What are the odds of BCR are for an RP guy when uPSA goes from < 0.006 to 0.012 in 2 years?

I have opinions. If you get above .03, I'd have a conversation with the doc. It's still not much PSA, but the over all trend isn't what you want.

Odds? No idea, but yes, keep a close eye on it.

don't have answers.

Speculation, while an interesting hobby, isn't going help. Right now there's nothing to do but wait and see.

Today - enjoy life.

If the next test is higher, call the RO and make your plans. As long as you're below .05 or even .1, clinically there's nothing to do. At .05 or .1, you'll want to plan the next treatment stage.

But that day is not today.

This article does not respond directly to your question, but it does address the question of when to initiate salvage radiation. The point it makes is that the old idea that BCR has occurred when PSA reaches 0.5 is outdated and dangerous. It argues for using a threshold of 0.1 or less. My view is that once an upward trend is established by two or three successive readings, it is unlikely that the PSA will settle down and quit rising.

https://ascopubs.org/doi/full/10.1200/jco.2016.69.0396

At .012 your PSA is still very low and it does not make sense (to me) to start RT yet. I started RT when my PSA reached .05, but it was rising faster than yours.

Post Edited (fiddlecanoe) : 1/26/2020 7:18:52 AM (GMT-7)

Jronne, please correct me if I am wrong, and please don’t take this the wrong way, my hope is to help, not to criticize.
I get the sense that you are, almost desperately, looking for someone, anyone, who has had a rise in PSa at a low level, after surgery, and then NOT experienced full bcr. And your thinking is that if you find one if those, it will make you feel better about your detectable PSA.

I think that’s faulty thinking. Even if you found that guy, or that story, it doesn’t mean that your experience will be the same. And if you don’t find that guy, it doesn’t mean that you won’t stabilize and never experience BCR.

One if the “features” of Prostate Cancer, perhaps one of the features that make it so difficult to deal with, is UNCERTAINTY. There are no definitive answers in situations like yours. The answer you seek does not exist.

My surgeon, when I became detectable, even after my PSA had slowly risen to .08 over 15 months, told me that I should do nothing because he has had patients who have seen their PSA rise to .1, even higher, and then level off. So maybe that’s what u r looking for. BUT, 2 radiation oncologists, both of high repute, told me that while there is no certainty, their best advice was to jump on it and treat, rather than wait.

When I was seeking answers here, a highly knowledgeable member who is no longer an active participant on HW , gave me the answer in the form of. Question... he said that I need to ask myself “how lucky do you feel” in other words, nobody knows for sure what happens next.

You are pretty far away from needing to make that decision. You may never even get to that point. Or you may in fact need further treatment down the road. Nobody knows and one mans experience may not be the same as your outcome. The best thing you can do right now is stay vigilant with regular uPSA testing, and at the same time, realize you can not control the outcome, so enjoy every day, and in between PSA tests, put the thing in a box and forget about it. It’s not easy. Maybe you could benefit from some professional help, or maybe just read about and learn to practice mindfullness. But try to take it as it comes.

This is advice that was given to me, when I was in your position. It was hard to follow. But I kept at it, and even though I ended up getting treated, it all worked out. I may still recur again, which would suck. But I have no control over it, so I’ll deal with it if and when it happens, and this disease ain’t gonna kill me. It won’t kill you either. Think about that.

My original readings after surgery were<.005. I eventually reached .06 at year eight. Both my urologist and RO said it was time to do salvage radiation. That was five years ago. My readings have all been <.006 since completion of SRT. I am due for my six month test now. My RO said at completion of SRT that she felt I was done with PC. So far she has been right= Thank you dear Lord!

thx DjinTonic

curious as to your exact full uPSA history as my Decipher score is 0.22 also low risk

you were 0.01 post RP which is not great but your doubling time is great

0.010 to 0.015 in over 2 years! probably a 4 year doubling time

I was 0.006 < at 18 months and now at 0.012 at 48 months with a doubling time likely greater than yours

I could buy the benign PSA tissue for you as 0.01 post RP means something was left behind

my zero uPSA is better initial news but worse later news

thx BillyBob@388 for your response

the Prostate Cancer Nomograms gives me 89% of being BCR free which does not account for post RP uPSA levels

Prostate Cancer Nomograms also use 0.2 for BCR despite the fact that at 0.03 most guys start preparing for SRT as BCR is inevitable as I understand things

I am 4 years post RP and could be facing SRT in the coming next few years if things do not slow down uPSA wise

InTheShop (Andrew?)

I did find this figure

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527538/figure/F1/

from the uPSA 0.03 BCR Kang study

Is the risk of BCR 50% for post RP guys with a uPSA of 0.01 as this study suggests?

https://healthunlocked.com/advanced-prostate-cancer/posts/142530980/is-the-risk-of-bcr-50-for-post-rp-guys-with-a-upsa-of-0.01-as-this-study-suggests

Strange how your perspectives change while dealing with PCa... I seem to have a pesky G6 and after RRP I freaked out when my PSA raised to 0.13 and I embarked on the SRT portion of my journey... SRT seemed successful for awhile only to have PSA raise once again... Worried for awhile but knew I had other treatment options... The next worry level is now 2 at which time I would embark on the hormone journey. I finally quit worrying about monthly PSA tests and every value... and strangely it has leveled off at the .20 - .30 range... I am now comfortable with levels in this range... Maybe it's just some benign tissue left in the bed area... I am 13 years since DX and finally learned not to let PCa run my life... Now it's like an issue in the background like an old injury that hurts sometimes but does not affect my daily outlook or enjoyment of life.

pasayten

uPSA testing has indeed left urologists confused. My doctor uses uPSA, so I knew when my PSA went from <.008 to .01 to .05. At that point my urologist suggested SRT. Before starting SRT I consulted with the prostate cancer team at VCU in Richmond. They do not use uPSA, so if they had been my only doctors I would have been unaware of the increase in my PSA. But they believed that starting SRT at .05 made sense. If they think that the information I gained by using uPSA was helpful in making a treatment decision, why don't they use uPSA?

My signature didn't attach to my previous message, but I hope it does now. My situation was much clearer than yours is now, Jronne. After surgery I reached a nadir of <.008, but after that and in less than a year it had gone up in two consecutive tests. You've gone two years, and the increase is much less pronounced.

There is probably no hard rule to guide you. Instead there are two contradictory guidelines. First, starting SRT earlier means less chance of mets. Second, starting earlier risks unnecessary treatment. Go figure.

jronne,
You don't have a prostate any longer, correct?
If so, then any extended rise in your PSA is BCR.
What you have to worry about is how fast it rises, PSADT, that's "PSA doubling time".
How long does it take for your PSA to double in value. Last mine was checked it was 6 weeks, that's not good.
They say anything less than 9 months is a matter of concern.
But your numbers are still very low, so you have time to breathe.
once you take a few breaths study your treatment options and make an informed decision.
If need be, get a second opion on treatment direction.

I'm sure the guys you are looking for exist somewhere. You have to remember the guys on this forum are a tiny representation of those with PCa.

You are searching for information that may not exist. As others have suggested, all you can really do is follow your PSA to wherever it leads you.