am going to get another test in a month.