@brianjarvis yes, good synopsis but again, if your BCR occurs before that ‘2 points above nadir’ you’d better hope and pray your PET will detect it…it might not.
I met a man about 3 yrs ago who had a recurrent PSA of something like 50…If memory serves he had had surgery and possibly SRT…he put himself on some very expensive ($20K/yr) diet and supplement plan involving coffee enemas instead of pursuing ADT therapy (can’t really fault him for trying).
When I asked him why he wasn’t getting radiation in some form he said, ‘Because they can’t find out where it’s coming from!’ Don’t know what type of scan they were using but some of the older ones (Axumin, choline) were even better in some ways than PSMA.
Oddly (or not) his PSA did drop by a large amount but I never saw him again to follow up.
I think there are always going to be outliers and anomalies in any cancer patient, regardless of the type. Best to you and my wishes for NO recurrence!!
Phil