posting after a long time. similar situation as redwing. PSA 0.01 till last month and it jumps to 0.5 suddenly! i have read the veterans posts. no panic. however would appreciate suggestions/comments. thanks
Hey Monty. From your signature, I'm a little puzzled.
First, it seems you've had only radiation and ADT, right? It seems uncommon for them to put you back on ADT at a PSA of 0.2. That would be the trigger level if you had a prostatectomy, but with radiation there wouldn't have been an assessment of recurrence until a PSA of around 2 or so. With an irradiated prostate still there, you can have a persistent PSA, hopefully around 0.5 or less.
Second, how many months was the Nov 17 Lupron shot to last? It can take a long time for your system to recover and begin producing testosterone again. Have you had your T checked? As T recovers, your PSA will naturally rise too.
You may be seeing something similar to my recovery from ADT. After ending ADT, for almost a year my PSA kept jumping alarmingly. But actually it was only recovering to what it would have been after radiation without ADT. The ADT suppressed the PSA while it was active, and releasing ADT let the PSA float up to the level it would have otherwise been on. The jump from ADT suppression up to the residual radiation therapy recovery level is a big gray area in the studies. Also, there are "bounces" after radiation, so that level can wander up and down a bit all by itself.
I made a graph to show this effect. Have a look, and see if it might help to explain more clearly. Click on this link
to look at that graph.
Unless I'm missing a surgery that's not shown in your signature, the "Phoenix" criterion of nadir + 2 would be when you consider recurrence, and subsequent treatments. In the meantime, watching these PSA trends can be a mind game. But that's part of the radiation + HT post-treatment "new normal", unfortunately.