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PSA never reaching undetectable

Posted by mlandry @mlandry, 15 hours ago

My partner was diagnosed with PSA 92, stage 3a in Nov 2023. Started Orgovyx March of 2024, did 40 sessions of radiation, finishing in June 2024. He has his PSA test done monthly, it's never dropped below .27, even jumped to .52 once, and is hovering now around .3. I just watched a PCRI video where Dr. Sholz says if you don't get below .1 in 5 months of ADT, it's a sign of castration resistant prostate cancer. Not sure how worried we should be, his MO hasn't brought it up, but he's an overworked and frazzled doctor. Anyone have similar experience with PSA?

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jeffMar | @jeffmarc | 14 hours ago

After radiation, the PSA does not always drop to Undetectable. Some people have taken three years to reach the low point. It could be your low point and target is around .27. The fact that it is not rising multiple times in a row is the key. If you get three rises in a row, it is time to think about doing something. So the point is, your PSA can bounce around, people do get paranoid when that happens, but it really is not abnormal.

When I was on a zytiga for 2 1/2 years, my PSA went as high as .7 to as low as undetectable, but it always bounced around. Now I’m on Darolutamide, and I’ve been undetectable for 15 months, Different drug different results. The bounces didn’t matter.

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