Undetectable and now .1 psa - What Does this Mean

Although you had ART, my understanding is that after salvage radiation, if PSA rises to .2 and it is confirmed by a second test of .2, it is usually considered a second recurrence. At your current level of .1 most MO's or RO's would re-test in three months. What does your doctor have to say about it?

To clarify, after using radiation as the primary treatment, with no surgery, the recurrence threshold is nadir plus 0.20. When using surgery, you should be undetectable. SRT does not change that.

So what does this situation mean? Don’t know yet. It could be a bad read. It could signal an upward trend that could trigger the next sequence of treatment. Since you had lymph node involvement, you might already have been systemic and not cured by local treatment of surgery and SRT. I imagine the doctor wants to see another reading to see what the trend is. Then there may be some scans to determine where any cancer may be.

Given your very high risk dx, There is a high probability of systemic disease. If you aren’t already being managed by a high quality medical oncologist that specializes in advanced PCa, I would be finding one.

There is really no hurry to do anything with your first unverified 0.1 PSA given your treatment history. The first step should be to verify your PSA but no rush, 3 mos sounds about right to me but what do I know. If the second PSA is higher, my guess is that your doctor will want to let your PSA go up until such time that scans might pick up the source/location of the PSA then determine the treatment scheme from there.

By any chance was your .1 told to you over the phone by a receptionist? Questionable. Or straight from the Dr or online report you saw? Not questionable. Others have suffered from phone anxiety with a misread number.

JNF said...
To clarify, after using radiation as the primary treatment, with no surgery, the recurrence threshold is nadir plus 0.20.

I don't want to derail this thread, but I thought radiation as primary treatment the threshold was nadir + 2.0 (not 0.20)

Sorry, got my decimal wrong. Good catch CA. I stand corrected. Main point was that the subsequent PSA thresholds are significantly different based on initial treatment.

Hello, Bob ~~~

You can easily see the members here, looking after you.

I will affirm the importance of adding a medical oncologist to your team --

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Simply put --- my urologist didn't offer these possibilities to me, when I needed some "next step" advice.

My urologist seemed solely focused on my "next LUPRON shot" --- and it had to be administered by a nurse sent over from the oncology department, anyway.

My local oncologist is truly the quarterback of my medical team these days.

I also visit Mayo Clinic twice a year, for additional scans not offered near here, and to consult with an expert at Mayo, as well.

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My ADT shot is now administered through my local oncology department, and they oversee all my prescriptions.

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It has made a tremendous difference for me.

Thinking ahead --- if you are thinking about adding an oncologist, this is the time to do your research, seek some recommendations, make your final selection, & then make certain your medical records have been transferred in advance.

You also want to make certain the oncologist is accepting new patients.

If this is an avenue you pursue, in the future --- get that initial consultation booked, in advance --- build that rapport ---- go over medical history --- and establish that connection.

That way, down the road, if you ever need additional treatment, you will have "built the bridge" already ... proactive steps ... peace of mind ... just some sincere thoughts to share with you.

Stay vigilant, keep looking ahead, keep setting goals, & living life!

All my best, from here in the Midwest,
CYCLONE ~~~ # Iowa State University ~~~ ("Go STATE!")

He heard everything we had to say...he thanked us...said no thanks...and that's the name of that tune...I suspected he would do that...as he likes his urologist who is a long time medico who in his mind has done a good job just be cause he wnt to him during the duration of his journey...he basically made up his mind before he posted and did his "due diligence" by checking in with HW...all this is totally his right to do...just my take...whats yours

We all have our own opinions and choices to make. I know I did before I came to the forums to get opinions from the fine people that offer them. And I still do. After all, isn't that what these forums are all about?

Glad one of the last posts was removed from this thread. It was a bit OTT.