Posted 1/7/2024 1:27 PM (GMT 0)
Welcome back Acoustic4. To refresh my memory I re-read some older posts and see you had radiation some three or more years ago along with three years of ADT for high risk PCa. Now that you are off ADT, it would be expected to have some expression of PSA since you still have some of your prostate. Some of it turned into scar tissue from the death of the cancer and some from radiation damage. Any PSA expression now will be from the remaining prostate tissue, PCa, or both.
Post radiation, the alerting PSA number is 2.0 plus the nadir (lowest PSA). Since ADT most always takes PSA to undetectable, this can be a bit difficult. When one has radiation without ADT the objective is to reach a nadir of .50 or less. So, many docs will give the PSA a range of 2.0 to 2.5 before being too concerned about a rise.
Could this be a bump? Yes. Could it be an increase to what will be a normal (for you) PSA expression without PCa? Yes. Could this be an indication of a recurrence of PCa? Yes. At this point you don’t know. You have to follow the trend and see what it indicates.
My suggestion based on your original high risk dx of G8 and PSA of 35 (similar to my high risk successfully treated by radiation and ADT,13 years ago). Test PSA every three months to watch the trend. Find now an excellent medical oncologist that can demonstrate to you great experience with high risk PCa management of recurrence. Don’t wait till your PSA is 3 or 4 and your urologist is scratching their head. Find the MO now and add to the team as the new captain. Hopefully your PSA will level and stay level indicating no new PCa activity. But, in my opinion, now is the best time to get to a medical oncologist PCa specialist for assessment and management.
Best wishes.