I'm sorry, though not surprised to see your rise has been confirmed by the latest PSA. I'd ask the doc about
when to start Lupron - right away or wait for a higher number. And also ask about
intermittent treatment. Does your doc think periods of Lupron alternating with Lupron vacations is a reasonable plan for you. It's very unlikely the PET scan will show anything at such a low PSA.
My history is different from yours in that I had much longer intervals between surgery and SRT and then another long interval after SRT before PSA returned, so what my oncologist recommended for me may be different than what yours might recommend for you. But my oncologist was inclined to let my PSA rise quite a bit before starting ADT - Degarelix (Firmagon) in my case, in part because I had such long intervals of low PSA after surgery and after SRT. I started ADT with a PSA of 6, but also with a rapidly shortening doubling time. Which seems to be my pattern over the 17 years I've had PCa - long periods of very slow increase that then suddenly accelerates. He thinks there is no added risk from an intermittent approach, so I'll be starting my first ADT vacation in April after a year on Degarelix.
I'm also in a clinical trial, but was randomized into the Degarelix-only group, so I'm getting the same treatment I'd have been getting otherwise other than a requirement that I stay on Degarelix for a full year before getting my first vacation.
-2002-PSA 9.4, 5 of 10 cores 30-50%
-RP 2002 PT3B N0 MX Gleason 3+4 75% left lobe small focus rt lobe
-PSA low 0.01 slow rise to 0.4
-SRT 2010 1 lymph node targeted. Casodex during SRT
-PSA 0.00 thu 2014
-0.02 Oct 14; 0.04 Apr 16; 0.2 Oct 16; 0.51 Jan 17; 2.46 Jan 18, 4.19 Apr 18;
-6.62 May 18 enlarged lymph node start Firmagon; PSA 0.45 Jun; 0.08 Jul '18; 0.02 Mar '19
Post Edited (Bohemond) : 3/29/2019 2:00:43 PM (GMT-6)