What would you do if PSA stayed at 0.15 after prostatectomy?

Posted by tj1967 @tj1967, Aug 29, 2025

Hi everyone,

I am 58 years old. I had a radical prostatectomy seven months ago and my PSA never dropped to undetectable levels. It has stayed at 0.15 for the past three months.

One doctor recommends a conservative approach with low dose radiation to the prostate bed only. Another recommends a more aggressive plan with radiation to the prostate bed, glands, and lymph nodes along with hormone therapy (relugolix for 6 to 18 months).

I am torn between avoiding side effects now versus hitting it hard to lower long term risk. Has anyone here faced this decision? How did you choose, and do you feel it was the right call?

Thanks for any insight. I would really appreciate hearing your experiences.

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jeff Marchi | @jeffmarc | Feb 21 6:12pm

@mtoka
It is so unusual to see a 5+3, Maybe once before I’ve seen this in five years.

A five is really aggressive. The fact that it’s an eight doesn’t make it any better since the five comes first there’s more five found than there was three found.

You could try to get a PSMA pet scan, I know people that have had them at .2 repeatedly because their doctor wanted to keep up if things changed. What has your doctor said about getting the PSMA Pet scan? Since your PSA isn’t moving, maybe he said no. Insurance actually would probably cover it since your PSA has risen.

If you are on ADT and your PSA has risen to .37 you may have become castrate resistant, has the doctor mentioned anything about this to you? If you have radiation to start with, .37 would be no big deal, but having surgery to start with, The PSA should stay undetectable.

Got to admit you have a real strange case.