one year post radiation advice

@heavyphil
Phil, thank you. Radiation was primary. The second PSMA was scheduled at the time of treatment. There was an equivocal node that orgovyx hadn't affected which made the determination that it was not metastatic. PSA reached the lowest .27 six months post radiation, now .28.
I wondered how unusual it was to have an after PSMA. The doctor said that she usually orders one at the one year mark.
I'm wondering how to handle the sub centimeter right iliac node close to the nerve bundle.
Do you know about microscopy? Would PSE be useful?
I appreciate your attention.

@jeffmarc
Jeff, PSA is .28 up from ,27 six month age. SUV in the prostate isn't concerning? If you take out the node does that prevent metastasis or if it is in the node does that mean that it has already escaped the prostate and is in the bloodstream. Is sooner better?
Thank you.

@gently
Going to .28 from .27 is really a non-issue. PSA can jump around. There’s no question about that happening frequently for people.. Since you started off with radiation, they usually don’t want to do anything until your PSA rises two point points above the minimum. I’m not saying all doctors feel this way, but that is the Documented procedure.

A PSE test at this point would make no sense at all. That test is to determine whether or not you have prostate cancer and need a biopsy. You are way beyond that.

Now a decipher test would make a lot of sense. That would tell you your chance of having a reoccurrence in the next five or 10 years.

You did say that they determined that that node was not cancerous. Very unlikely they’re going to do anything about it. They zap what lights up on me PET scan not what doesn’t light up.

@jeffmarc They can do an accurate Decipher on biopsy material over a year old?
Or are you suggesting a new biopsy on an already irradiated prostate?

@heavyphil
The biopsy material is frozen, sliced into thin sections and put on slides. They can last many years. I don’t think one year would be a problem three or four might be.

From AI

To do a Decipher test for prostate cancer, labs need a sample of your actual prostate tumor tissue, usually a Formalin-Fixed Paraffin-Embedded (FFPE) block or unstained slides from a previous biopsy or surgical removal (prostatectomy), containing enough tumor cells (around 0.5mm for biopsy). They don't need new samples; they use existing pathology materials, along with the required physician forms, to perform genomic analysis on the cancer's genes to predict aggressiveness.