It's your choice, but...with a PSA of 2.5 after surgery instead of <.1 it means your PCa was advanced, outside of the prostate, possible the lymph nodes, though not impossible to include bone or organs. Was there any imaging done o try and determine where the recurrence was after surgery. Since you had surgery, you have a pathology report, sharing that with the forum will help members with their advice. In My case, it was T2CNoMX, SV, ECE, Margins negative, GS 8.

From what you say it seems your had SRT, was it to the prostate bed only or did it include the PLNs?

Al this is irrelevant now, question is, what to do now...

First, I would ask your medical team to schedule imaging to locate the site(s) of your PCa. At your PSA, any of the FDA approved ones will likely determine where it is.

You can have your PSA checked again, 30-90 days, it would tell you whether or not the rise is a continuous upward trend or a increase that can occur after radiation and then it goes down.

Informed by clinical data - your pathology report, PSA results which can be used to calculate PSADT and PSAV and the imaging, you and your medical team can make a decision on treatment, if, when to initiate and what. If your decision is to treat, you will have choices so consider what the clinical data tells you but most likely monotherapy will not be the answer, you will want to consider a combined regimen.

Kevin

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