@yfarah57 So you started with PSA of 0.55 in 2013 (12 years ago), to PSA of 29 in July 2023. It has been undetectable since after radiation, then it rose to 0.3 after a 10-month holiday off ADT.
After reading Jeff's comment that you replied to, I figured that after surgery, PSA ideally should not hit above 0.2; my previous readings in this forum indicated that it would be a concern if "after radiation and after stopping ADT," the PSA rises 2 points above nadir. Therefore I am a bit surprised that your doctor seems concerned already with your 0.3
But here's the (my) thing: I completed radiation treatment (SBRT) in April 2025, with 6 months in ADT-Orgovyx. I stopped Orgovyx in September; my oncologist indicated that my January 2026 PSA may go higher than my October 2025 PSA, due to my Testosterone level going up by then. But unless the PSA rise could not be explained by a corresponding rise in T, it should not concern me, I was told. After some time that I'm off ADT, my PSA will start going down until it reaches nadir (as late as April 2027 or even later). After bottoming out, it will be a concern when my PSA gets 2 points above nadir (the lowest PSA before it starts going up, e.g., from 0.01 to 2.01).
But your case is different: You were on ADT for 18 months. So maybe it wasn't expected for your PSA to rise 2 points above nadir before it's a concern. This I will confirm with the doctor, if I were in your place. Will your doctor say the rise to 0.3 can't be explained by your rising T (unlike what my oncologist told me)?
But right now, I will not be worried about your case. If I were you.
Regards,