Yes. Apparently, the 0.5 is around when there are (unfortunately) enough PCa cells that are in sufficient clusters to be more readily detectable.

My RO feels that despite this, it's possible that at lower levels there has been clustering - particularly when the PCa is persistent (where PSA never dropped to a post radical prostatectomy level of < 0.01, which unfortunately reflects my own circumstance), as opposed to PCa recurrence.

This makes me simultaneously hopeful and fearful, which is really a weird place to be - kind of like feeling both overheated and cold at the same time. With any luck, the persistence is not related to metastasis but rather locally left-behind cells from the non-focal EPE and seminal vesical invasion. The RO tells me that he feels it "extremely unlikely" that the PCa has metastisized. The RO team here is very experienced, so I find some hope in that too.

This is quite the journey, isn't it.

In shared experience and support ... I am deeply grateful for communities like this and I hope I can be around long enough to pay all the support forward to the unfortunate many more who will find themselves with a ticket on the same boat.

- michael