Post Prostatectomy 6 years. PSA <.01 until now. Anyone else?

I can identify with the nagging anxiety of minor changes in psa. After immediate post surgery surge to 2.8 followed by 20 months adtI enjoyed 3 1/2 years at less than .01. Last October .01 January .04, march @ mayo less than .1 they call undectable. April locally .1 july locally .15 . Will go back to mayo in sept . A trend to thimk about. Stay strong and keep testing!

@diverjer Not really a stupid question at all.

Pathology after my RARP showed I had a positive margin, and Prolaris Score indicated at 53% chance of a BCR in ten years. Gleason was 3+4.

At eight years after my surgery, my urologist detected a small nodule in my prostate fossa during a routine DRE, but my PSA was still undetectable (<0.1). So no further action at the time. Two years later, my PSA rose to 0.11. A PSMA PET scan was performed and the nodule lit up with a SUVmax of 13.3. A pelvic MRI further indicated that the nodule was a cancersous lesion. At that point, I was diagnosed with a local recurrence and treated with radiation therapy.

If not for the DRE, I suspect that the PET scan would not have been performed, and I would be on active surveillance at most. Instead, the palpable nodule set things in motion and I got a jump start on treating the relapse.

In my case, a DRE gave the first indication of a local relapse, two years before PSA did.

@diverjer
A bill.

Australia just announced they will no longer do DRE‘s. Plenty of other ways to figure out whether somebody has prostate cancer.

@jeffmarc
Guess I am way behind, before my long time PCP retired the DRE was done even on my Wellness test. Actually his wellness visit was a full physical, not like today when they just talk to you. Then I found this on a Google search:

(DREs) are generally not recommended by major U.S. health organizations like the U.S. Preventive Services Task Force as a standalone or primary screening test for prostate cancer due to a lack of evidence proving a net benefit compared to blood tests.

@jeffmarc
Guess I am way behind, before my long time PCP retired the DRE was done even on my Wellness test. Actually his wellness visit was a full physical, not like today when they just talk to you. Then I found this on a Google search:

(DREs) are generally not recommended by major U.S. health organizations like the U.S. Preventive Services Task Force as a standalone or primary screening test for prostate cancer due to a lack of evidence proving a net benefit compared to blood tests.

That is for sure, but my PCP I had for around 30 years would still do complete physical for my wellness.
Now they give me 3 words to remember and draw a clock with time of 10 minutes after 11. Its a circle they want me to draw the time in. I have thought about drawing a rectangle in the middle of the circle and draw a digital reading of 10 minutes after 11. I doubt he would see the humor in that?

I am just going on my experience (career) as the Director of Clinical and Anatomical Laboratory services in hospitals and one reference (outside, non-hospital) Lab. Generally speaking, any test result that shows a >10% variance from a prior test result is "clinically significant"...there is clinical causation. Our Laboratory Information Systems ("LIS"...a.k.a. "Lab computers) catch unexpected results.
That said, literally every test that is measured quantitatively, whether in grams, milligrams, micrograms, or picograms, has a lower level of detection determined when the assay is being set up in the Lab. Just as linearity measures how high the assay can accurately measure elevated upper-end results, the lower end of that is measuring "how low" can this assay accurately detect and measure the analyte (chemical), and done so with acceptable "precision" (reproducibility), and accuracy without false positives or negatives.
In their "practice" of the "art" of medicine, physicians, or subspecialty groups, decide at what level of change they will take action. While I agree that we are talking about unbelievably small quantities, any "doubling" of a test result is in fact a 100% increase, and again, there is clinical causation that exceeds any random variation in the testing and instrument on which out is tested. That result needs to be investigated. Before they reported the result, the lab already did investigate it...their computer system has the prior results for that patient, and if there is a "clinically significant" increase (or decrease for other tests), they will repeat that test to verify it has in fact doubled (in this case) or increased beyond 10%. Each test report will have "canned comments" print out on the test report as to the significance of that result and its variance to the previous result(s). It is up to each physician as to how they will respond to the clinical information provided by the Lab.

I can identify with the nagging anxiety of minor changes in psa. After immediate post surgery surge to 2.8 followed by 20 months adtI enjoyed 3 1/2 years at less than .01. Last October .01 January .04, march @ mayo less than .1 they call undectable. April locally .1 july locally .15 . Will go back to mayo in sept . A trend to thimk about. Stay strong and keep testing!