PSA rising with 3.3month doubling time after Radical Prostatectomy. Further actions?

[InterestedInResults]

Patient age 60.

Radical Prostatectomy was done in October 2021. Gleason 4+3.

After the surgery the PSA has risen:

24.11.21 0.009 ng/mL

17.03.22 0.027 ng/mL

31.05.22 0.032 ng/mL

What is the best route of action that should be taken now?

What scans, PSMA/PET or something else, what radiation (would Cyberknife be ok in this case), hormones or no hormones?

Problem is the urologist for the person is not available until August. We are trying to find a different urologist, but I would like to know general opinion of those on internet also.

Thank you for any advice.

[auntiejessi]

The PSA isn't radically high, or rising dramatically. It's still not even at 1, or close to it.

Can you (assuming you're the patient) get an appt with your oncologist while you wait for the urologist?

I found an article about PSA after radical prostatectomy. Ideally, it will be undetectable, or less than 0.05 or 0.1 nanograms of PSA per milliliter of blood (ng/mL). Yours is below that level. (https://www.healthline.com/health/prostate-cancer/psa-after-prostatectomy)

It's not a concern, apparently, unless the result is greater than or equal to 0.2 ng/mL and it’s risen on two separate tests taken at least two weeks apart. Then it's called biochemical relapse. I'm not a doctor nor a prostate cancer expert, but it doesn't seem like this is what's happening.

Definitely check with your oncologist, or maybe the urologist who is covering for your regular one.

Good luck!

[BonzoDog]

Great answer, auntiejessi- I was gonna say the same thing. His PSA is still so low it’s not a concern…

[auntiejessi]

Thanks. I'm so happy when you post. :)