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ADT and rising PSA
I could have added this to my previous discussions of “PSA Wrong Direction” but felt this is important enough for its own thread.
A couple of things I’ve learned since I started that first discussion in December:
1. If you are on ADT, your PSA is NOT SUPPOSED TO RISE!
If your PSA starts going in the wrong direction, even if it is a minimal increase, as mine was, DO NOT listen to the conventional wisdom of…
“It’s probably just a “minor bounce” or “lab variance” or “inflammation from radiation”. We’ll check it again in a few months”.
If you are on ADT, your PSA is NOT SUPPOSED TO RISE!
INSIST on monthly PSA testing immediately. Had I done so last December, the flare up on my spine would have been caught sooner, treated sooner, and I might still be able to walk normally and sleep through the night. Instead, it’s six months later and I don’t even start treatment until next week. It’s a $60 test. DEMAND it. If it turns out to be nothing, no harm, no foul. But if you can catch something earlier, maybe it can be treated before it hurts.
PSA:
4/21/25 - 30.11
6/7/25 - start ADT
7/9/25 - 0.55
8/26/25 - 0.19
10/2025 - IMRT
12/3/25 - 0.23
3/17/26 - 8.80
4/1/26 - 10.29
5/18/26 – 14.90
And…
2. Prostatic Adenocarcinoma is a very slow growing cancer…until it isn’t.
That is all…Don’t make my mistake.
Enjoy your day!
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@denis76 - Nope, no chemo yet.
With those regular PSA tests, at what date did you come off of ADT?
Typically, those conventional wisdoms occur post-radiation & post-ADT. But, they all warrant close monitoring of both PSA and testosterone.
Yes, Prostatic Adenocarcinoma is a very slow growing cancer…until it isn’t. Which is why we did a PSA test on the last day of treatment, then 6 weeks later, then every 3 months for 2 years, then every 4 months for 2 years, and now we’re testing PSA every 6 months for 2 years. We’re now 5 years out and still confident in how it’s going.
Good luck!
@brianjarvis - Still on ADT, Brian. Therein lies the problem.
@mjp0512 Do you know what your testosterone level is?
Remember, there is not a direct connection between ADT and lower PSA levels. ADT results in your testosterone level being suppressed, which results in your PSA being suppressed.
If the ADT is no longer resulting in your testosterone being suppressed, the solution to your problem will be different than if the ADT is suppressing your testosterone but the PSA is not responding.
Last T on 4/1 was 11. Its been between 9 and 15 since July.
@mjp0512 In the U.S.? 11 ng/dL (U.S. measure) would be deep in the castrate range, while 11 nmol/L (International measure) would be into the normal, non-suppressed testosterone range.
It's one of those rare cases where we don't all use the same units of measure. My testosterone of 0.8 nmol/L is well suppressed by Orgovyx, equivalent to 23.01 ng/dL in the U.S. system.
@northoftheborder - Yep...U.S. ng/dL.
@mjp0512
Hey Mjp - just stopping by to ask how are you doing ? 💗
Did you have chance to talk to your MO ?
I hope that you are still sleeping well now and that your back pain is completely gone 😌 .
Thinking of you and sending healing vibes ✨