PSA 0.06 at one year post RARP

Yes, it can be a fluke or the first indication of recurrence. Depending on how concerned you are can get another test in 4-6 weeks. Should get another one in 3 months to get a better handle on the PSA trend.

@jim18 Thanks! Yes, I plan on getting another one in 4 weeks time. I wonder if anyone on here had such a jump that turned out to be nothing.

It can be a fluke !
Just test it in 4 weeks again and see if there are any changes.
Make sure to use the same lab, but I am sure that you already know that.
Sometimes PSA can fluctuate even after RP, at least that is what our surgeon told us. Unfortunately my hunch proved to be more correct than his *sigh... BUT - my husband had so many unfavorable findings to begin with and he was gleason 9.
Not to mention that one node was glowing on the first PSMA and was dismissed by urologist and RO as "false positive".
Try not to panic but be proactive and keep checking uPSA every month until it stabilizes 👍.

Thanks @surftohealth88! I hope it’s a fluke, but the jump
is big. Will see what the next test says.

Could other factors influence PSA levels?

For example, for those with a remaining prostate, ejaculation frequency.

And for those without a remaining prostate, are there other factors?

I mean, taking into account all possible factors for PSA elevation, not just relapse. Plus, fluctuations, different labs, and different device settings. There may be errors with small numbers.

Disconcerting and nerve wracking, I know, but ultra sensitive PSA tests can give up and down results due to various factors, including sample quality, instrumental drift, and operator error. That said, if I was in your situation, I would follow with monthy testing (as has been suggested) to see if a trend is developing or not. And there wouldn't be any harm in doing a repeat test immediately, just to see if it was a fluke. I would definitely do that (and I did with my recent PSA bounce, as desfribed below).

Although PSA bounce is usually a phenomenon associated with primary raditotherapy, there is a case of PSA bounce that was documented in a patient who had primary prostatectomy AND salvage radiotherapy.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7450009/
Following my salvage radiation last fall for a local recurrence (I had a prostectomy in 2015), my first PSA (Feb 2026) was 0.086. Then in May it jumped to 0.113. Very concerning at the time, but since then, my PSA has been slowly declining and is currently at 0.09. Will test again in three weeks.

Hope you are just seeing a bounce or a "lab fluctuation". Regardless, just stay on top of further testing. Keep us posted.

Mel

@melvinw Thanks, Mel! I will get another test in 3-4 weeks time.
I went to the doctor’s office to pick up the actual lab reports (the portal only shows the number) and realized that my doctor erroneously requested the regular Quest « PSA, Total » which reports down to 0.04, but is apparently very unreliable at low PSA levels. So, there is hope it might have been a fluke…

@topf Oh, that may be good news for you. I once did a normal PSA test (Quest) and an ultra sensitive PSA test (Labcorp) on the same day (back-to-back blood draws at adjacent facilities). Quest yielded 0.11 and Labcorp yielded 0.097. Close, but not the same. My experience has been that at low values (around 0.1 or less), small PSA variations are normal, and can cause a lot of alarm that usually proves to be clinically insignificant “psa anxiety”.

Footnote: for ten years after my prostectomy, my doc only did normal PSA tests. Results always came back as undetectable (<0.1) until June 2025 when my PSA hit 0.11. I was a happy camper for those ten years and never gave things a second thought. If I had been doing usPSA tests for those ten years, I may well have been one rolling ball of PSA anxiety. I’m glad I had those ten “carefree” years, but I’m also glad I stayed on top of my PSA and caught the relapse at “first light”.

The LabCorp regular test uses a different analysis method than the Quest regular test so there are built in differences. The LabCorp ultra-sensitive test is different from their regular test so those can be different even when the PSA is high enough to register on both.

@jim18 Indeed. I can’t tell you how many times docs, and medical staff, have looked at me quizically when I insisted on getting the same test from the same lab and even the same facility. When that has happened, I usually ended up saying something like, ‘Well at least humor me, I spent a career as a research scientist. I’m a stickler for consistency’. I’ve had docs tell me there is no significant differences between the various labs, much less the various assays.

When my PSA first registered as detectable (0.11) in June 2025, ten years after my prostectomy, my new urologist brushed it off as “lab variation” and was not even interested in retesting. I went ahead and retested a few days later (same lab, same assay, same collection facility). The result was 0.12. He immediately changed his tune and referred me to advanced prostate cancer colleague and put in an order for a PSMA PET scan.

As has been said many times in this forum, you really have to be your own advocate, even at the risk of seeming obnoxious.