Post prostatectomy: What do rising PSA levels mean?

Radical open prostatectomy 10 years ago. Levels and risings low for years. Recently, readings went from 0.13 in May of 2021 to 0.28 in February 2022. Is that much increase in 9 months reason for concern ?

3185 Have you consulted an Oncologist ?

Hi @3185, I assume you got some of your answer in the responses in this discussion. As many have reported there can be a variety of reasons for rising and falling PSA values. While PSA is a useful indicator, it must be coupled with other diagnostics if there is reason for concern. Only your oncologist can determine whether your increase from 0.13 to 0.28 over 9 months warrants further investigation. Have you discussed this change with your oncologist?

I have a question about Prostate MRI second opinion. I am having a MRI using 3t MRI equipment. Group is relative new to using this equipment in Des Moines. Can I contact MAYO as the patient and make the request of a second opinion reading of the MRI results at the time I am getting the MRI in Des Moines? Thank you.

507.284.2297 is Mayo urology number. Try a call and see what they say

Thank you. Mayo told me I would have to go there and become a patient and get another mri for them to provide a second opinion

Hello all,
I had a radical prostatectomy 4 years ago. Surgeon said that the post surgery biopsy indicated an encapsulated cancer in the prostate that had NOT spread. However over the 4 years the PSA levels have now reached 5.17 . I have undertaken 7 PET PSMA scans and also had 2 rounds of focused radiotherapy to treat 2 lymph nodes that have shown positive in the scans.
Now I am due to start Hormone treatment to try and contain further spread. I am very hesitant to start due to the obvious side effects. Any comments on hormone treatment are welcome- what can I expect, side effects, quality of life, and any alternatives??
Also does light exercise cause testosterone to rise, which defeats the purpose of the hormone treatment
Any tips and encouragement are welcome

Hi @isrexpo ,
Sorry to hear your having to go through all that. Had RP about a year ago. I'm on orgovyx. The side effects for me have been fatigue, shrinkage and hot flashes (although I just finished a round of radiation so some of the fatigue may be that), I guess I'll know more in a few weeks. I do seem to have joint pain as well.

Testicles have definitely shrunk, I'm guessing the orgovyx is the culprit there. I can still get erect (with a little more effort as opposed to before). There's shrinkage there as well but again, how much did the surgeon take vs the hormone therapy, my two treatments are so close together it's hard to tell.

"Also does light exercise cause testosterone to rise, which defeats the purpose of the hormone treatment" this is a great question I've asked my Radiation oncologist, he claims that the answer is not enough to matter. He feels that if exercise helps you mitigate the side effects or just helps you deal with them, it's better to do so. I lift 4 days a week and run 8-10 miles a week. Having said that, in lifting you I've had no gains in muscle mass or actual lifting capacity since on the orgovyx, is some of that psychosomatic, possibly.

I really believe for me, the worst side effect is the hot flashes when they happen at night effecting my sleep. It has gotten better (less frequent) over time. (approx 5 mos at this point)

I just had a blood test, before radiation and orgovyx my level had snuck up to .091, now it's back down to .014. My PSMA was negative.
Good Luck !

Hi. There are great meds for your hot flashes. Megesterol twice per day. I was on it for 2 years. Works great.

Here's my clinical history.

First, side affects of ADT that I experienced

Penile and testicle shrinkage
Hot flashes
Moderate fatigue
Moderate joint and muscle stiffness.

I did not lose my libido, some statistics say 20% of men do not.

I pretty much maintained my normal lifestyle while on ADT, well during radiation no travelling and during chemotherapy the fatigue was moderate to severe. I exercised - rode my bike, went skiing with friends, hike in Colorado and Nevada, lifted weights, played basketball, swam, yardwork, walked the dog...

You don't say how long your medical team wants you on ADT. From my readings and what you describe, that could be as "short" as six months or as long as 18-24 months. They may be recommending you do ADT because of micro-metastatic disease, too small for any scans to show.

At no time during ADT did my testosterone rise, the Lupron kept it <7.

I would consider getting some baseline clinical data based on the cardiovascular and metabolic side affect profile of ADT. Consider a CBC, metabolic panel and a consult with a cardiologist.

Kevin