Should I be worry?

the "jump" in PSA coincides with the return of testosterone. i think you are fine

You would expect the PSA to rise as the Lupron wears off and your T recovers. This would be different from a bounce, in which PSA is going down post treatment and then has a short-lived increase. At this point, I think it's too early to know what your PSA trend is--you'll need a few more scores in the book first. It looks like you're testing every three months, which is good.

This is the exasperating phase where you're done with treatment, but now you're waiting to see if it worked. For my part, after treatment (I had the same combo as you) I decided I was cured unless someone told me I wasn't. No one ever did and it's been 10+ years.

Dave - Based on my observations since 2018, I think I am getting convinced that PSA should not be monitored after RT primary therapy for some time, maybe at least a year. PSA, ADT, & RT do not get along very well which results in all sorts of panic situations of which only a few become long term issues. The bounce is another issue that can occur at about any time but not a real helpful rationalization in the first year.

Think of the present logic, if you get a low PSA you are doing well and don't worry about it; you get a higher PSA, don't worry about, you are doing fine. What did we learn? Not much? You have to fail big time to get anyone's attention early on with RT.

Not saying that concern is not warranted at some point but the nadir + 2.0 PSA criteria for failure/recurrence is very broad to accommodate large PSA variances before next steps. However, I think the PSMA scans have changed the landscape a bit and it would be prudent to get a scan if your PSA gets to a point when your oncologist thinks 1) a scan would help verify your status and 2) your insurance agrees (not sure that a standard exists quite yet until recurrence is established) so you are at the mercy of the "system".

More points are needed as usual to come to any conclusions so put the worry off for another day.