"A 3rd RP friend (no BCR in over 3 yrs) is freaking out because his PSA went from .00something to still .00something higher (you get the point)."

It still baffles me any clinic would give patients their results to three decimals in any scenario. It's useless based on all the data to date and only creates unnecessary anxiety. There are some studies that show 0.01 and 0.015 were predictive but even 0.02 was not more than 75% accurate at best. Even if say two readings at or above 0.015 was confirmation of BCR, I doubt there's a single Urologist, Radiologist or Oncologist in the world that would recommend any treatment at that PSA level unless the doubling time was say, 4 months or less. Seems no one these days believe there's any advantage to doing SRT prior to 0.05. So there's no point of it no matter how you look at it. It's only detrimental to the patient psychologically.

When my result went from < 0.02 to 0.02 and I reached out to local small city Urology clinic about it, they were like that's a GREAT PSA you have nothing to worry about. Ya maybe relative to your patients about to go on Lupron with a PSA of 5. And even a gal at UCSF said, some labs don't use the < sign. Well if my lab changed their practice, they should have told me. Both naive responses in my opinion. Yes, I know it's no confirmation of BCR at this point but should I be testing in 2 month instead of 3 month intervals now? They both said "just keep monitoring" with no other information. (For uPSA, I doubt it since it didn't jump to 0.03 or 0.04)