PSA still going up - scans?

Hello all. Hubby had PSA this morning. Result is 1.7, up from .92 four months ago. Calculated PSADT at 6.1 months. We see med onc doc Thursday. He'll do scans. Can't find my notes on type of scans. What's the norm? MRI? PET? Hoping with PSA still fairly low that nothing shows up. He needs shoulder/knee surgeries (as confirmed by his orthopaedic doc and xrays) but praying these issues aren't PC related. Thoughts?

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Age 58 at surgery
Sep 2013 PSA 3.7, clinical stage T1c, 3+4
RRP 10/31/2013, path stage pT3bN0Mx
SVI bilaterally (direct, not distal), LVI, pos margin at apex (3+3), EXE at base
4+3 w/ tertiary 5 (65% 4, 35% 3, 5% 5), tumor involved 15% of gland
12/2013 PSA 0.02; 2/2014 PSA 0.03; 3/14 PSA 0.02; 4/2014 PSA 0.02; 6/2014 PSA .03
MRI/bone scan negative
7/01/14 to 8/27/14 - 40 sessions adjuvant radiation
11/26/2014 PSA three months after radiation: .03 (same as before radiation)
2/25/2015 PSA six months after radiation: .05
5/21/2015 PSA nine months after radiation: .17 (referred to Med Onc at Moffitt)
7/20/2015 PSA .41 (more than doubled, classified "incurable, micrometastatic")
10/5/2015 PSA .47 (slowed down considerably; second opinion from MSK - same plan as Moffitt, wait and see)
1/6/2016 PSA .62 (only half increase - at least it didn't double)
3/30/2016 - .93 (took about 5+ months to double from the 10/5/2015 reading)
07/08/2016 - 1.7 (PSADT at 6.1 months)

Boy, Bololidat, you're good! I read your response to my husband. Brought a big smile to his face, and mine. Mainly because it is our belief - live life, never give up, never surrender.

They'll probably just do a bone scan and CT, although it's unlikely to show anything at PSAs that low. Has he started ADT yet?

What may have changed their thinking was a practice-changing study just published in Lancet last month. You can read about it on the following thread:

When to start ADT when there is rising PSA after salvage options are exhausted

I suggest you email the referenced Lancet article to your MO and ask whether it changes his thinking about the time to start ADT. It is hard to ignore the fact that early start reduced the 5-year mortality rate by almost half.

- Allen

The study was multi-institutional and allowed for any kind of hormone therapy. I talked to a man being treated by Howard Scher at MSK who was started on daily Casodex only and is now taking only one pill per week. I think, whatever works and has fewest SEs.

Interesting - we weren't able to get in with Scher. Seemed he was only able to add the more complicated cases to his workload. Understandable. Any idea how your contact is feeling on the Casodex?