There is still much discussion about USPSA tests and what changes mean compared to conventional PSA tests that only measure to single decimal.

There can be variation in lab results. Some factors may be if different labs are used, type of assay, calibration of equipment as well as the conditions, were you dehydrated, ore lab routine, did you intensely exercise prior, is the lab the same time of the day...

So, a change from .005 to .01 may mean different things. One thing is may not mean is a call to action, treatment! What you may want is multiple readings over time, say three, stretched three months apart that indicate a continuous upward trend. web265 is correct when he cites his radiologist - One of the statements my radiation oncologist made to me was that rate of doubling in those very low numbers such as you're in is not nearly as troubling as in the higher numbers, i.e. 2 going to 4 etc. As you can see from my attached clinical history, my PSA has bounced around since triplet therapy starting in Jan 17 through Nov 18 after surgery and SRT failed but my medical team has not felt there is a reason to act given its variability and low levels.

We do know there may come a day where that variability ends and there is a need to act. What might that day be? Well, PSA would have to hit .5 a continue to climb, why, well that's the earliest we would image endeavoring to locate where the recurrence might be. No treatment decision unless we know where it is! Belo .5 the newer imaging has <30% chance of locating the recurrence.

Another thing to think about is does acting now or waiting until you have more clinical data supporting a decision change the outcome, you and your medical team's treatment decision. Before USPA tests or if your medical team was not using USPSA then the decision criteria for recurrence was a detectable PSA defined as .2 followed by a 2nd rise that showed .3 or higher. So, by that standard, you are undetectable!

Consider to continue actively monitoring your PCa, decide if it continues to increase, what constitutes a decision to treat - I would consider not treating until I had imaging to inform the decision and for me and my medical team, that comes somewhere between .5 and 1. If there is clinical data to support a treatment decision, hit it hard with double or triple therapy.

Kevin