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Conflicting take on PSA results

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Posted 3/17/2022 2:09 PM (GMT -5)
Here are my most recent results:
PSA:
6/16/21-1.99 before start of treatment. GL-8
12/9,21-1.21 during RA with two Firmagon injections and two months of Orgovyx.
1/25/22-0.17 after RA and three months Orgovyx. URO has problem with PSA, RO has no problem.
Uro wants another PSA test. Couldn’t get blood test until March.
3/16/22-0.13 and four months Orgovyx.

I didn’t get a pre testosterone test but they have been as follows since the start of treatment.
12/21- 25.88
1/22 - 20.62
3/22 - 23.98 up some after RA
My question is why was there a difference of opinion between my URO and RO? I don’t get to see the URO for several weeks. Could he be thinking that the RA or ADT is not working? Thanks a bunch and best wishes to all,
Jack
Posted 3/17/2022 3:03 PM (GMT -5)
Jack, I'm not a huge expert on PSA post Radiation and Orgovyx, but you're only a few months out since your Radiation is done, so it may still be dropping to it's minimum (Nadir). Personally, I'd listen to the RO--he's the expert here. Since you still have a prostate, you will still have some PSA going forward.
Posted 3/17/2022 4:20 PM (GMT -5)
As we've said many times, don't ask a urologist for advice on radiation treatments.

Seems like you are on track to me. Listen to the RO.
Posted 3/17/2022 5:36 PM (GMT -5)
Well, seems to me you have TWO txs (radiation and ADT) and one expert for each. It IS conflicting, SOMEWHAT, Ideally, you would like the HT (ADT) to drive the PSA to undetectable or closer to it. However, it seems to be heading in the right direction.

Yeah, I'll be curious to see future test results and your doctor's comments, as well as our fellow HW folks.

Oh, from an RO perspective, the numbers look very good!

Mel
Posted 3/17/2022 6:20 PM (GMT -5)
A urologist is not the expert on ADT, a medical oncologist is.

I have found that uro’s, many of whom I have spoken with on cruises and other travels, are often shockingly uninformed on radiation and other treatments.
Posted 3/17/2022 6:23 PM (GMT -5)
Thanks everyone for your replies. I guess it is still a wait and see as it is with everyone here. I am not worried, just curious. Thanks again and best wishes,
Jack
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