PSA doubling time after RALP I'm worried

Hi Onestepforward and welcome to the forum though sorry you have to be here, Your PSA rise from 0.1 to 0.22 after your surgery is concerning, though i think it's usual for your oncologist to wait for your biochemical recurrence to rise 0.2 from it's lowest point before acting, I can understand your anxiety your PSA shouldn't be rising with no prostate, but your PSA is still very low, PS mine has risen from 0.08 to 0.48. No one here is an expert, but i think most of us would see a recurrence as the likely cause of the rise and RT the likely treatment, but that is for your team to decide. Maybe some of the guys on here have been through something similar and can share their experiences, best wishes.

Eddie

Hello Onestepforward  A warm welcome to the online Community from me. It's pleasing to know you have been around for a while but sorry you have had to join us.

Having read your history and being aware of the statistics on recurrence I too would be pushing for a further MRI and PSMA pet scan, followed by radiotherapy to mop up whatever is found.

Your team appear to have everything in hand - it's just the time gap which causes the anxiety. All I can suggest is that you make sure they are aware of your anxiety and that you are willing to accept any cancellations at short notice.

Best wishes - Brian.

Hi Onestepforward , although any rise in PSA is worrying, your Gleason indicated you have a little time to wait.  I think there is always a balance between acting now (which seems what we all want to do) and waiting for the PCa to show itself so that it can be eradicated.  Waiting feels like the wrong thing to do, but I think your team have it in hand.  That said, I would, like others have suggested, would want a PET scan.  Best wishes, David

Sorry to hear one-step.

It probably is a recurrence as showing an upward trend so I would Def be pushing for Radiotherapy but also some more scans to try and find it ,  PSMA needed.

PSA still very low so you do have some time but do keep pushing them

Good luck

Steve 

Hi Onestepforward. My PSA has risen to 0.2 since my prostatectomy in Sept 22 (18 months ago). I have another 3 monthly test today which I am anxious about and dreading that it may have risen again. I also am worried of course and am desperate for medical action to be taken and for my PSA to become undetectable. I offset that desperation however on my faith in my medical team and also papers and experiences I have read on the internet on when and how corrective action should be taken. There are what seems to be wide differences in opinions as to whether RT should follow at an increase of between 0.2 to 0.6 and also whether there is any advantage to also having HT. My team work on the basis that nothing will be done until  PSA rises to 0.4 and then at that stage an accurate PSMA PET scan / MRI will be carried out to determine how and where RT will be directed. My team's view is that accuracy of a scan below 0.4 cannot be relied upon and also that the disadvantages of HT would outweigh the advantages for my situation. I have read that others on this forum have had a scan at 0.2. Obviously I have absolutely no idea whether my teams views are correct but I know that my faith in them does help in enabling me to accept my situation. So, I think my main point is that you may find your team will not carry out further investigations in April and that you may have to wait until 0.4 and indeed that may (or may not) be the best approach.

Hi Static

Have been reading through your profile, PSA has  certainly kept low for a long time since end of  2022.    .1 if have read that right

I know it has now gone up to .2 but too early to speculate, could be a blip, I presume that u have only had 1 PSA above .1.

HT wouldn't be a good idea as could mask any spread.

The next PSA is crucial, hopefully not gone up again but the problem when so low is will anything show on the scan that's if there is anything there

So I know difficult but just hold fire and  hopefully the next PSA will be more settling

Best wishes

Steve 

Thanks Eddie, I suppose I'm less worried about the PSA at 0.22 rather more the time frame in which it got there. When I had my appointment 9 weeks after surgery and my PSA was 0.1, the surgeon said it could be 18 months to 2 years before it reached 0.2. I'm just trusting the experts to keep me right

Hi Brian,  thanks for the advice. Yes I will make the team aware of the anxiety caused by waiting and not knowing when things will happen next and what to expect. Cheers

Thanks David. Yes I'm putting my trust in the experts here totally

Thanks Grundo,

My oncologist did say at my meeting when mh PSA was 0.15 that I might benefit from RT but was advising still to early to decide and he went through a list of potentially life long side effects of the treatment when not sure at my level if it is required. I'm hoping to have another meeting with him soon to disulcuss further.