PSA still going up

[ODave]

I had last PSA 5 months ago. It was 1.134 Dr said check again in 6 months. I went a month early. Now its 1.430 He emailed and said to go back to checking every 3 months and to call and discuss. This doesn’t sound promising..

[Tall_Allen]

So, you had RT and your PSA went from 1.1 to 1.4 in 5 months, barely moving. Every 3 months only seems to be a good idea because you seem prone to worrying about it.

[ODave in reply to Tall_Allen]

Yeah I’m worrying for sure, the only reason I got it at 5 months instead of 6 months was the online portal said to get it done.. the lowest I went was .74 so I guess the rising freaked me out a little since I’m 18 months from treatment. I know I know its a marathon not a sprint

[cpcohen in reply to ODave]

FWIW and IMHO --

Your concern is justified.

After a prostatectomy, if everything went well, your PSA should be 0 (or formally, "undetectable"), well before 18 months after surgery. So something didn't go well, for you.

You have either normal prostate tissue making PSA, or a prostate-cancer tumor making PSA. If it's normal prostate tissue, your PSA will stabilize. If it's a tumor (or tumors), your PSA will continue to rise.

Talk with your doc about one of the new high-sensitivity scans (the names change faster than I can track them). I think the sensitivity of old-fashioned "bone scans" was about PSA=2, but the newer scans are sensitive enough to pick up tumors (and normal prostate tissue, I think) at PSA levels below 1.0 . So you might get some useful information.

I'm not saying that you definitely need further treatment. But you definitely need more diagnostic work, to find the source of that PSA.

. Charles

PS -- If you had radiation treatment (either brachy or open-beam), it's normal for the PSA to _not_ fall to 0, and there's a "PSA bounce" that sometimes happens.

[ODave in reply to cpcohen]

Thanks yes I am in the “PS” category. I had SBRT mono-therapy. I expected bounces but expecting and seeing are two different things. .

[cpcohen in reply to ODave]

>>>. . . the lowest I went was .74 so I guess the rising freaked me out a little since I’m 18 months from treatment. . . .

>>>

I sympathize with your nervousness. I _think_ that 18 months is a reasonable time for the peak of the "PSA bump", so you might have to wait for another six months to get a clear answer to:

. . . "Bump, or recurrence?"

There's a relationship between "nadir PSA" and the chance of a recurrence, I think, but I don't have details. Tall Allen probably knows.

Stay in touch, please --

. Charles

[jdfamily]

Sounds much like mine. Now my PSA is only .25 and my oncologist is suggestion I do radiation right now!! I keep hearing others with much higher PSA and doctors are still on observe. Do not understand the differing opinions

[jazzy53 in reply to jdfamily]

Recommending radiation for someone with a PSA of 0.25 sounds like over-treatment to me. I'd definitely get a second opinion from a comprehensive cancer center . You really don't want to go through radiation and, presumably, ADT if you don't have to, and your PSA sounds like background noise.

[ODave]

Follow up: RO had me go back to testing PSA every 3 months since I was having a few rises. Last time I posted was 1.4 then 3 months later it was 1.2 in July so happy it went down a little. Tested this Monday and it was 0.653 😁 so that beats my lowest point of .74 after treatment, he said recheck in 6 months