← Return to Many years since radical prostectomy: PSA values rising

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Profile picture for Jeff Marchi @jeffmarc

They should be setting you up for salvage radiation. When they can’t find it, that is usually where it is located. Your urologist is not following the standard of care.

Here’s information from the America Society of clinical oncology that discusses what to do after your PSA rises following a prostatectomy

From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.
0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.
0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/

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Replies to "They should be setting you up for salvage radiation. When they can’t find it, that is..."

@jeffmarc I see you are up and posting - how did your procedure go? Feeling OK?
Phil

@jeffmarc
Thank You Jeff for responding and for the information!

@jeffmarc Aren't their other scan types available if the PSMA doesn't find it?