PSA Progression

[DrDavidBanner]

Hello, I hope everyone is well. I'm checking in because I received my latest PSA today. Prior to today I had three consecutive rises from .01 to .04. Today's came back at .05, so that makes four consecutive PSA rises. I have already had a prostatectomy and salvage radiation. I know in my heart that the cancer has returned. What's a bit frustrating is that my oncologist says that he will not consider it a recurrence until the PSA is at .6 or .7. Any thoughts on this?

[Mascouche]

For people who like you had their prostate removed surgically, it is considered recurrent at 0.2, which you are not yet.

But I don't understand why he wants you to wait until it reaches 0.6. Maybe he feels that he won't see it well enough on scans until the psa gets to that level?

[Mascouche in reply to Mascouche]

And Dr David Banner, do you turn green when angry? Just wondering

[DrDavidBanner in reply to Mascouche]

Haha. "You wouldn't like me when I'm angry," Lol!

[Tall_Allen]

The only problem is the ultrasensitive PSA test you are using.

Your oncologist is right, so why torture yourself?

[DrDavidBanner in reply to Tall_Allen]

No need to write off ultrasensitive tests. They can be very reliable...especially in determining a trend. Dr. Scholz states that there's no need to wait until .2 is reached. If the assays are showing a consistent rise, you know that the cancer has returned (of course we're talking about after first and second line treatment). Some urologists go by the three consecutive rise paramanter to determine recurrence.

[Tall_Allen in reply to DrDavidBanner]

The value of any test is the changes in therapy that even potentially can be made because of it. On that basis, uPSA has no value and only causes unnecessary anxiety. Dr. Scholz is only expressing his feeling and has no data to back it up.

The second BCR is discussed here:

prostatecancer.news/2019/08...

[street-air]

You may like to look at this video cancernetwork.com/view/psma... scroll the thumbs to Ep4 , play that, around the 7 minute mark. And then send that to your oncologist. (However it is for primary (initial) recurrence not for potential second recurrence after radiation).