How Concerning is this?

Agree on that -which is why they now include (or should) the pelvic lymph nodes as well. That was over 30% right there.
Phil

Is it really easier to kill than roaches? Why would a top regional research doctor tell me that? How often do we hear of guys with .3 reoccurrences having anything showing up on their scans. Yeah, I had a big question mark on my face when he said that. My insurance changes next month to medicare so I believe I will be free to seek opinions at NCCN facilities.

Yes, and that is why it is also advised to PC patients to lower meat consumption.

Yeah, it’s all very confusing. In fact, the more I thought I ‘knew’ is becoming murkier by the month, depending on which ‘expert’ is holding court…

One of the problems with social media. Social media guru's need to be taken with a grain of salt. I am convinced that if we search every available social media and web site for information we will go insane. Kind of like listening to what someone says vs. what they do behind their front door.

Regarding the “< “ (undetectable) symbol —> It’s important to note that there is no real difference between 0.1 and < 0.1. What the “< “ means is that that’s the lowest PSA that their test equipment can measure. So, < 0.1 might simply be 0.09 (0.08 or 0.07 or……) - there’s no way to know.

What you might consider doing is having your doctor find a lab that tests PSA to lower levels (an ultra sensitive PSA test). The cancer center that I go to tests PSA down to 0.008.

Note that following prostatectomy, a PSA of 0.2 is the technical definition of biochemical recurrence. Yes, this should be of concern. You need to follow that path to confirm or rule out recurrence, starting with a PSMA PET scan……

I had a radical prostatectomy five years ago at the age of 61, with a Gleason of 7, 4+3, extraprostatic extension right bladder neck, and perineural invasion. Like you, there was no treatment after the RP; I monitored my PSA. For three years, my PSA remained < .1. Around three years in, it increased to 0.1. Dealing with other serious health issues, I failed to retest for almost a year. When I finally got tested about a year after the first reading of 0.1, my PSA had risen to .38. The doctor I had been seeing left the area, so since I live in a rural area, I had to find another doctor over 100 miles away. Another 45 days passed before I could see this new doctor, and my PSA was now at .48. I had a PSMA PET scan, which revealed lymph node metastasis. My PSA level continued to increase; 45 days later, it was at 0.78. I am now on ADT. My PSA has lowered, but my T-levels are now over 300. Perhaps signs of castrate resistance. All that said, if you're at PSA .2, I would consult with the experts. Best wishes!

Interesting. You say that you’re on ADT, your PSA is lower m, but your T is not.

How ADT works —> ADT lowers T which results in lower PSA. So, if on ADT and your PSA is lower, but your T is not, then something else is going on. (Which ADT are you on?)

It takes 2 to 3 months for most people to get their PSA down to undetectable. Your testosterone doesn’t go up if you are castrate resistant, more likely it just hasn’t gone down all the way, yet. If castrate resistant your PSA goes up even though you’re on ADT. Give it some time.

If your PSA does continue to rise while on ADT then you need an ARSI like Zytiga or a Lutamide, That can get your PSA down when ADT alone won’t do it.

Exactly! I’m not sure what’s happening. I am on Lupron and experiencing some obvious, not-so-great side effects, yet my T-levels are low normal. I have no pre-treatment T-levels for comparison. A lower PSA post-Lupron injection should correlate with a very low T-level. The last PSA test was rising slightly, so we'll see where this all goes. I’m considering stopping the Lupron and monitoring. The only treatment I am on that would lower the PSA is Lupron.