RISING PSA 2 YEARS POST EBRT/ADT

[Waldo13]

Two years post EBRT plus 6 months ADT. Meeting with Oncologist in a few weeks and am wondering what he is going to make of the following PSA progression.

Sept 2022 - 0.29

March 2023- 0.56

June 2023 - 0.97

Sept 2023 - 1.77

Testosterone went from near zero post ADT back to 483 in Sept 2022 and now back down to 268 in Sept 2023. Dr told me that we weren’t going to worry unless/ until PSA hits 2.0 but I’m definitely worried now and Don’t know what to make of the plunging T level! Any advice/ information would be greatly appreciated!

[Tall_Allen]

You will qualify for a PSMA PET scan when your PSA reaches 2.0. You can get an mpMRI too.

[Waldo13 in reply to Tall_Allen]

Well, my PSA keeps shooting up, from 1.77 on 9/1 to 2.12 on 9/22. It has basically quadrupled in the last 6 months. Looks like I will qualify for that PET scan. What am I to make of this extremely rapid ascension? Should I schedule ASAP or wait until the next reading? Should the unthinkable become reality what treatment would you consider. My RO seems to favor Cryotherapy…

[Tall_Allen in reply to Waldo13]

I think you should get that PSMA PET/CT now.

Next steps are based on the results of the PSMA PET/CT, the mpMRI and maybe a biopsy. It would be premature to discuss salvage treatment before you know where it is.

[OldVTGuy]

Curious - your profile says 18-24 months of ADT but your post says 6 months. Which was it? And you had proton beam RT?

[Waldo13 in reply to OldVTGuy]

Ended up quitting after 6 months. Couldn’t take it. Yes, Proton beam.

[805guy in reply to Waldo13]

What ADT drug were you receiving?

[Waldo13 in reply to 805guy]

Lupron, 6 month injection. Extreme Hot flashes, penile shrinkage, loss of libido, etc. felt that the difference between 6 months and 24 months was not worth it… a gamble, for sure.

[OldVTGuy]

thanks. I’m leaning toward a year.