New Higher PSA after steady decline: A little worried, thought?

I'm so sorry, I'd like to know what they say if you can message here or privately!
My husband is 56 now, was diagnosed a year ago exactly with PSA at 300, gleason mostly 8 and 9s, scans showed all over his body. Terrifying!
He started Firmagon and Zytiga and did chemo over the summer, now the PSA is 0.28 or maybe 0.33, I can't remember but we'd expect it to be closer to 0 but as long as it's down it's good, but they DID tell us that it would probably last 18 months or so before the PSA starts rising again and then we'd shift gears, I'm guessing pluvicto which is scary and really only works half the time.
Hubby is "fine" otherwise, eats right, exercises every day, no pain.... but no sex life.
We're worried every time he goes to get his Firmagon injection every month, that the PSA is going up, but so far it's still going down a tiny bit each month.
Keep me/us posted!

@oldfords

1. What was your testosterone level throughout 2025?
2. How many bone metastases were there? Exactly. And where exactly?
3. Show the PSA decline. How much did it decrease after chemotherapy? How did it decline afterward? Show how your PSA decreased every 3 months.
4. How many chemotherapy sessions were you on?

5. When did you start taking Nubeca: along with chemotherapy, after chemotherapy, or a significant time after chemotherapy?
6. What is your Gleason type?
7. How old are you?
8. What other medical conditions besides prostate cancer?

Don't panic yet, gather information.

Thank you!

@oldfords
Since you have been on Nubeqa Not having complete ADT protection should not be a serious problem, Nubeqa prevents testosterone from working with the cancer. I stopped ADT for eight months and my PSA still stayed undetectable because I was on Nubeqa.

Sounds like you had small metastasis in the bones before you went on the drugs, They kept it suppressed, but over time the effectiveness of the drugs wanes. The thing is, The metastasis had probably not gotten worse, Has your PSA risen?

Getting them zapped would be a good idea.

I am scheduled for a pet scan next week. I have already metastasis in my bones so I will ask about radiation. Yes I am still on Nubeqa and Lupron, but for the past year I have been getting the three month dose every six months. Maybe that is the problem. I guess I will know more after the scan and meeting with my Dr.

Time for a PSMA PET scan to see if a metastasis can be located in your body and could be zapped with SBRT radiation which shuld get your PSA back down.

Are you still on Lupron and Nubeqa? If those drugs don’t keep your PSA down, you may have become castrate resistant. Something to ask your doctor about. If you are off the drugs, then your testosterone has probably risen and started to feed the cancer again. The pet scan is really necessary.

@mjp0512
I have a call in for my Dr. now. My lowest PSA after starting treatment was 0.46

Certainly not the best of things to go through. But now is the time to use all the knowledge you’ve gained since April 2024 and work with your medical team to fight this.
> You’ll have to first see where the recurrence is. (If you can find it, you can fight it.) Are you scheduling a PSMA PET scan?

> What were your previous biomarker (genomic) test results?

> What were your previous genetic (germline) test results?

Once you begin to figure out the specifics of what’s going on, you can begin putting together a game plan.

You’ll get through this.

I sure wouldn't like that much either. Doubling time with just those 2 data points is about 2 months. No bueno.
I would want another test in a shorter time period just to check trend. Probably 2 months maybe even one.
What's your doc have to say? What was your lowest PSA after treatment began?