Where is it then ?

Morning Big Col  That's a good question.

I am aware that non-cancerous prostatic cyst's and other non-cancerous Prostates have been found giving rise to enlarged PSA levels of up to 50  Other factors can also give rise to a high PSA - Age - Exercise - Sexual Activity. If all your scans MRI - CT - PSMA-PET - and Ultrasound are all clear and you still have a raised PSA - then it's above my pay grade!! I would be back to my Consultant to ask the very same question. It may be one for our Professionals - here's the link:

Ask a Nurse  Please allow 2/3 days for an answer.

I would love to know the answer myself.

Best wishes - Brian.

1. Thanks mb  the picture is getting clearer for qu to be answered at my next appointment. So far,a week later,I have not had any bicalutomide?My oncologist changed his mind as to when I should start.I will chasit up with my gp.Can you explain  why delaying start might be considered  

Hi Big Col.

The delay in Bicalutamide is possibly because your oncologist is thinking of waiting until you have a PSA at a level which can be detected by something like a PSMA PET SCAN. There is better accuracy when it goes above 0.5.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10340269/#:~:text=The%20detection%20rate%20for%20sites,0.50%2D0.99%20ng%2FmL.&text=Ga%2DPSMA%20PET%2FCT%20also,in%20a%20subgroup%20of%20patients.

Just realised, you are well above the threshold. Possibly they are thinking of putting you onto a different antiandrogen?

The urologist told me that the HT would interfere with the scans so he wanted to wait until the bone scan was carried out and then, since that was clear, he wanted to wait for the PET scan. I wanted 7 weeks between scans.  HT started a few days after the PET scan

Chased the hospital starting bicalutomide straight away....he hadn't signed the letter.Only having another ct and psa test before next consultation but no bone scan ?