Anyone get PSA Test Angst days before that post-treatment PSA test?

@larrypt3b
It sounds like you need to go to a different doctor. Maybe you can present the below information to your doctor so they are aware of what the standards are. Your doctor is ignoring the standard of care. Here’s what the American Society of a clinical oncologist has to say About rising PSA after surgery.

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.

This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/

My angst comes after getting the results of the PSA days before I see the Urologist. I know I don't HAVE to look, but I can't resist. I just confirmed my RARP failure this week. It's been 18 months since the surgery and every time I've gotten tested my PSA is higher. I went from 0.13 to 0.25 in three months. A week later it is 0.29. My angst is heightened because my Urologist doesn't seem to care that its rising. In the end, I think knowledge is power as long as you don't give it power over you.

Always. When I have those “moments” I try to focus on something that’s a distraction. My next test is April. 👍🤞🙏

I call the first year of "every 3-months" PSA testing - and every 6-months for subsequent years - the "black raven" sitting on my shoulder that I carry with me everywhere." I know it is there...it routinely pecks on my head/neck reminding me that it is going to be there forever, and then one day, if after my PSA starts to rise, it is going to say: "I'm baaack, and I am going to kill you now...slowly...miserably....and painfully." I see why women with breast cancer call themselves "survivors" but that they also say that they (still) "have" breast cancer. They had the mastectomy and radiation or other therapy, but they know that it will eventually come back to kill them. That is no way to live..for any of us.

Everyone. My most stressful will be this November, the first test 3 months after completing 18 months of Orgovyx. Currently PSA and Testosterone are < .01/“undetectable,” so I’m hoping the first stays down and the second begins recovering. All the best for your journey.

@capatov From your post 6 months ago: "Learned Something New Last Week,
@capatov, Jul 29, 2025. While meeting with my NP 3 months post IMRT and HDR treatment for Gleeson 4 +3, PSA 7.1 I learned something new. When I asked if my 3 months post-treatment PSA going from 7.1 to 0.04 could be largely due to the fact that I was on my last week of 6 months Orgovyx/ADA therapy vs. the impact of the radiation. ..."
and yesterday's update of "new PSA is at .1 but testosterone is only 158. I think I should be very encouraged at the PSA but my testosterone seems very low?"
Based on your experience, I confirm what my RO told me last October when my PSA was 0.22 "six months post-SBRT /6 months of Orgovyx." She prepped my mind with the possibility of PSA getting higher than 0.22 this month of January 2026 when I will have my next blood draw, about 9 months post-SBRT and 3-1/2 months off Orgovyx -- woul;d be normal as long as the PSA rise correlates/can be explained by a corresponding increase in T. Your concern of "T only 158" is the opposite of what I like, to be lower than that so that my PSA 0.22 won't rise too much before it would start going down again until becoming undetectable two or three years post-SBRT.
You were already undetectable July or earlier a year ago, I think that was super-excellent compared to mine. I hope your PSA will stay well below 2.0 post-treatment and then back to undetectable again. Wishing you the best.

@jeffmarc I would have to agree. We are all human and have emotions. Being able to feel is a gift. I just got my 6 month post BCR treatment results and it is good news. Will feel a little lighter for the next 5 months and 25 days. Best wishes.

Yes, PSA angst is awful!! I have been on the roller-coaster for 11 years now. After my prostatectomy and radiation 11 years ago, every 3 months waiting to make sure it was still undetectable. Then after 9 years, my Psa began to rise quickly. My doctor said he thought it was hiding somewhere, and he was right. Did a PSMA petscan and it showed 11 lymph node tumors. So yes PSA angst is awful, but God is good. I trust in Jesus my Savior and Lord. And His word says in Roman's 12:12, Paul says, "Be joyful in hope, patient in affliction, and faithful in prayer ". That's what the Lord has taught me. And I have had 11 more years and I am hoping for maybe 11 more, even with Psa angst!

@jeffmarc thank you for this info. Much appreciated!

@capatov

It is likely your testosterone will rise higher soon. Here are the results of a study.

Overall, 74 of the 137 men in the relugolix (Orgovyx) cohort recovered to testosterone >280 ng/dl, with a median time to recovery of 86.0 days

You can read the whole thing here
https://www.sciencedirect.com/science/article/pii/S2588931123002900