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PSA showing up two years after salvage radiation

I had RP in 2013, radiation in 2019. Since the radiation my PSA has been undetectable but today's test shows 0.011 ug/L

What is the significance of this result? It means that cancer is growing i'm quite sure of that but I can't find my feet in it? What am I looking at here.

I'm 72, in good health. I had a battery of other tests today and all are good.

  1. Hi . First, let me say that it is good that you are so on top of monitoring your PSA and overall health. A reading of 0.011 is extremely low, to the point that even the PSMA, which is the gold standard in detecting recurrent prostate cancer (see: https://prostatecancer.net/clinical/psma-imaging-scan) is generally utilized at 0.02. Your doctor should be able to provide further guidance on next steps. Best, Richard (ProstateCancer.net Team)

    1. I frequent a number of prostate cancer forums and have done a lot of reading and carefully chose a top Urologist. I like participating in the discussions and think the forums are very beneficial.


      But I've got to be honest here. When I keep seeing questions like this, the first thing that is coming to my mind these days is, didn't your Urologist or Oncologist also see the results and have a discussion with you about it? That's really their job. If you trust the patients in these forums more than your doctor to give you straight answers about your tests results, seems to me you should consider changing doctors???


      Or is the issue in a lot of cases that you get the results at the same time as your doctor and it can take them several days before contacting you and you are just anxious to discuss it with anyone right away before you hear from your doctor?

      1. I get my results directly through the lab's website. I will be talking with my urologist later in July.

    2. I think we are off on some decimal places. Unless I am really confused, levels aren't detected to 3 decimal places. 0.01 is the lowest. I think 0.11 is what member376 intended. .11 is very low. I am on a similar path and given age and time since RP my understanding is that may not be a concern if subsequent test shows it rising.


      To Jazy's comment, I do tend to see my results a day or two before I'm contacted because I am looking for them. But a discussion with the doctor, or at least seeing their comments posted, is absolutely necessary asap.

      1. I always have the test results sent to me vs waiting for the MD - and agree best to check with your MD

    3. Undetectable is defined as < 0.05. Biochemical recurrence is defined as >= 0.2 or increase of 0.2 above your lowest point if you had radiation. So you are still in the 'undetectable range' which basically is saying anything below 0.05 is negligible as to it being a significant level. PSA can fluctuate. PSMA scans are not that sensitive below 0.5 and commonly will not detect very small cancer areas with cancer. No scan is very sensitive below 0.5. In many cases early salvage radiation therapy will be done in the 0.1 to 0.5 range in the absence of anything showing up on any scans as studies show the earlier the higher the chance radiation will be a cure. Your Oncologist isn't going to recommend doing anything until you are over 0.1. I don't even know if you can get insurance approval for any treatments when PSA is below 0.2. I think some people got their decimal places wrong here.

      1. The lowest report from this lab is "<0.008" which is how it's been for a couple of years. So this is a jump of 0.003. It's a small number but I don't know how significant it is . Thanks for your reply.

      2. If it were me... I would not be concerned - My MD told me a few years ago not to be concerned until the post op PSA was approaching 0.2 . Today they suggest you start looking at options when the number is closer to 0.1 ... Keep on eye on it and in the meantime it may just be best to enjoy life and living

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