Post prostatectomy: What do rising PSA levels mean?

The good news seems to be it's remaining pretty low. I had a couple confusing readings from the same lab when I started but it was because they were looking a two different sensitivities.

My first two looked like this...
10/22/21 PSA Result of <0.1
01/26/22 PSA Result of 0.039
They could literally be equal.

I'm a little surprised your team was content with that less sensitive test after RP till '21, makes spotting a trend a little tougher in the lower numbers.

My next result was 04/26/22 PSA Result of 0.091, we wouldn't have spotted the trend without that sensitive test. Water under the bridge for you thankfully at this point.

Equipment types and sensitivity may be what's happening between lab 1, 2 and 3. I would ask the doctor on the last two at lab three, if he doesn't give you a definitive answer, I'd try to get one from the lab.

I've had to check and make sure that the orders are for "ultra sensitive" PSA tests and go to the same lab so that they are apples to apples.

Either way the differences would be pretty minimal for the last two. Maybe it's something like
0.04 and 0.039 but their equipment doesn't get that specific.

I am confused by the post-RP psa results I've gotten. My readings were as follows since my RP surgery in 2015.
From 2015 through 2/21: < 0.1
8/21: 0.00 (different lab)
6 weeks ago: 0.04 (a 3rd lab)
today: < 0.04 (same lab as 6 weeks ago).

I don't know how to make sense of this. Since the last 2 tests were sent to the same lab, does the change from 0.04 to < 0.04 indicate that the psa actually went down? Or is it likely that the 0.04 from 6 weeks ago was actually < 0.04, and that 0.04 is the lowest reading that lab can detect? Does the 0.04 from 6 weeks ago indicate that the psa rose from the 8/21 reading?

Try a search for PSA LEVELS AFTER PROSTATECTOMY May 2022.
I don't know if it will help, Good Luck
There are a lot of therapies out there if something turns out crappy
I have PCa also and opted for radiation. PSAis good so far. Prognosis is iffy w lymph nodes involved and other signs of metastasis.
Such is life.
Spryguy

Yes. Orgovix

Post radical our urologist referred to radiation oncologist at 0.2 and before first appointment hit 0.331 day of first Eligard injection, starting 40 Radiation treatments mapping appointment 2.5months..
PSA 5.3 at diagnosis
at biopsy Gleason 9
radical prostatectomy biopsy edges clean seminal vessel clean lymph’s
clean
8weeks post RP PSA less than 0.1
12weeks post 0.2
16weeks 0.3

It sounds like your doctor is being very cautious because of the first 2 findings on your report maybe. Is he putting you on hormone therapy also?

My RP was just over a year ago, Sept 2, 21.
I'm going to quote the pathology report

Perineural invasion is identified
Lymphovascular invasion is identified
Surgical margins are free from carcinoma.

I had also had the actual right pelvic lymph node removed, it was "negative for matastatic carcinoma"

Did you recently have RP? If so, did they find microscopic levels of PCa in the removed lymph nodes or anywhere else perhaps?

Interesting article, a little tough to digest before my second cup of coffee, but, if I'm reading this ;"American Society for Radiation Oncology)/AUA (American Urological Association) guidelines for adjuvant and salvage XRT after RP define BCR as detectable or increasing PSA that is 0.2 ng/ml or greater after RP with a second confirmatory level of 0.2 ng/ml or greater.15"

I wasn't even at BCR yet when we started the radiation....
I only got as high as .091 and there was no second confirmatory before they referred me to the RO. If this is still the current train of thought, I'm a little surprised the insurance co didn't balk at it...
As suggested though, I may have missed some other variable...:)

Colleen - After RP In 5/16 my psa was < .01 for about a year. Then it was .01 and started slowly escalating. It was up to .11 about 16 months ago, but has come back down to .07. My oncologist agrees that treatment does not make sense yet. So no further treatment since the RP. Thanks for adding the link. - Steve