Rising PSA post IMRT and ADT

[EdinBmore]

It's my understanding that an increase in PSA post radiation is an indicator of recurrence. The PSA "cut score" is 2.0. Anyone know why 2.0 is considered a recurrence metric? Typically, what happens next? Treatment options? Indicators of success?

Many thanks,

EdinBaltimore

[Tall_Allen]

Your understanding is partially correct. Rising PSA post-radiation and Lupron is expected and is NOT an indicator of recurrence. When PSA reaches 2.0 over its lowest value, it indicates a "biochemical recurrence." Then they have to figure out if that is just from your PSA jumping around (remember, urinary retention causes PSA to rise) or if the cancer is causing it. If the cancer is causing it, it is called a "clinical recurrence." They will do a pelvic MRI and a full-body PET scan to hunt for any metastases.

Nadir+2.0 is used for "biochemical recurrence" after radiation because PSA tends to jump around a lot. This is especially true as T recovers. They found that PSA numbers below 2.0 were NOT well correlated with clinical recurrence.

[EdinBmore in reply to Tall_Allen]

Thanks, once again.

[cesces]

A bump in psa is generally expected.

With the same treatment as you mine never got to 0.00.

What is important to keep an eye on is the trajectory of your psa readings.