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PSA doubled (again), should I be concerned?

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Posted 7/4/2020 7:48 PM (GMT 0)
Last Monday (June 29) I had another PSA test. It's doubled from 0.2 in the previous test on Dec. 16, 2019 to a 0.4 now. (it also doubled in the last test from a 0.1 in August of 2019). Should I be concerned?

Some background info, it's been a little over three years (April 2017) since I completed RT, and my T has been back at a somewhat normal level for about 15 months now after two years on Lupron.

At this point I'm not real concerned and my URO doesn't seem to be either (he hasn't commented on it anyway), but I thought I'd run it by some of you guys here.
Posted 7/4/2020 8:25 PM (GMT 0)
Hi Kent,

We have similar high PSA diagnosis and G7, though I had more positive cores. We had basically the same treatment regimen. So far I have stayed undetectable, which is somewhat rare for us radiation guys. Your nadir appears to be At the undetectable reading, but probably due to the ADT. If we look at your 0.1 and treat that as a nadir, then you could go to 2.10 before you would be considered to have a recurrence of the PCa.

An increasing trend is somewhat expected, but should level off. While I wouldn’t yet be alarmed, I would be concerned. Because of the trend I would go to three month resting and watch it closer. Since you had pelvic radiation, if there is cancer, it was already out of the area and only systemic treatment would be indicated. If you do continue to increase, the next steps may include some scans to see if anything shows.

Pull another test in September and let’s hope it stabilizes.
Posted 7/4/2020 9:20 PM (GMT 0)
I agree that three-month testing would make sense. I also had the same treatment and my doc told me he was only going to be concerned if my PSA was north of 0.50. You're not at that point, but I think it makes sense to keep a close eye on things in the meantime.
Posted 7/4/2020 10:15 PM (GMT 0)
If you are not seeing a MO, I would start seeing one...Also, check back in with your RO...Another doubling or two, you need to get back on ADT..Also maybe time for a fresh set of scans (bone and CAT)....Don't let it get too far ahead of you..
Posted 7/6/2020 12:22 AM (GMT 0)
I concur with your URO that there's no need to be concerned right now. As was stated earlier in this thread, keep monitoring the situation at an interval that feels comfortable to you.
Posted 7/7/2020 1:56 PM (GMT 0)

Fairwind said...
If you are not seeing a MO, I would start seeing one...Also, check back in with your RO...Another doubling or two, you need to get back on ADT..Also maybe time for a fresh set of scans (bone and CAT)....Don't let it get too far ahead of you..

Not a doctor, but I concur.
Posted 7/7/2020 7:44 PM (GMT 0)
You may be experiencing a bounce from your radiation. I bounced around for the first several years before things starting heading down. I would agree with the advice to continue to watch but feel it is too early to make a judgment.

Paul

Post Edited (PDL17) : 7/7/2020 7:28:31 PM (GMT-6)

Posted 7/8/2020 8:03 PM (GMT 0)
Get a MO, no not rely on your URO. I just went through this and got a MO after 3 straight rises one year post RP. I just finished 39 sessions of radiation and 1 more Lupron shot to go. I was 0.09 when I start treatments this year.
Posted 7/8/2020 10:49 PM (GMT 0)
Tough situation. Many radiation men don’t reach nadir for five years. PSA bounces are mainly in the 18-36 month range, which you are just on the outside of. What is going on?.......Who knows.

Be patient.....you are in no immediate risk. Watch the trend, follow it closely...and monitor your PSA at least every three months. A great time to interview several medical oncologists that specialize in PCa. Get the information....asses the fit....long before you need to hire one.
Posted 7/9/2020 4:01 PM (GMT 0)
Kent, Great advice from people that have similar experience...that’s why I believe this forum is so helpful. Although my biopsy showed far less cancer than yours I do understand the stress that comes with each PSA especially following a bounce. I think the 3 month PSA checks is the best short term advice. My RT finished up 6/17 and my current PSA is currently close to your number following my bounce so possibly quite normal for us both. Good luck and keep us posted.
Posted 7/10/2020 7:43 PM (GMT 0)
Thanks for the replies.

I did finally get a message yesterday from my Urologist (actually his Nurse) about my latest result. Said my PSA is "slightly elevated" and he would like me to test again in three months or so (anytime in October she said). That echos what some of you here are recommending, so I'll go with that and see what happens.

As far as getting setup with a MO, I'm not sure about that. It was my understanding that not having had surgery I shouldn't be surprised to have some amount of PSA. The consistent upward trend is a bit of a concern though.

Trying to set up appointments is kind of a problem right now. Since early March I've spent the majority of my time helping my 92 year old Mother, at her home in Iowa, two states away from where I live in Indiana. First I was here with her during the Covid-19 shutdown. In early May, when things started to open back up, I returned to Indiana. Exactly one week later she fell and broke her hip. Since then I've been back in Iowa again (mostly). I was home (in Indiana) for about 10 days in late June and thru the 4th of July weekend, which is when I got this last PSA test done.
Posted 7/10/2020 9:04 PM (GMT 0)
I wouldn’t be rushing to a medical oncologist just yet. Nothing indicates that, yet. Live your life, help your mother and retest in three months. The increase you have had is in no way an emergency or would indicate changing doctors due to specialty or medical capability.

As a fellow Hoosier....two questions........where in Indiana are you? Are you a Hoosier fan or Boilermaker?
Posted 7/10/2020 9:27 PM (GMT 0)

JNF said...
...As a fellow Hoosier....two questions........where in Indiana are you? Are you a Hoosier fan or Boilermaker?


Fort Wayne. I guess I lean more towards Purdue (Boilermakers) but I'm not that big of a sports fan.
Posted 7/10/2020 11:54 PM (GMT 0)
Good area, Kent. We spent several years in Decatur. My kid brother and sis-in-law both work at the Journal Gazette and live on the Northside. We grew up spending summers at Wawasee, so I know the area well. I am from New Castle. We can help you overcome the Boilermaker syndrome. Best wishes with your mother. We are in a similar situation with my 92 year old mother-in-law living in north Florida. We visit every 4-6 weeks and daily phone calls. Circle of life.
Posted 10/13/2020 12:06 AM (GMT 0)
Back with a update.

My PSA test from last week (on 10/07/2020) has it still at 0.4. That breaks the doubling trend and makes me feel better about things. Comment from my URO "not terrible" but he would like me to do another test before the end of the year.
Posted 10/13/2020 1:10 AM (GMT 0)
Good news! Good luck ahead!
Posted 10/13/2020 6:29 PM (GMT 0)
Great news on your latest test result.
I concur that getting another test in three months or so makes sense.
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