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Biochemical rerrurrence after SRT

Posted by oliveb @oliveb, Jul 23, 2023

Had RP Jan 17. PSA undetectable for 1 year then reoccurred at .016. Tested 2 months later and at .028. Then underwent SRT and PSA was undetectable for 5 years. Now came back at .018. Tested 3 months later and now down to .008. Without a prostate why would I have any PSA number unless it was a reoccurrence and why would it go down on its own. Perplexing? Appreciate any clinical thoughts.

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pianoman | @philipbrachko | Jul 23, 2023

I believe there are several factors than can affect PSA. Also I think that the tests may have a margin of error. I have heard from other members of this group about PSA going up and down for no apparent reason.

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kujhawk1978 | @kujhawk1978 | Jul 24, 2023

PSA can vary, particularly with USPSA. Here's my clinical history, as you can see, while I was on the standard test, measure to a single decimal point, labs would say undetectable, >.1. When my urologist switched me to USPSA. it was all over the map, up, down...

My urologist didn't have an explanation but we both agreed that single results were not triggers for imaging or treatment decisions, rather trends, specifically three continuous increases spaced 2-4 months apart and imagining when PSA between .5 and 1.

We met that criteria this year, we imaged using Plarify, it located one PLN, we did five SBRT toi ikt and decided on six months of Orgovyx for micro-metastatic disease.

There is discussion though not necessarily agreement on USPSA and what the values mean.

Consider discussing with your medical team about trends vice single results when using USPSA.

Kevin

Kevin
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1 reply
wellness100 | @wellness100 | Jul 24, 2023

Recent research shows that the kidneys can produce a small amount of hormone.

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sam60 | @sam60 | Jul 25, 2023
In reply to @kujhawk1978 "PSA can vary, particularly with USPSA. Here's my clinical history, as you can see, while I..." + (show)
@kujhawk1978

PSA can vary, particularly with USPSA. Here's my clinical history, as you can see, while I was on the standard test, measure to a single decimal point, labs would say undetectable, >.1. When my urologist switched me to USPSA. it was all over the map, up, down...

My urologist didn't have an explanation but we both agreed that single results were not triggers for imaging or treatment decisions, rather trends, specifically three continuous increases spaced 2-4 months apart and imagining when PSA between .5 and 1.

We met that criteria this year, we imaged using Plarify, it located one PLN, we did five SBRT toi ikt and decided on six months of Orgovyx for micro-metastatic disease.

There is discussion though not necessarily agreement on USPSA and what the values mean.

Consider discussing with your medical team about trends vice single results when using USPSA.

Kevin

Kevin

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Thanks Kevin. We are using trends. Took 8 months to go from.06 to .5 did PSMA scan 2 uptakes but radiologists said to small to radiant. Now waiting till 1. Or greater.

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1 reply
bettwils16 | @bettwils16 | Jul 31, 2023
In reply to @sam60 "Thanks Kevin. We are using trends. Took 8 months to go from.06 to .5 did PSMA..." + (show)
@sam60

Thanks Kevin. We are using trends. Took 8 months to go from.06 to .5 did PSMA scan 2 uptakes but radiologists said to small to radiant. Now waiting till 1. Or greater.

Jump to this post

Hi, had RP 8 yrs ago. Biochemical recurrence this year, PSA .24 x 2. PSMA PET Scan neg. Had 38 radiation treatments to prostate bed. PSA 3 months after radiation .02. Did not take any meds

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