What PSA to expect after radiation and ADT?

I would think that is excellent. If your nadir was "undetectable" then recurrence would be indicated by a PSA of 2.0

I finished SBRT on Dec 28 . My 3 month PSA while still on Orgovyx was 0.09 and my RO was thrilled.

Here are links to a couple papers.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9664688/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306761/

Congratulations, and Stay Strong Brother!!

Not knowing your medical history makes answering a question like this very difficult. Well, that and me not being a doctor. 🙂

My understanding is that it really depends more on rate of increase (or time of doubling). It's really difficult to extract much info from one reading, especially if you still have the prostate. Also, what are we using for a definition of "undetectable"? How many months after radiation did you continue the Eligard? Minor fluctuations in PSA can happen, particularly if you still have a prostate.

I'm not suggesting with all those answers I could give you a definitive answer, it's really something to discuss with your doc.

Assuming this is your first "detectable" I would think that the level in 3 mos, in comparison to this one, will be more telling. My understanding is that .07 is still pretty low for a person with a prostate and not in active treatment.

Best of luck!

There are a number of factors to consider;
> how long were you on Eligard?
> with your recent PSA of 0.07, what was your testosterone level then?
> what was your lowest testosterone and PSA while you were on Eligard?

If your testosterone is still being suppressed, then that 0.07 PSA is still artificially suppressed and can’t be used as your nadir for detecting biochemical recurrence using the Phoenix criteria. Once your testosterone is back to normal (whatever that was pre-Eligard), and a true PSA is measured, you can use that as your nadir.

For now, keep measuring both PSA and testosterone going forward.

(My PSA while still on Eligard was 0.008 ng/mL, going undetectable (< 0.008) at one point; my testosterone went as low as 3.0 ng/dL, but typically varied between high single-digits and low double-digits).

@sailorman2003, I'd be curious to know what you learned from your oncologist when you posed the same question to them. How are you doing?

They said this is a good response. They will establish what they call a nadir, say .07. So long as my PSA stays below 2.0 + the nadir, they won't do anything. If it rises above 2.07 they will do another scan to see what is going on. They also said in the case of radiation with an intact prostate, they don't expect my PSA to remain undetectable.