The good news seems to be it's remaining pretty low. I had a couple confusing readings from the same lab when I started but it was because they were looking a two different sensitivities.

My first two looked like this...
10/22/21 PSA Result of <0.1
01/26/22 PSA Result of 0.039
They could literally be equal.

I'm a little surprised your team was content with that less sensitive test after RP till '21, makes spotting a trend a little tougher in the lower numbers.

My next result was 04/26/22 PSA Result of 0.091, we wouldn't have spotted the trend without that sensitive test. Water under the bridge for you thankfully at this point.

Equipment types and sensitivity may be what's happening between lab 1, 2 and 3. I would ask the doctor on the last two at lab three, if he doesn't give you a definitive answer, I'd try to get one from the lab.

I've had to check and make sure that the orders are for "ultra sensitive" PSA tests and go to the same lab so that they are apples to apples.

Either way the differences would be pretty minimal for the last two. Maybe it's something like
0.04 and 0.039 but their equipment doesn't get that specific.

Your results from 2015 through 2/21 indicate you and your medical team were using a standard PSA test that only detected to a single decimal. So, <.1 meant it was "undetectable" since it could not measure below a single decimal point.

Now you appear to be be using an Ultrasensitive PSA test which can measure to two decimal points...

A couple things to think about. If you were still using the standard test your lab result's would say <.1 and you would smile, set your next appointment and enjoy life.

With your USPSA test now comes "worrying" about every change in your results. As you can see from my attached clinical history, once my medical team and I switched to USPSA my results have been up an down.

With the standard PSA tests there are pretty agree upon definitions of BCR, a PSA of .2 (assuming you had surgery) with a subsequent PSA of .2 or higher usually 90 days later. There is also a wide range of discussion abut whether or not you can use USPSA in calculating PSADT and PSAV at such low levels.

Not so much agreement with the USPSA...What you and your medical team have to decide is what do you do with the results of an USPSA given the variability? What in your minds will constitute an contiguous upward trend - how many USPSA tests, how far apart...? What are the decision points, at what PSA, then to image, What PSA constitutes a decision to treat, 2, 4, 10...Some of that may be based on your decision on when to image, below .5 and current FDA scans have roughly a 30% chance of locating PCA, around .5-1 it climbs to around 60% and of course after that, keeps going up. Imaging can be a powerful decision tool in your treatment plan as long as you and your medical team believe the results may change your treatment plan. I believe it does, particularly if radiation is involved as then your radiologist can build a plan that includes boosts and wider margins around the identified sites.

With your PSA results, I would just continue to actively monitor,2, 4, or 6 months and based on your decision points about the results, act when you need to.

Kevin