Phenom, I am in a similar position. Had a PSMA scan in Jan which showed no visible mets (yet) but takeup in the prostate bed.
My PSA In Jan was .7 but doubling fast. I expected to go back on ADT then, but allowed myself to be talked into waiting another 3 months - purely for QOL.
PSA last week was 2.6, which gives very short doubling time. Maybe should have started ADT back in Jan, but too late to worry about that now. Seeing RO next week and will certainly insist on ADT now.
Hey Chas - do you mind an unsolicited comment or two?
Out of curiosity from my recent math explorations, I ran your signatures PSAs on a log slope. Based on everything before March, the predicted value for your March PSA would be.... wait for it.... 2.7
. Reality? 2.6
(+/-0.1 probably as std PSA tests go). That's pretty close!
The PSA doubling time (excluding last September's above-trend reading, which should have been 0.25 or so based on the log slope), averages less than 2 months which is pretty short. Less than 3 months is a significant concern level from many studies.
Interesting (to me anyway), if you'd have made this analysis at your last PSA check, even though it was still less than 1, you and your onco could well have predicted this number, and maybe did. So, what criteria should we patients be using along with the doctors to help guide treatment plans like this? I do understand the QOL issues, having been on ADT for 3 years! Timing to restart ADT is sure a gray area.
The so-called Phoenix criterion of "Recurrence iff PSA>2.0" (with logic's "iff" meaning "if and only if") is only a standard to allow various studies to be compared. I don't think it was ever meant to be, nor should it be, used to guide clinical practice.
Your RO appointment should be interesting.