How to cope with stress/anxiety, waiting for PSA blood test

PSA marker test is a bit nerve racking...I have only been doing this 4 months...my PSA when I started Orgovyx was 70..in less than 2 months, it was down to .05 !! Yay...but now for some reason, I am looking ahead..will it stay down?? am i doing well..is there now hope !? my brow is a bit wrinkly... and these hot flashes.. holy hell..sometimes no big deal, other times-if I get upset or nervous- like trying to repair a ceiling fan attachment in attic on very hot day..and you cant find the screws..

I can only imagine guys like you who have been thru the wringer many yrs..waiting to see if you are still in remission/cure state ...

I think you just have to stay positive and go get it it done...if you are feeling good, no symptoms of anykind, then prob ok for another 6 months/yr run...

( also, research Alpha Lipoic Acid- can get on line or any pharmacy.. it suppreses PC from replicating..Google it and see !)

good luck..report and let us know...we are all in this together..!

Yes! I have to get tested every 3 months, and I was originally told my cancer definitely *will* become active again at some point in the future (they've softened that a bit to "possibly" since my PSA has remained undetectable for 4 years now).

The secret sauce for me was adding a couple of pleasant things to the test. First, there's a little hole-in-the-wall Indian cafeteria in the medical building across the street from the clinic that makes the best masala chai in the city: they start by roasting the spices in the pan once you order, then gradually add the tea and milk. And second, my cancer originally paralyzed me, so walking the 1.5 km to the clinic at the hospital where I spent a month in bed staring at the ceiling feels like a kind-of vindication.

So while I still get nervous a couple of days before each test, I also think of test day as masala-chai day and celebrate-being-able-to-walk-again day. Obviously, your "treats" will be different, but try to figure out something positive you can add. Do you have a favourite restaurant or cafe near the clinic? A fishing spot on the way home? A store where you can buy more kitchen gadgets or shiny tools you'll never use? 😉 Make that as big a part of the ritual as the test itself, and it won't be quite as hard — the stress will still be there, but it will be manageable.

Also, consider this: if you're getting tested only 1x/year, you're in a good place. When they're worried, you move to a 2–4x/year test schedule. So when you're heading in, think to yourself "I'm still in the LOWEST monitoring tier. Another successful year completed!"

@northoftheborder just curious- why did your team say your cancer *will* return.

I don't think I'll ever
NOT sweat a PSA. I try to mitigate it via meditation. It definitely helps but was still anxious.

I had a RP in 3/2020. Cancer came back in 2022, but at low levels. Finally in Feb. 2025, I hit. 20 which is the trigger point for follow up treatment at Sloan Kettering. Started Orgovyx in MArch,then 27 radaition shots ending July. At that point my PSA was undetectable. I just had it re-tested last Friday.Now- I knew since I was on ADT , the chances of it *not* being undetectable were slim. BUT, I was a wreck because if it detectable that would mean the radiation probably didn't work.

Thank you for your answer. Best of luck to you

@tjv1156 asked ❝why did your team say your cancer *will* return?❞

Because I'm stage 4: my cancer had already metastasised to my spine before it was diagnosed.

Received wisdom at the time was that castrate resistance on ADT would last only 18–24 months, then I'd have to progress to other measures like chemo or Pluvicto, and I'd die a couple years after that. But that was before there was as much data from new clinical approaches like starting on an ARSI early instead of waiting for castrate-resistance, treating oligometastatic cancer with "curative intent," etc. Things look much more promising for us now.

This is a timely topic - I have an appointment in a couple of hours to go over my first post-op PSA test. My post-RARP pathology was less encouraging in several aspects (EPE, SVI, large cribriform) than my original biopsy, so the PSA test has perhaps loomed larger than it otherwise would have.

Here is what has helped me not be crushed by PSAnxiety: my Christian faith, including prayer and daily Bible reading, active church membership and fellowship, exercise (primarily running), parenting a middle schooler (!), focusing on and finishing a few side projects at work, encouragement and wisdom from this message board

Here are some things that haven't helped: fixating on this one aspect of my life (i.e., PSA, PCa), spending too much time on this message board trying to predict the future and figure out the optimal way to eat, sleep, take vitamins, etc. etc. etc., and a less-disciplined post-op diet.

I tend to be all-or-nothing so striking a balance between harmful internalizing (whistling in the dark) and constantly researching, talking, thinking, worrying about the dreaded 0.2 ng/mL is not as easy as the two lists above imply, but in general, life seems better when I spend less time thinking about myself. There are numerous ways to do this, some probably more healthy than others. Is it better to serve in my church food pantry than to watch several hours of funny pet videos on YouTube? I don't know - there seems to be a season for everything.

Of course you stress. I do also.

And with all the BCR stories on this site, how can I not worry.

I try to remember:

1 - Don't borrow trouble before it's time.

2 - Worry is the interest you pay on borrowed trouble.

Easier to say then to do.

1st, I stressed about whether my PSA went down, and would stay down, after RP, persistent PSA and Salvage Treatment.

Now, 2 yrs after completing those treatments, I stress about whether it will go up. And with G 9 and EPE, I also have been warned that it is probable that my PCa will re-recurr.

I try to channel my inner Alfred E. Neuman.

Best wishes for a peaceful mind.

I have only been on this journey 1 1/2 years and have my PSA checked every 3 months. My wife asked me how I can handle it. As I have said on this forum before, Everybody is only one test away from having their life changed instantly. I just happen to have a known risk and I am happy to have it checked regularly. I view it as a positive because I want to know quickly if something needs to be addressed.

@northoftheborder do you mind if I ask what your treatment was? Congrats on 4 years!!!!