PSA Climbing after Salvage EBRT

rp-2343

New Member

Joined : Nov 2023

Posts : 3

Posted 9/27/2024 2:31 PM (GMT -5)

I had post RALP Salvage EBRT rad. therapy ending Jan 2024. (I am 74yo)
Since then my PSAs were 3/31/24=0.13, 7/19/24=0.030, 9/26/24=0.050. (66% increase from 0.030)
My pathology "-pT3a pN0" had positive margins (3mm), PNI and EPE, but nodes were clear.

Question is what are opinions on how freq. should I test and at what PSA level should I press for another full body scan (one was done b4 my surgery and came back clear other than prostate)? I think that at 0.200 they may want to talk about putting me on ADT (it was contra-recommended to me by my radiologist before starting RT).

Thanks in advance for any opinions..

Mumbo

Veteran Member

Joined : Nov 2018

Posts : 2848

Posted 9/27/2024 4:30 PM (GMT -5)

Your numbers are still “microscopic” so no need to get excited or make calculations. It is possible that you had some local cancer that the RT is still working on thus your PSA is unstable for a good reason.

It is not really clear what the thresholds should be after both surgery and SRT. Is the surgery criteria or the RT recurrence thresholds followed? 0.20 or 2.0? All depends on what is actually going on.

I would not consider ADT until your PSA is high enough for PSMA scans to find something. ADT would suppress any findings and you would not have any answers. Keep an eye on PSA on your 3 month testing schedule and see what develops. IMHO, you are still too young to consider ADT for the long run until it becomes necessary. You will want a prostate experienced medical oncologist if the rise is sustained which will take more readings and time, maybe at >0.10?

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