Post RALP PSA - how concerned should I be?

Well
It's early days and you've had a lotta stuff w weird even ominous sounding words thrown at you and your husband.
Bottom line-they seem to have caught it early enuff to treat; it successfully. By that I mean while he may not ever be "cured" he'll be around a long time with attention and treatnent.
Suggest you AI Google his case info and see what comes back
Sounds like they think it still may be in lymph nodes near or in the prostate bed and they're going to zap them. That often results in a complete cure. If it doesn't there's still lots they can do to go after any so called mircrometasis that's slipped out further
Today's PSMA PET detection technology let's them see the stuff at very low levels of manifestation so they can go after it
Have them explain the 71% figure- is it 71% he'll be completely cured or 71% that with the right treatments he won’t die of it but merely with it,

How worried should you be...?

From my foxhole, very little...

At your next consult, talk with your medical team about what constitutes "actionable" clinical data?

I have used this analogy before, those who have driven in areas like western Colorado, you can see the headlight of a train coming your way far off in the distance (it's similar to trying to estimate distance in the desert..). You know your paths are going to intersect, question is when and what do you do when they do!?

While you're waiting for that intersection to happen, you continue to drive, enjoy the scenery, have the sunroof open and the music cranked up loud, unless your spouse is with you, then she is not amused by the wind blowing her hair, the noise of the wind, the loudness of the music nor your singing along...

For my medical team and I, we have decision criteria to guide us about when to treat.

Three or more consecutive increases spaced three months apart
AND
PSA between .5-1.0

Granted, if this was after my surgery, those criteria may be different given that waiting for PSA to rise between .5-1.0 would decrease the curative intent behind SRT.

But, for my particular clinical history, those decision criteria work since it avoids reacting to singular results and it provide a 67% or so chance that PSMA imaging will locate the recurrence and inform the treatment decision.

Kevin

I had similar PSA results, but over a 5 yr period, not months.
I too had multiple tests which showed plateaus had been reached but then they went higher…plateaued again, etc.
All you can do is continue every 3 months and monitor the rise and velocity. If it’s moving up steadily - and quickly - good chance salvage therapy is in the cards. Best,
Phil

I just met with an RO that my urologist set me up with. I’m 14 days post op RP with a small amount of seminal involvement. He told me he expects my first PSA to be 0, if monitoring sees a rise in PSA he would be looking at an intervention before.1. All this to say that the pet scan wouldn’t pickup till maybe .7 so by the time it was detectable with a scan we would already be treating based on where he knows the cancer to be

"Steady as she goes:
But you might ask your doc about getting an MMAI test while the block of your prostate material they retained is handy and still fresh
Google it
"The multimodal artificial intelligence (MMAI) prostate test uses an AI algorithm to analyze digital images of a patient's prostate biopsy alongside their clinical data. This analysis provides a more refined, personalized prediction of cancer outcomes and treatment benefits than traditional risk stratification alone. The test is commercially known as the ArteraAI Prostate Test."
I wish it had been available after my prostatectomy in 2018.
Good luck!!