Has SRT Failed?

After salvage radiation to prostate bed only with ten months of ADT in Feb/Mar 2016 my PSA remained <0.008 for about one year ie till May 2018.
After that it started increasing and the latest has come to 0.041as on 09/13. Please advise for further action.
1.Can it be a PSA bounce after radiation?
2.If no then can I take a second chance for whole pelvic radiation minus the area already radiated earlier, for a possible cure, without waiting further?
3.What should be the next best course of action?
I am physically very fit and had very few problems from the SRT and ADT.
Thanks and Regards.

That still a very low PSA. Yes, PSA can bounce post RT. More RT at this point would be tricky.

So are you still on ADT?

The most common suggestion would be retest and wait for a rising pattern over three or more tests. If it keeps rising, then you'll have to seek more treatment.

For the moment, waiting, and retesting in three months would be the course. Waiting being the hardest thing to do.

Andrew

You could talk to an RO, but likely they'll say you're done with RT. There might be something in the lymph nodes, but that's speculation. At this PSA scans won't show anything useful.

You might want to consult with a MO who specializes in PC.

Maybe others have something you can do, but other than engaging your medical team and waiting for the PSA to rise, there's not much more you can do. You could go back on ADT or wait for the PSA to rise enough so a scan might be useful in showing where it is.

That's my thinking at the moment.