Monitoring PSA post Prostatectomy when should I be concerned?

I don't think I'd be too concerned. At those very low numbers, seems like a slow(ish) doubling to me.

My RO claims that the rate of doubling is not a big a concern when you're talking about numbers that low. The statistics already posted on here would indicate it's likely too early for imaging to give you much of an answer as well.

Obviously see what your urologist says. For my money, if the urologist didn't suggest it, I might suggest moving to 3 month intervals to keep a closer eye on the PSA for a while. My PSA went up to .091 before we started salvage radiation, that was almost doubling in 6 mos post surgery. There are quite a few folks that think this was potentially a little early. I was comfortable with being proactive.

Best of Luck!

Thanks gor the reply. Much appreciated!

Those numbers are low. I have never had the USPSA test, but maybe you might want to ask about the accuracy of the reported number. Is it's tolerance +/- .005? +/- .001?. If its the former your results are very close to within the tolerance level of the test. If you're worried maybe you could have the test every 3 months as stated by another poster? My Urologist/Surgeon has me on a 3 month schedule for the standard PSA test for my first year after surgery (August 22). Hopefully if everything is ok after 12 months I will request to stay on 3 month schedule even though the standard interval is twice a year after 12 months.

On another thread, there was a link that lead me to two studies (UCLA, Johns Hopkins) that suggested that on the uPSA, 0.03 was a threshold for predicting biochemical recurrence [BCR]. My urologist, though, agreed approximately with @web265, saying that we would act when 0.1 was reached (on the uPSA test assay.) So what this tells you is that there is some possibility you will be facing BCR in the future, but it's still perhaps a couple years away. Here's to a good journey in the days yet to come!
As others have stated, at these lower levels, the doubling rate has not been found predictive, to the best of my knowledge.

Thank you all for the replies. They were all very helpful. I'm not overly concerned but it's always good to hear from others. It's been a very good 6 years since my surgery with no major issues. Looking forward to many more! My best to you all!

Just curious, are you currently on any type of treatment going forward, such as a ADT or an antiandrogen med, etc?

I had my prostate removed about 11 years ago, but have been on Lupron pretty much the whole time and then Abiraterone(Zytiga) added a couple of years ago. I was doing pretty well and tolerating everything until about 6 months ago. Currently my PSA’s have been rising. PSMA Testing shows that the cancer has metastasized into my bones so will be seeing my oncologist next week to discuss options going forward. Looking at chemo, Xofigo, Pluvicto to name a few. Things are getting a bit scary for me now.

Sorry to hear about your situation. I wish you well going forward and hope and pray for a positive outcome.

I had no other treatment following the surgery. Just regular PSA testing.

@jmp6477, you may also be interested in these related discussions:
- Post prostatectomy: What do rising PSA levels mean?: https://connect.mayoclinic.org/discussion/post-prostatectomy/
- PSA Doubling Time Under Active Surveillance: https://connect.mayoclinic.org/discussion/psa-doubling-time-under-active-surveillance/

I'll be interested to hear what you learn from your urologist next week? At what point should you be concerned? Good question.

I agree with @perrychristopher's comment. At 71 years, my prostate surgery was in May, 2022. I've had my PSA tested every 75 to 90 days and, thankfully, it has tested "undetectable". We follow each test with a 30 to 45 minute Zoom call regarding other post-surgical issues, because I live a distance from the Medical Center, and due to my Covid-19 concerns of meeting l in its crowded setting. My surgeon said that if the PSA is "undetectable" at 1 year, he suggests we transition to testing every 6 months". I'll wait and see but, right now, I see no reason not to continue with the 3 month protocol.

Had my appointment today and my urologist was not concerned at all. She said they wouldn't be concerned until PSA reached 0.2. Very good news indeed!