Prostate Removed--Rising PSA: What are my options?

My guess, and it's just that, would be Androgen deprivation therapy (ADT) and possibly a form of chemo would be the next steps. It seems these can be pretty successful.
Hopefully someone with more experience in this kind of issue will offer more information.
What does your treating doc(s) suggest?

web265:

Thanks! All I have at this point are PSA Numbers. I see doc on Monday and will let you know.

Nick

I would suggest imaging (bone, ct, mri, psma pet) to get a sense of where the pca exists, and it might make sense to wait until the psa rises a bit more.

I thought the rationale for waiting was so cancer would be more likely to show up on imaging studies, and thus more precisely targeted by radiation. If the only treatment is via shotgun of hormones and chemo, is there still a value in waiting after a documented PSA rise following prostate removal?

Had RP done last April. PSA was 0.047 after two months and 0.087 after four months. Hence, the PSA rate went up double in two months which is alarming. In August 2023, started the 6 months hormone treatment (Trelstar) as suggested by urologist. PSA went down to < 0.008 in Sep.2023. Took 20 rounds radiations in Oct. 2023. Last month PSA was still < 0.008. Hope it stays that reading all the time.
Things need to watch is how fast the PSA rises up in a given time.

All:
Thanks everyone for your responses. I went to doc today. He says .93 PSA score is minuscule but rising gradually. He wants me to do a PMSA scan to try and find out if cancer shows up. If nothing then watchful waiting and possibly another scan. Fingers crossed.
Nick

@rnpalarino1, that's good news. I like to use the phrase "active surveillance" because it makes me think of actively monitoring rather than "waiting" impassively. Your doctor sounds like they are keeping an eye on you. No need to invite treatment and unwanted side effects until necessary, right?

You might also be interested in this related discussion:
- Monitoring PSA post Prostatectomy when should I be concerned?
https://connect.mayoclinic.org/discussion/6-years-post-prostatectomy-when-should-i-be-concerned/
You can use the Search function to find more relevant discussions: https://connect.mayoclinic.org/group/prostate-cancer/?search=PSA%20and%20prostatectomy&index=discussions

Hi Everyone:
I had my PET scan. As a reminder I am 77 years young. My PSA rose to .93 three years after prostate removal. Scan did not find any cancer. I am inclined to tell doc when I see him on Monday, “I don’t want any treatment now and wait 3-4 months until next PSA test.”
Thoughts???
Nick

My thoughts would be that this is a reasonable approach to make sure that the PSA result on 4/6 wasn't an anomaly of some kind. If it's not, you'll also get a better handle on the rate the PSA is rising.

Best of luck to you!

your PSA is very low still , so may not show on PSMA . BUT , I understand your concern. Your on it and doing things about it - good ! I had prostate removed and it climbed post operation ( 3=4=7 ) to about 0.14 after 2 years . Then EBRT for 22 sessions ( not ADT or anything else . ) then it went from 0.14 , to 0.11 now at 0.072 . The trend is my friend I gather . The doctor say the external beam radiation especially the Rad's and short sessions (22) I was given works gradually after the external beam radiation. I am post one year external beam radiation and it is just working now. Find out what the risk: rewards, is for external beam radiation. Is it not recommended or is it definitely a no? I think External beam radiation is a natural progress of treatment. However, ADT would also take it down and large or more however I have always been afraid of ADT and never been on it. God speed friend!