PSA detectable 18 mos after prostatectomy

You need to chat with your urologist. They will probably do a couple more PSA test over the next couple months to see the trend. It is important that the same labs be used as different lab test can delivered a confusing result I had my RP also in june 2022 and when the 3 month PSA test time rolls around, I always get nervous. Good Luck

We’ve had different labs collect sample but same lab has processed them. Does collection method differ?

I doubt that there is a difference in the way that they draw blood. I suspect that testing the blood by the same place is the important thing. Nevertheless, the doctors want to see a trend in PSA results

I had RP in 2008 with no follow up treatments. Eleven years later my PSA results were rising every 3 months. It was recommended that I see a oncologist and after MRIs cancer was detected in the prostate bed. I began hormone treatment for 6 months while having 36 proton radiation treatments. My PSA scores initially were undetectable but that was short lived. They're now approaching a 4 at 3.84. Three PET scans have not been able to show any cancer yet. I don't particularly want to begin treatment unless a PET scan can show me where and what to treat.
Just don't be too hasty to begin treatment. Involve your urologist and a oncologist to listen and learn. Do plenty of research.

Because of a weird bureaucratic thing, I once had the same test performed by two different labs from the EXACTLY same blood sample drawn from me (it wasn't the PSA test). One result showed me in the middle of the normal range, and one showed a slightly abnormal result.

That's why, as others have mentioned, the medical team watches for trends so that the variability in test results cancels itself it. 0.14 is still very low for PSA (I think anything under 5.0 is considered low, depending on the medical team). Of course it's frightening to think that this could be the first tiny step in a rising trend rather than a temporary blip — I'll feel the same the first time my PSA is detectable again — but at this point, it's just a gust of wind rattling the shingles a bit, not the roof coming off.

I hope for the best for both of you.

Biochemical Recurrence (BCR) after prostatectomy has been defined as PSA rising from undetectable < .1 to .2
Generally accepted stds look for a trend over time of rising PSA.
Helpful references may be:

SPPORT trial

PCF.org video Jan 2023 "Rising PSA following initial treatment"

If trend/increases continue, Radiation Oncology and/or Medical Oncology consults are appropriate.

There is information that if PSA rises, sweet spot for additional treatment is PSA of .2 - .4/.5

There also is a trend toward initating treatment at lower PSA readings.

Summary: See Rad/Med Onc and follow PSA in 2/3 mos increments to watch for trend.

Best wishes

kscharmer; I would second everything that michaelcharles has said in his post.

At 16 months after radiation PSA went from < .1 to .9 in one month. I had been using alpha keto glutamate for muscle growth. Obviously, it is excellent for cancer. Makes it grow. I followed mayo, James Kirkland’s Experimental advice. Cancer was undetectable a month later. It pays to be proactive.And read the cancer effects for all food and supplements.

Been there, done that...

a .14 sounds like an USPSA test.

With USPSA, measuring to two decimals, there is not, at least that I have found, a commonly agreed upon definition of BCR.

With the standard tests, to single decimal, the generally agreed upon definition of BCR is two or more consecutive increases where PSA it .2, then .3, spaced several months apart. As others have said, use the same lab and generally try and follow the same routine prior to the draw.

Going back to my high school math, if your husband's PSA was a single decimal one, rounding off would be to .1 (< .5, round down,,,)and likely you two would be saying to your medical team, "see you in...!"

As others have said, what you and your medical team look for are trends. A single data point with PSA shouldn't constitute clinical data sufficient for a treatment decision. Discuss with your medical team about when to have another PSA test, one, two, three months...whatever you decide, you'll have another decision when that comes:

If it increases again, what do you do? The urge will be to act and do something. But, then the question of imaging comes in, do you into image then or wait until it increases say to .5-1.0 where imaging such as Plarufy (not C11 Choline or Aximun!) statistically has a better chance of locating any recurrence. If you decide that, you may have more clinical data to make an informed decision on any treatment, likely doublet or triplet therapy.

Take some time to do your homework, read the NCCN guidelines, do a literature search on doublet or triplet therapy. That will inform you and may guide your discussion with your medical team.

This may also be the time to bring a radiologist and oncologist onboard if you have not already done so. If so, they should have a focus on treating prostate cancer!

I've attached my clinical history. As you can see, 15 months after a very successful surgery my urologist hesitated after looking at his screen and my PSA results. You can also see that when my urologist switch to USPSA test, it went from undetectable to .36, then went down, later it went up, then back down. Finally in late 2022 and early 2023, it went up and up...That's when we decided to treat again, not the previous two ups and downs.

You don't give his pathology report, GS, ECE, SVN % of prostate involvement, Margins...so the forum doesn't know his risk category. Certainly if he has BCR at 18 months, that is a high risk factor.

It's frightening, I know. I think the good news is the revolution in treatment and management of advanced prostate cancer, and more is in the research pipeline. That means a dizzying array of treatment choices though!

Kevin

My PSA has been detectable for 10 years now. I have been Stage 4 Prostate cancer for 10 years. From a low of .18 to a high of 20.83