Do I have to worry about a recurrence?

[Yearofthecow]

Curious about anyone else's thoughts on this, or if anyone has had a similar situation.

I had SBRT on 9/24/2022 with Dr. Kishan at UCLA using ViewRay, Image guided SBRT no ADT.

Been on Avodart since 2013.

PSA prior to the SBRT was was 2.7 ng/ml 8/9/2022

3 months later the PSA dropped to .92 ng/ml 12/2/2022

The PSAs are the following:

12/2/2022 .92 ng/ml

3/2/2023 .40 ng/ml

6/9/2023 .49 ng/ml

9/11/2023 .44 ng/ml

11/29/2023 .44 ng/ml

3/4/2024 .52 ng/ml

9/6/2024 .54 ng/ml

9/24/2024 MRI Performed at UCLA, no evidence of prostate cancer

3/18/2025 .68 ng/ml

The .68 ng/ml is very concerning to me, along with what seems to be gradual increases since 11/2023. In general it seemed like mostly mid .55 ng/ml, then in 3/18/2025 it jumps .13 ng/ml. That seems like a lot.

Not that I am grasping at straws, but is a PSA bounce possible 2 years 6 months after treatment, and does this pattern even resemble what a bounce would look like?

I have an appointment with Dr. Kishan on April 11, where of course I will ask him about it.

Any thoughts or input are appreciated.

Thanks,

John

[petabyte]

Maybe you already tried this. It is from chatgpt (o3-mini) and seems reassuring.

chatgpt.com/share/67db1cf2-...

This is perplexity (pro)

perplexity.ai/search/someon...

[Yearofthecow in reply to petabyte]

I didn't even think about chatgpt. That is a great idea. Thanks petabyte, I really appreciate it.

When I see Dr. Kishan on April 11 I will ask him if a PSMA would be worth considering.

Thanks,

John

[addicted2cycling in reply to Yearofthecow]

redjournal.org/article/S036...

[Yearofthecow in reply to addicted2cycling]

Thanks addicted2cycling.

seems it can be quite variable for some when they indicated in that study that 1 in 13 experienced a bounce of NADIR +2 ng/ml by 5 years".

Next month I will be talking about this with my radiation oncologist.

John

[Yearofthecow]

Just adding a little more information. Before my up coming appointment in April the NP did get back to me regarding my PSAs with the following response:

"This is very common for the PSA to move around a bit, and since you had a negative MRI prostate in 9/2024, I would not be concerned for recurrence at the time. If the PSA continues to rise to >1.0, then we can consider additional imaging. No need to come in person if you don't wish to, we can keep the telehealth visit as planned if that is easiest for you."

While somewhat reassuring, I am still concerned, because nothing is perfect including MRIs. I plan to ask Dr. Kashan his thoughts about having a PSMA, and if that would shed more light.