PSA is .4 ng/ mL 3 years after prostectomy

Two sequential PSA readings over 0.2 indicates likely reoccurance. A PSMA PET scan will likely be the next step. Doctors want to see the scan prior to starting ADT or other systemic therapies as they could impact scan results. My reoccurance started on my 1st test after my prostatectomy in June of 2024 with PSA of 0.26. Six weeks later I'm at 0.41. Hang in there and make sure you have a good team working with you!

The alarm clock is ringing. You need to find out what you need to do now. Good luck.

3.5 after my prostatectomy, my PSA started rising. When it hit .2 they set me up for salvage radiation. They gave me 2 1/2 more years before it came back again, I was not an ADT at any point.

It’s pretty standard to have Salvage radiation when it hits .2 After a prostatectomy.

RP 2020. Three years later PSA went from undetectable to .38 to .71 in a few months. PSMA PET scan when PSA was at 0.42 showed lymph node metastasis. Started Lupron Depot 2 weeks ago. As stated by others, many doctors consider 0.2 and above a biochemical reoccurrence.

In your area is 'undetectable' 0.07 ? Ours here in Canada ( Vancouver Island ) is a very low 0.008 PSA ? What is your Gleason score ? Has it always been sub 0.07 since your surgery ? What did the pathology of your Prostate say ? I would think a PSMA PET scan would uncover many things for you . Your 0.7 is high enough for a good MRI with contrast and PSMA PET scan at this point . IS your URO ( Urologist)concerned ? - What did he say ? . Have you consulted with a radiation Oncologist (RO) yet and what did he say ? Let us know .... I care and are praying for the best for you brother ! ! James on Vancouver Island .

Yes, .2 is where salvage radiation is usually indicated. Did you use the same lab? Your PSA went up almost six-fold in a 7 month period….concerning!

Interesting how you say .07 and then later say .7, and about the benefits of getting testing. Was that a mistake since he is at .07, Or did you mean to say it differently? A PSMA pet test might not be a good idea at .07.

May be my error . He was at .07 PSA ( which is his 'unreadable) , now at .4 PSA . time to look into why the rise and consult a RO too . Am I wrong ?

PSA tests have been undetectable (< .07 ng/mL) as recently as 7 months ago. New test last week came back at .4ng/mL. Should I be concerned?

Hi Vancouver Hiker,

My Gleason score was 7 (3+4), grade 2. Since surgery each test has been sub.07 until Nov 20 it cam back at .4. Here is what pathology said. (I don't understand all of it)
FINAL DIAGNOSIS:

A) LYMPH NODES, RIGHT PELVIC, EXCISION:
THREE LYMPH NODES WITH NO METASTATIC CARCINOMA IDENTIFIED (0/3).

B) LYMPH NODE, LEFT PELVIC, EXCISION:
ONE LYMPH NODE WITH NO METASTATIC CARCINOMA IDENTIFIED (0/1).

C) PROSTATE AND SEMINAL VESICLES, RADICAL PROSTATECTOMY:

PROSTATIC ADENOCARCINOMA

PROSTATE SIZE: 45 g, 4.1 x 4.0 x 3.6 cm
HISTOLOGIC TYPE: ACINAR ADENOCARCINOMA
HISTOLOGIC GRADE: GRADE GROUP 2 (3+4=7)
- MINOR TERTIARY PATTERN 5: NOT APPLICABLE
- PERCENTAGE OF PATTERN 4: 31-40%
INTRADUCTAL CARCINOMA: NOT IDENTIFIED
CRIBRIFORM GLANDS: PRESENT
TREATMENT EFFECT: NO KNOWN PRESURGICAL THERAPY
TUMOR QUANTITATION: APPROXIMATELY 11-20% OF PROSTATE INVOLVED BY TUMOR

GREATEST DIMENSION OF DOMINANT NODULE: 14 mm
EXTRAPROSTATIC EXTENSION: NOT IDENTIFIED
URINARY BLADDER NECK INVASION: NOT IDENTIFIED
SEMINAL VESICLE INVASION: NOT IDENTIFIED
LYMPH-VASCULAR INVASION: NOT IDENTIFIED
PERINEURAL INVASION: PRESENT
MARGINS: ALL MARGINS NEGATIVE FOR INVASIVE CARCINOMA
REGIONAL LYMPH NODES (INFORMATION FROM PARTS A AND B): ALL NODES
NEGATIVE FOR TUMOR
- NUMBER OF LYMPH NODES EXAMINED: 4
DISTANT METASTASIS: NOT APPLICABLE
PATHOLOGIC STAGE: pT2, pN0

I have an appointment with my urologist on Dec 20. He tells me he want to see what the PSA level is then to decide how to proceed. I have not consulted with an RO at this point. I very much appreciate your prayers and concern and welcome any feed back you can give be based on the information I provided here and your experience dealing with this. Thank you