My PSA jumped from 0.13 to 0.41 HELP

Hi Sober. Any unexpected PSA increase should be confirmed with a retest--what has your doc told you about the next step? I see you had ADT therapy, but didn't you have radiation also for your cancer? I don't see it in your signature.

Djin

I feel your concern. And our many Brothers on this site helped me weather the uncertainties of a fluctuating PSA.

After completing IGRT, my first 6-month PSA was down from 8.7 to 2.6. Of course, I bowed in prayer thanking Almighty God.

Another six months and it was down to 1.0. Yes!!!

Next, it went up to 1.4 - - OMG! And that's when I posted hereupon, and the guys talked me off the cliff by explaining that PSA can go up and down at times. And, of course, the lab might be a factor; such is why I wholeheartedly concur that you should go for a retest.

Now, I am elated to share that the 1.4 is down to 0.9 via a PSA drawn less than one week ago. Excepting the very first test (the 2.6), all were done via Labcorp at the same southern New Jersey location.

Godspeed, sir. The Best is Yet to Come for you!!!

NJ Fred

So you still have a (crispy) prostate.

A recurrence for you is a psa of like 2.0

So what you have here is some early warning. Use the time to your advantage. Start looking for a medical oncologist. A person you will literally trust your life with…assuming the trend continues.

There are newer scans available. Psma pet. Might provide some intelligence even at 0.5 as to the location which may lead to something actionable on your part.

Considering you had radiation therapy, I don't consider 0.13 to 0.41 to be a big jump. Nevertheless, as others have written, a follow up test is justified and keeping track of your PSA at 3-month intervals for the time being. Hopefully your PSA will stabilize at some point in the future at a value (considerably) less than 2.1.

Every fellow here understands what it's like to hit the PANIC BUTTON whenever one's PSA goes up. Even when it's by a little bit!

That being said, you can consult with your oncologist & simply continue to monitor things.

My oncologist has taught me that we need to watch for trends, over time. Trends are different than fluctuations. Your oncologist will likely recommend additional PSA tests - a proactive step.

VIGILANCE is the name of the game. Worrisome thoughts are natural, but they don't pay dividends.

Remember, too --- and I have walked in these shoes --- there can be bounces in PSA after radiation.

PSA levels can bounce up, but then level off - or tick downward. I have experienced all of these scenarios, over time.

That's why consistent testing - over time -- helps build data -- to assess trends & fluctuations.

Stay in touch with us here - let us know what your doctors say --- and how you're faring!

We all row together, in the same boat, alongside each other!

Here's to SMOOTH SAILING ahead!

CYCLONE - # Iowa State University

I had the same treatment as you, although with 18 months of ADT instead of 36. When I finished my ADT, my PSA predictably started trending up. The number my oncologist was concerned about was if it went north of 0.5, which it never did. I can see how you'd be concerned, but this is quite possible because you're in a stage in which your PSA is fluctuating. It looks like you were on a three-month PSA test schedule, but then this last one was extended. I'd certainly think you would want to stick to a 3-month testing schedule for now.

I also think you need to have someone besides your regular doc on your team, although I'm not sure if a uro is the right person. Have you had any contact with the RO since finishing your radiation? It would seem to me that they'd have more experience with the fluctuating PSA that's often seen after treatment.

BTW, you've had quite the testosterone recovery at 627! Congratulations on that. Like some others here, my T has only reached a middling level following my ADT. I'm not sure if your strong T recovery has any link to the fluctuating PSA--probably not, but hopefully others can comment on that.

NJ Fred & Michael_T......I hear ya my friends......I went through a bounce stretch and it scared me some initially.......I came off HDR Bracy treatment diving down to 1.84 from an 36.0 PSA. After additional EBRT I then went down to 0.07 but then three months later it went back up to 0.10 - then to 0.12 - and my RO was actually telling me at that point they were hoping by then it would be down to 0.05, but I was also told to not be overly concerned either. Nonetheless, I was still concerned about the bounce, but then I started reading here at Healing Well that some had also had bounces occur after radiation was completed......well those here sharing their stories were spot on as my next PSA reading was a 0.07 and then my last three PSA have come in a <0.05. The < part if really good. I am so glad I found this forum in order to realize bounces do happen and to not overly react. I intend to help out others as I can as it relates to being a Triple Play guy. I can not say enough good things about UT Southwestern RO for those living in the DFW area.

Post Edited (WayneTX) : 3/13/2022 12:22:34 PM (GMT-6)

You shouldn’t count your nadir as 0 since it was ADT induced. Radiation alone shoots for a preferred nadir of 0.50. Thus you have a little more leeway in determining a recurrence since you still have a prostate. You are off ADT and clearly in the possible radiation bounce period as Mumbo mentioned. And many radiation men don’t settle in on a PSA level for 5 or 6 years. And since you have a prostate, you should expect some expression of PSA. Watch the trend over the next several months to see what happens.

On the less optimistic side, your high risk dx with a lot of tumor load could indicate some PCa was already outside the radiation zone and is re-awakening as your T recovers. Were your pelvic lymph nodes radiated? If your PSA continues steadily up it will be a time for some very sensitive scans to see if anything can be found.

I would get a urological oncologist, get a 2nd test and if needed stay off ADT and a PET scan. If you PSA is rising, you got a 50% chance it’s in the prostate and the radiation didn’t kill all the cancer.

Hello
I did a retest for psa and now it’s. .3 do I just wait for next test or get to an radiation oncologist now.

Down is good. Seems to be a normal bounce for primary radiation treatment. I think you can relax, and maybe even celebrate. Have a great day.