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PSA increase from .01 to .06 Should I be concerned?
Hello All:
I am a 79 year old male. Gleason score was 9, prostate removed and I was two years with a of PSA < .01. After two years biochemical recurrence, PSA eventually reached .93. PET Scan could not find anything. Docs said no radiation because I have a J-Pouch. I took Orgovyx for about 9 months. Some sleeplessness, hot flashes and some tiredness but I dealt with it, even though I couldn’t hit the golf ball as far. After two months on Orgovyx PSA went back to < .01. Doc took me off Orgovyx after a 9 month treatment, and after 4 months without Orgovyx, PSA went back up to .06. I see the doc on Friday. I assume he will put me back on Orgovyx. I have a great deal of respect for this group and would like any recommendations or thoughts.
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This is not a huge jump in PSA, Considering you stopped ADT. What would be more Important would be to see the doubling time in the next few PSA tests. Your doctor may want to wait for that, rather than put you on Orgovyx Immediately.
I guess you will find out when you see him on Friday.
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Hug
10 Reactions@jeffmarc Thank you!
@rnpalarino1 Or perhaps if your PSA continues to rise, you switch from T suppression agent like Orgovyx to one that blocks the T receptor site like Darolutamide and others.
Less SE’s overall.
@jeffmarc
My PSA went from 0.02 to 0.25 2 months after stopping ADT (was on it for 13 months. In this same 2-month period, my T went from < 12 to 528 ng/dL
I had radiation with ADT. Saw my oncologist yesterday - scheduled a PET scan.
So I have to wait to see
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Hug
3 ReactionsI hope you have positive results!
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1 Reaction@pcrich How was your PET scan?
I was PSA 7.9 and 10.5 in Nov 2024 and January 2025. I had my SBRT in April and completed six months of Orgovyx two weeks ago.
My PSA in July was 0.36 and yesterday it was 0.22; T was 0.4 in both the July and October tests.
I am preparing for my oncologist meeting next week, and I'm looking for information, experience of fellow PC warriors like you, to see if I need to ask my RO about PET scan as well.
Thanks.
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1 ReactionAfter having SBRT radiation The PSA can go up and down a little bit As the cells die off due to radiation. In some cases, it can take up to three years before it hits the actual bottom PSA . I wouldn’t be too worried .22 is perfectly acceptable as a Constantly reducing PSA due to the radiation slowly killing off cells.
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2 ReactionsWell, if radiation is out of play, the question is, when to resume treatment?
In part, that may be a function of clinical data such as
PSA
PSADT
PSAV
Age
Genomic Testing
Health - co-morbidities, life expectancy, physical fitness.
The dilemma we all face is whether to treat, if so, when, with what, for how long?
I trust your radiologist was ruling out radiation and making that decision based on imaging and the location(s) of the recurrence. If not, see a radiologist, discuss imaging and revisit the issue.
I have seen some discussion on this forum and others about not starting systemic treatment until {Sa was between 2 and as high as 8-10. Again, back to that clinical data...The reasoning of those folks and their medical teams was their risk category were intermediate, they were older and there is some data that points to a period of up to 8 years before metastases show and require systemic treatment.
I am not in that intermediate risk category, so we treat soonest!
Kevin
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1 ReactionReading through the comments, I'm wondering if everyone is getting the decimal point in the correct place. It's confusing for me at my current stage.
I'm postprostatectomy, (10/5/17), and undetectable for 6 years, then < 0.2 in 2023 with no action taken, then 0.3 in 2024. In 9/2025 PSA was at 16.4, and then 10/2025 was at 18.6. PSMA PET showed multiple locations in lymph nodes in region. I started Eligard 9/17/25 and as of 10/9/25 PSA was 3.6
I'm encouraged and meeting with MD Monday, 10/13/25. I know I've got my decimals in the right places, but wonder if ADT actually brings patient down as low as 0.01 ?
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1 Reaction@jeffreyg
Yes, ADT alone can Bring some patients PSA down to .01. It doesn’t happen for everybody, but it is pretty common for lower level PC (Gleason 7 and even 8).
After having a proctectomy, my PSA started rising 3 1/2 years later. When it hit .2 my doctors had me on radiation two months after giving me a six month Lupron shot.
The standard is that you should get treatment at .2.
Here is the standard that is set for when you should have been treated
From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL: Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%). Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.
0.2–0.5 ng/mL: Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.
0.5–1.0 ng/mL: Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.
You have been grossly untreated. The doctors you’re working with are not treating you with what is considered the standard of care. Your solution to go to MD Anderson Is a good answer. Hopefully your cancer has not spread too much and they can still treat it effectively. You should have been treated in 2023 if you had competent doctors.