I definitely missed the fact that you had radiation after the surgery. Once you’ve had that radiation, they can’t radiate that area again. Usually, the rising PSA is a result of cancer somewhere else. As others have said a PSMA PET scan is the way to go First. The problem is that .2 you are unlikely to be able to have anything seen in a scan. I know somebody that was having them every three months when they had .2, So some doctors feel, they can find something eventually. If they do find a metastasis, they can zap it with SBRT radiation unless it is near some delicate organ.

Since you’ve had radiation, they’re probably going to wait to see what your doubling rate is rather than do something right away. Getting a PSA test to find out how quickly the PSA is rising, tells a lot more than a PSMA Pet test that is unlikely to show anything.

I’ve been where you are right now. Having my PSA rise after a prostatectomy and radiation. I’m 12 years past that radiation and had three more reoccurrences, but the drugs have worked very well. I have the BRCA2 genetic problem, which makes my cancer more aggressive, and I’m still around. Your chance of living decades longer is very good even though your PSA has shown a small rise.

If you are still on Lupron and your PSA is rising, you are becoming what is called castrate resistant to ADT. That happened to me 2 1/2 years after having salvage radiation. I was put on Biclutamide For a year and then Zytiga for 2 1/2 years. That kept my PSA down for a long time. I then switched from Lupron to Orgovyx And started taking Nubeqa. That is kept my PSA undetectable for the last 29 months. Just an example of how the drugs can help.