When does PSA level increase warrent action after a prosetimy?

[jdfamily]

Had a prosectemy two years ago. Since that time my psa has very slowly increased from .0 to now .21, which my oncologist and radiaologist say is a trigger point for further action such as radiation. Thoughts?

[Tall_Allen]

I already responded.

[jdfamily in reply to Tall_Allen]

sorry must have missed it

[sryoung44 in reply to jdfamily]

You may want to read this:

pcf.org/c/pyl-psma-pet-imag...

[Justfor_]

In the same condition like yours but before deciding on further steps I will have a PSMA PET scan. It was scheduled for November last but the 4th wave of the pandemic imposed a change in plans. To stall things I started taking Bicalutamide with good results. I am documenting this phase in my "Bicalutamide maneuvers" thread.

[Jaffa_2001]

Diagnosed late 40’s and decided on a UK Rad. Prostatectomy in April 2001, Gleason score 5 and T2a staging. All contained in the capsule, no lymph's infected and bone scan negative, and the surgeon spared my nerves. My Pre-Op PSA stood at 15.

Post Op. PSA 0.04 and it stayed at that level for just 6 months before slowly rising to 0.10 after a year, was at 0.34 at 18 months and when it reached 1.11 at 2 ½ years I was lined up for radiation.

That was in July 2004 some 3 years after the RP. By July 2006 my PSA was down to 0.17. But it has slowly risen and fallen ever since and after 15 years stood at 4.21 and on the 20th anniversary of my RP stood at 9.

My doubling time has always been 36-48 months and all MRI and Bone Scans clear.

Ironically after my PSA has been steady for 2 years, suddenly this year it took a giant leap to 15, which was always the figure I thought would be time to re-asses things. My consultant (now retired) was always saying he would not consider starting hormonal manipulation till it stood at my Pre-Op. PSA of 15, or unless my doubling time came down to 6 months.

PET scan is lined up but Covid has seriously affected the NHS here in the UK so not sure how quickly that will happen, maybe a month’s time, but another test a week ago showed PSA dropping to 12 so my readings as usual are up and down.

I know the NHS here thinks/behaves differently to the USA, but it is 21 years in April since my Op. so I feel strongly that you should not rush into any decisions, before getting at least some clarification.

However everyone's journey is different as is the prognosis. I think I have been lucky to have gone as long as I have without more treatment, but I can only say that with hindsight. None of us have a crystal ball, unfortunately!

All the very best.

Brian

[WickedNeptune in reply to Jaffa_2001]

Not clear to me- did you have the radiation in 2004?

[Jaffa_2001 in reply to WickedNeptune]

Yes I had radiation, and I refused to have pre-radiation hormones, despite the oncologist saying they were necessary. I had by then learnt a lot more about my condition and started making my own informed decisions. So I went straight into salvage radiotherapy hence the drop in PSA to a nadir of 0.17 two years after. Regards Brian.