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PSA "undetectible" for amost a year

Prostate Cancer | Last Active: 5 hours ago | Replies (13)

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Profile picture for johnfinch @johnfinch

I'm 70, a year out from surgery. I'm still experiencing incontinence but it's decreased from a post surgical peak of 5 pads a day to 3 pads a day. I do the kegels daily. My PSA numbers have crept up from .028 a year ago to .041 now. I'm at the borderline zone for recurrence. The numbers are not disagnostic and not alarming but I understand they are worth monitoring. I've just moved from CA where I was being treated to AZ. I need to find a new urologist. My urologist in CA is keeping track of my PSA results. No talk of radiation yet.

Is anyone else experiencing similar numbers? What's been the urologist's response?

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Replies to "I'm 70, a year out from surgery. I'm still experiencing incontinence but it's decreased from a..."

@johnfinch
Actually, according to the American Society of clinical oncology, you should’ve had Salvage radiation when your PSA hit .2. Waiting as long as you are, could make it worse. Here’s their specific recommendation for those that have had 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/