@sriddle1 If you test frequently, you will get a clearer picture of the random variations (which we tend to forget when we see a specific number,) but not a clearer picture of the long term trends. Once the baseline/nadir/lowest point is reached, the climb will take time--of course, hopefully years rather than months. One of the points researchers may consider is doubling rate, so if you test again halfway between your last test and March, you might get a clearer idea of the actual bottom if it was still declining last time as the PSA dissipated from your body after surgery but then starts growing again before March, but then if you test every three months you'll know within a couple rounds if it appears to be moving. After about three rounds you may begin to know how fast it might be moving.
Here's my actual results: • ultrasensitive PSA (series) after surgery 2/27/22 from 0.012 8/22, 0.016 11/22, 0.012 2/23, [exclude < 0.006 6/23,] 0.020 12/23, .016 4/24, .019 10/24, .021 3/25, 10/25 .023 ng/mL. You may notice I exclude one measurement as likely wrong. This is using the Roche assay from Labcorp. I think Quest Diagnostics, the other major testing lab in our area, uses a different assay with a 0.020 minimum. [If you want more on this you might try a google (AI) prompt: what are the different assays for ultrasensitive psa after radical prostatectomy.]
The first test after my RALP, about 4 months later was either intentionally or more likely accidentally prescribed not specifying ultrasensitive so I always check on this now. In my case, the result in 12/23 (21 months in) was most alarming, but since then my urologist has considered my PSA stable rather than increasing.
In addition to absolute levels, researchers and clinicians also consider doubling rates. However, until 4/24 all my results were multiples of .004, which led me to believe that might be the sensitivity in the bottom range of the test. In that case the reporting choices might be >.006, .008, .012, .016, ... and one tick every 3 months looks like a doubling rate of every 6 months, but now the doubling rate looks like more than every 3 years. My urologist is more optimistic than I am and just calls it "stable, " and he has since 12/23. So far he's been right and I hope he continues to be, but I am STILL skeptical. If I had to guess I now expect it to come back between 5 and 15 years, but of course I don't know. My pathology after surgery was bilateral Gleason 4+3 with a small positive margin.
If you are comparing just the two sets--my results and yours, you can see why I would hope you are still declining after surgery as your absolute results are several times higher than mine, but that really isn't diagnostic or good medicine. Let's pray that your results stabilize, or failing that, that your doubling rate is slow.
@surftohealth88 is doing monthly tests for the first 6 months. That should do a great job of pinpointing the nadir. Since watchful waiting and various targeted ablation strategies (like radiation) are now more common, I would assume the population that opts for RALP is more likely to have complications than when more less serious cancers were also being treated by RP, laproscopic, robotic, or open. The clinical reference charts including more data points are intended to give more detailed guidance as to what to expect, but just looking at uPSA, you could try a Google AI prompt like "what psa level after prostatectomy leads to further treatment".
But, as you might be able to tell, I like to prepare for the worst and hope for something better, and I'm not (this kind of) a clinician, so I've been learning all this since about where you are at in the timeline. (Before the surgery I was focused on making that decision, then on the immediate recovery and side effects, only later on what would come after. I found this forum a few months after my surgery.)