I share your concern with data not aligning. I had just the opposite problem when diagnosed with a local recurrence in June 2025. My PSA hit 0.11, ten years after a RARP (barely above detection). A DRE detected a small nodule in my prostate bed. Conventional medical wisdom would predict that with such low PSA, there would be a very low probability of anything showing up on a PSMA PET scan. Well, not only did the nodule light up, but it did so with high intensity (SUVmax of 13.3). Some docs think that uptake intensity relates to cancer aggressiveness (I’ve yet to see hard science to back this up).

I finished 8 weeks of IMRT on November 18 to treat the local recurrence.

So, in both our cases, the question is, “Which test is telling the real story—PSA or PET scan?” Well, I don’t know, and none of my docs seem to know. Frustrating, but one thing for sure--PSA testing is still the front line test moving forward. Further scanning will only occur if PSA tests warrant it, or some other physical symptoms manifest.

Glad to hear you are doing well with the Orgovyx and RT. Hope you stay on that course.