2nd Biochemical recurrence

[rnewman751]

What is next ? I had DaVinci prostatectomy 2/6/2014. T2b, Gleason 4+3. Salvage radiation for bcr 9/2015. Psa undetectable from January 2016 to June 2019. June 2019 Psa .03, stayed around .03 until 9/2020 .06, then back to .05 until 2/2021 .06 again. 3/16/2021 .08 I have an appointment with MSK in 2 weeks. Has anyone had similar experience or any advise? Thank you.

[Danish-patient Moderator]

At some point, the next step would be to do a PSMA PET scan to locate the cancer. However, your PSA probably needs to be at least 0.3 before a scan can detect it. If it winds up being a single lymph node that is active, that node might be a candidate for radiation treatment.

[rnewman751 in reply to Danish-patient]

Thank you for your response. That is what the MO said as I wait for psa to approach 0.20. Best wishes to you.

[jsva]

The PSMA PET scan is a good recommendation, but good luck getting one in the US. It was only approved by the FDA in December, and is now only available on the west coast. I am treated at Johns Hopkins here in the east. That being said, my insurer finally agreed to cover an Axumin scan for me (also designed for us low PSA recurrent guys). My situation is similar to yours. I'm with a PSA of 1.1 and I am 12 years out of treatment. My Axumin scan came back clean, with no evidence of disease. I'm grateful, but it does have us all scratching our heads as to how to treat. Best of luck to you!

[rnewman751 in reply to jsva]

Hi jsva, thank you for your response. I had an appointment at MSKCC yesterday and like you said , no treatment or scans at this level of .08 psa. He said we should meet again when psa approaches 0.20. He did say after May 2021 ga psma 11 pet scan will be available in NYC. Thank you again, best wishes to you . Please stay in touch,

[Hidden]

When you had salvage was it to just the fossa or also your pelvic lymph nodes?

[rnewman751 in reply to Hidden]

The fossa