Thanks, guys.
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.153 (7 yr)
Yesterday's uPSA result just came back: 0.213. This is my first result that is > 0.2.
I messaged my uro asking whether I should wait one month or retest sooner. He replied
"For a temporary condition that might affect the PSA, waiting 5 half-lives will allow clearance of the temporary increase. Certainly, waiting one month should be sufficient, however, if you wanted to repeat the test in 2 weeks (15 days), that should also give an idea as to whether the increase is "real" or transient."
I believe the insurance coverage for a PSMA-PET for BCR requires a confirmatory test that one's PSA is 0.2 or above.
It's been my belief for some time that reaching BCR wasn't a question of "if," but only "when."
Djin
I messaged my uro asking whether I should wait one month or retest sooner. He replied
"For a temporary condition that might affect the PSA, waiting 5 half-lives will allow clearance of the temporary increase. Certainly, waiting one month should be sufficient, however, if you wanted to repeat the test in 2 weeks (15 days), that should also give an idea as to whether the increase is "real" or transient."
I believe the insurance coverage for a PSMA-PET for BCR requires a confirmatory test that one's PSA is 0.2 or above.
It's been my belief for some time that reaching BCR wasn't a question of "if," but only "when."
Djin
Post Edited (DjinTonic) : 9/3/2025 1:00:57 PM (GMT-4)
Djin, I am hopeful this will be a small bump going forward in your progress and that any treatment if needed will get you back on track.
As always, my best wishes and positive thoughts going forward.
Jack
Age 73
DX 2017
5/16 BLOOD IN SEMEN FOR OVER A YEAR CHANGED URO
6/17 PSA 2.1 10/17 PSA 6.1 TURP, blood continued in semen. CHANGED URO
PSA-12/21 1.21 1/22 0.17 03/22 0.13 6/22 0.06 9/22 0.04 12/22 0.04 3/23 0.01 6/23 0.41 11/23 0.74 4/24 0.89 10/24 0.61 5/25 0.55
BX-8/21 GL 8 -1 CORE 20% PNI 10/21 ADT FIRMAGON, 11/21 IMRT 28 FRAC 70GY. 18 months ADT Orgovyx
As always, my best wishes and positive thoughts going forward.
Jack
Age 73
DX 2017
5/16 BLOOD IN SEMEN FOR OVER A YEAR CHANGED URO
6/17 PSA 2.1 10/17 PSA 6.1 TURP, blood continued in semen. CHANGED URO
PSA-12/21 1.21 1/22 0.17 03/22 0.13 6/22 0.06 9/22 0.04 12/22 0.04 3/23 0.01 6/23 0.41 11/23 0.74 4/24 0.89 10/24 0.61 5/25 0.55
BX-8/21 GL 8 -1 CORE 20% PNI 10/21 ADT FIRMAGON, 11/21 IMRT 28 FRAC 70GY. 18 months ADT Orgovyx
Thanks, Jack! I'm actually hoping I get another result > 0.2 before my next R.O. visit in Oct. I'd like to get the scan done to know whether something shows up, and if so, where it is.
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.153 (7 yr)
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.153 (7 yr)
Djin, sorry for the seeming confirmation of what you've been expecting. If I were you I think I would go for the 15 day test. You can always do another one after that but if you do get the confirmation you can get the ball rolling for your PSMA test.
Good luck,
Jim
Forum Moderator-Prostate Cancer. Age 62 (77 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-15 yr: <1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1
Good luck,
Jim
Forum Moderator-Prostate Cancer. Age 62 (77 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-15 yr: <1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1
Tudpock18 said...
Djin, sorry for the seeming confirmation of what you've been expecting. If I were you I think I would go for the 15 day test. You can always do another one after that but if you do get the confirmation you can get the ball rolling for your PSMA test.
Good luck,
Jim
Thanks, Jim, Yes, That's what I decided, also because I see my R.O. again on Oct. 20 and testing at 2-week intervals lets me get another result or two in (if needed) should my retest in 2 weeks be slightly below 0.2. My R.O. messaged me that she agree with the 2-week interval.
I wrote in a post above that I at my last visit, I asked my uro about the new Prostox tests (from MiraDX) which were designed to look at a patient's genome to help decide if one type of radiation may be better (i.e., less toxic) than another. He wasn't familiar with it; however, by coincidence, it turns out that my R.O. is not only familiar with the tests, but she helped with the research for it some years ago and said we may want to look into my having the test done if/when it comes time for RT. I'll report on it to the Forum at some point if I learn more.
Djin
Post Edited (DjinTonic) : 9/3/2025 5:00:13 PM (GMT-4)
Djin - I am not sure what you hope for at this point, do you hope PSA goes up measurably or drops to 0.19 after next test? It seems like your slow progression could drive anyone crazy then starts the PSMA testing lottery to go along with it. I hope you keep your sanity during this stage.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024
Mumbo said...
Djin - I am not sure what you hope for at this point, do you hope PSA goes up measurably or drops to 0.19 after next test? It seems like your slow progression could drive anyone crazy then starts the PSMA testing lottery to go along with it. I hope you keep your sanity during this stage.
Since I think my PSA is definitely rising (even with fluctuations) and I don't think it will plateau, I really am hoping for another result of 0.2 or higher so I can get the scan! I feel good that my Decipher was low-risk; however, right now we are in a non-invasive posture and it would be short-sighted not to take my cancer seriously. I think the result will likely be: (1) I should treat now or (2) I could treat now or I could wait a bit longer and re-scan at a higher PSA, say, 0.4.
Almost everything about my post-RP history has been on the unusual side, so I shouldn't be surprised if we are surprised again
Djin
Post Edited (DjinTonic) : 9/3/2025 8:30:42 PM (GMT-4)
I would probably feel the same way, get this show on the road. I wrestled with this when making the decision to go with ART after surgery and ultimately plowed ahead and dam the torpedos. It is not always clear cut.
Hi. Most people don't know me...I don't post much...I have to say Djin you have been on my mind a lot...and as I was on a long drive today...I was thinking of you and your status.
I had SRT with a decipher of .12, 18 months ago. It was a pain in the tush, that's it. Fun? no. Tolerable, yes. And once it starts...it's over. It's a nothing. More side effects? Sure. That is life. But I am unaware of any study that would suggest waiting to treat. You have a high GG. A clearly rising PSA. There is data in the RTOG 9601 that supports no ADT with a low decipher...My RO at DFCI went with no ADT and WPRT in addition to the prostate bed.
The curative window is not getting larger, it's closing. How quickly? No one here (and probably no physician knows how quickly). Most RO's want to get the SRT rolling at .1. If you were my brother, and in some way you are, I would urge you to treat this, now. And as all brothers, we open our mouths, give our thoughts...and then we will all support you during this and all chapters going forward. Wishing you only good things....Howard
Age at DX and Surgery 48 (2015)
pre-surgery PSA 2.4 RALP 11/15 pt2c tumor vol. approx. 5% Path 3+3 - Epstein re-read (2/20) confirmed G6 neg SVI, Neg nodes, no epe, PNI +, clear margins (exceedingly close margins) Decipher Test .12 5 week PSA <.02. 06/17 .02. 03/18 .04. 01/02/24 .1 SRT/WPRT 70.2 (no adt) 39 sessions 01/24-03/24
I had SRT with a decipher of .12, 18 months ago. It was a pain in the tush, that's it. Fun? no. Tolerable, yes. And once it starts...it's over. It's a nothing. More side effects? Sure. That is life. But I am unaware of any study that would suggest waiting to treat. You have a high GG. A clearly rising PSA. There is data in the RTOG 9601 that supports no ADT with a low decipher...My RO at DFCI went with no ADT and WPRT in addition to the prostate bed.
The curative window is not getting larger, it's closing. How quickly? No one here (and probably no physician knows how quickly). Most RO's want to get the SRT rolling at .1. If you were my brother, and in some way you are, I would urge you to treat this, now. And as all brothers, we open our mouths, give our thoughts...and then we will all support you during this and all chapters going forward. Wishing you only good things....Howard
Age at DX and Surgery 48 (2015)
pre-surgery PSA 2.4 RALP 11/15 pt2c tumor vol. approx. 5% Path 3+3 - Epstein re-read (2/20) confirmed G6 neg SVI, Neg nodes, no epe, PNI +, clear margins (exceedingly close margins) Decipher Test .12 5 week PSA <.02. 06/17 .02. 03/18 .04. 01/02/24 .1 SRT/WPRT 70.2 (no adt) 39 sessions 01/24-03/24
Hi Djin, I’ve been mostly on FB dealing with newly-diagnosed men the past few years, and just checked in here and read this thread. Well, you are among, if not the, best-informed PCa patient that I know, and it’s informative to read how you approach this sequence of test results and consultations.
Sounds like SRT may be in your future, and you and your specialist are on top of the triggers and the options.
One thing I might add is that I had an experience last year where a PMSA scan reported false positives. I apparently had inflammation that spiked my PSA to 12, gave MRI PIRADS scores of 4/5 bilaterally, and lit up the PSMA scan.
A twenty core targeted biopsy found no cancer in those lesions, just a lot of inflammation. My PSA later dropped to 3.
My oncologist commented that I had “won the lottery”, and should stay on active surveillance, but this probably can happen in other cases. In my opinion, our diagnostics are still imperfect.
My best wishes for your well-deserved advantage in this continuing fight.
DOB: May 1944
In Active Surveillance program at Johns Hopkins
Strict protoco of tests, including PHI, DRE, MRI, and biopsy.
Nine biopsies from 2009 to 2024. Numbers 1, 2, 5, 7, and 8 were negative. Numbers 3,4,6, and 9 were positive with 5% Gleason(3+3) found. Two were Precision Point transperineal.
PSA has varied over the years. Is 3.2 as of May 2025. Hopefully, I can remain treatment free.
Sounds like SRT may be in your future, and you and your specialist are on top of the triggers and the options.
One thing I might add is that I had an experience last year where a PMSA scan reported false positives. I apparently had inflammation that spiked my PSA to 12, gave MRI PIRADS scores of 4/5 bilaterally, and lit up the PSMA scan.
A twenty core targeted biopsy found no cancer in those lesions, just a lot of inflammation. My PSA later dropped to 3.
My oncologist commented that I had “won the lottery”, and should stay on active surveillance, but this probably can happen in other cases. In my opinion, our diagnostics are still imperfect.
My best wishes for your well-deserved advantage in this continuing fight.
DOB: May 1944
In Active Surveillance program at Johns Hopkins
Strict protoco of tests, including PHI, DRE, MRI, and biopsy.
Nine biopsies from 2009 to 2024. Numbers 1, 2, 5, 7, and 8 were negative. Numbers 3,4,6, and 9 were positive with 5% Gleason(3+3) found. Two were Precision Point transperineal.
PSA has varied over the years. Is 3.2 as of May 2025. Hopefully, I can remain treatment free.
ASAdvocate said...
...One thing I might add is that I had an experience last year where a PMSA scan reported false positives. I apparently had inflammation that spiked my PSA to 12, gave MRI PIRADS scores of 4/5 bilaterally, and lit up the PSMA scan.
A twenty core targeted biopsy found no cancer in those lesions, just a lot of inflammation. ...
Hi ASA--Wow! That's scarily impressive--thanks for that heads-up! As to "winning the lottery"--yes indeed, although you certainly had your "ticket" punched (groan). Very good to learn that inflammation can cause all three signs. That also helps explain the men we see who have those PIRADS 4 and 5 targets that turn out to be negative.
I wish you continued good heath (but without the scares, obviously).
As to me, I do feel like one of those characters with an angel conscience on one shoulder and a devil conscience on the other: A great RP outcome with a low PSA nadir, good Decipher score, a fairly slow PSA rise to BCR and docs who don't think my history is characteristic of metastatic disease vs. Gleason 9, which branded me forever as high risk. That helps explain why my R.O.at my first visit 11 months ago--said she didn't think I could find an R.O. who would advise SRT at my (then) PSA of 0.12, but that she wouldn't say no if I insisted I wanted treatment (then) anyway.
Stay tuned.
_______________________
Howard, thanks for that helpful post, and I hear you about the closing window. Our histories are quite similar--except, perhaps, for your very close margins. What was your Gleason score after surgery? I assume that going into surgery as a G 6, your surgeon removed only a few (or even no) nodes. It looks like you had conventional WPRT. Was hyperfraction a consideration?
As I mentioned, my hunch is that--should a PSMA-PET scan turn out negative--that my uro would advocate for SRT and my R.O. might either advocate to wait for a rescan at 0.4 or say it's my choice--we'll see. From what I understand the "SRT at 0.1" is for high-risk with steeper PSA rises and/or rises relative soon after RP. Also, there are those like Dr. Scholz, who say PSMA-PET is a game changer and--as long as the PSA is relatively low--to wait until you have a target to treat.
It's all subject to change, but should the scan turn out negative, I think I'll probably delay further only if both my docs advise me to (I'm pretty sure my URO would say zap). Right now, I'm leaning towards no ADT.
Djin
Post Edited (DjinTonic) : 9/5/2025 4:49:15 AM (GMT-4)
Hi there...I stayed a Gleason 6 post-RP. MGH re-reviewed it..said they saw a little 7...Hopkins/Epstein looked twice and re-cut and said...no way...just Gleason 6.... Had the typical prostate bed and whole pelvic radiation...(RO Paul Nguyen is pretty aggressive and the side effects were minimal during the whole pelvic part). They never offered SBRT but that seems to be more and more common....
everyone I met with in Boston wanted to treat at .1 I kid you not, it was a non-event. A lousy couple months but the side effects kind of blend together...but so far so good.
Age at DX and Surgery 48 (2015)
pre-surgery PSA 2.4 RALP 11/15 pt2c tumor vol. approx. 5% Path 3+3 - Epstein re-read (2/20) confirmed G6 neg SVI, Neg nodes, no epe, PNI +, clear margins (exceedingly close margins) Decipher Test .12 5 week PSA <.02. 06/17 .02. 03/18 .04. 01/02/24 .1 SRT/WPRT 70.2 (no adt) 39 sessions 01/24-03/24
everyone I met with in Boston wanted to treat at .1 I kid you not, it was a non-event. A lousy couple months but the side effects kind of blend together...but so far so good.
Age at DX and Surgery 48 (2015)
pre-surgery PSA 2.4 RALP 11/15 pt2c tumor vol. approx. 5% Path 3+3 - Epstein re-read (2/20) confirmed G6 neg SVI, Neg nodes, no epe, PNI +, clear margins (exceedingly close margins) Decipher Test .12 5 week PSA <.02. 06/17 .02. 03/18 .04. 01/02/24 .1 SRT/WPRT 70.2 (no adt) 39 sessions 01/24-03/24
It seems that early salvage radiation is not a thing anymore. In 2018 when my journey began, it seemed to be big deal if there was any doubt and treating at PSA > 0.03 - 0.05 was fairly common as well as ART. Not all RO’s agree with this but more recent studies seem to endorse waiting unless it is really obvious to treat given bad post-op results.
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024
7/2018 (66yr), PSA 4.1->5.1
8/2018-MRI PI-RADS 5, MRI guided biopsy, 8/14 cores, G7(4+3)
9/2018-CT/Bone scans clear
11/6/18-RALP Surgery
11/2018-Post-Op Path G7(4+3) Tert Gr5, pT3a pN0, Grp 3, SM, EPE, <3mm
11/2018-Decipher 0.47, Ave Risk
1/2019-Epstein-G9(4+5) Grp 5, pT2x, margin vs. incision not clear
4-6/2019 ART 37 sessions
PSA<0.10: 2019, 2020, 2021, 2022, 2023, 2024
Djin i was hoping you’d never see a “2” in your PSA, but here you are. Not much i can say, you knpw so much more than me. And as you may recall, i hit it with SRT at a PSA of .08, and thats with a low risk decipher score of .37.
So for me to comment would be silly. All i can do is wish you the best and say as always, I’m thankful that yo are here at HW
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
So for me to comment would be silly. All i can do is wish you the best and say as always, I’m thankful that yo are here at HW
I am not a doctor, just a guy without a prostate
Dx Age 64 Nov 2014, PSA 4.3
BX 3 of 12 cores positive original pathology G6
RALP Jan 6, 2015
Post surgical pathology G7 (3+4), - ECE, - Margins, -LN, -SV
PSA @ 6 weeks 2/15, <02, remained <0.02 until 1/2017, .02, repeat 2/2017, still .02. 5/2017-.033, 8/August 2017- .033 8/17 .046, 3/2018 .060. 6/2018 .068, July 2018 - .08, 8/ 2018, .078, Start ADT+SRT.
Sept 2018 thru May 2022 –PSA = <.05
Decipher test, low risk, .37 score
My story.... tinyurl.com/45w7789x
Every day’s a bonus – Sonny3
I had my 1-yr visit with my R.O. at Duke today. My current PSA is about 0.2. Given that I've gone up only by about 0.07 over this past year (equivalent to a doubling time of about 2–3 years), she is confident that a PSMA-PET scan would come back negative, based on her experience. So unless I insist on SRT now--which I don't--she suggests waiting until a PSA of at least 0.3 for a scan (she has patients that fluctuate around 0.2 without further increase). The higher PSA increases the chances of the scan finding existing cancer. Of course if my rate of PSA increase goes up, we'll re-evaluate. I've been sending her my Labcorp PSA results, which she has been following closely.
I sent my uro a message with this plan and he replied "Sounds reasonable." I see him next month and will discuss. I'm cutting back to monthly PSA checks.
In response to my question, if it comes to SRT of the fossa, my R.O. wants the usual 6 1/2 weeks of IMRT with no hypofractionation.
Labcorp uPSA:
11-28-17 0.010 (3 months post RP)
...
05-30-18 0.007 (nadir)
...
10-07-24 0.118
10-15-24 0.12 (Duke Labs) – Initial consult with R.O
11-08-24 0.123
01-07-25 0.153
02-05-25 0.143
03-04-25 0.174
04-08-25 0.142 (6 mo. visit with R.O. on 04-15-25)
05-14-25 0.185
06-11-25 0.174
07-07-25 0.156
08-04-25 0.181 (8 yr. visit with uro on 08-20-25)
09-02-25 0.213
09-17-25 0.182
09-29-25 0.187
10-14-25 0.198 (1 yr. visit with R.O. on 10/20/25)
Djin
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.213 (8 yr)
I sent my uro a message with this plan and he replied "Sounds reasonable." I see him next month and will discuss. I'm cutting back to monthly PSA checks.
In response to my question, if it comes to SRT of the fossa, my R.O. wants the usual 6 1/2 weeks of IMRT with no hypofractionation.
Labcorp uPSA:
11-28-17 0.010 (3 months post RP)
...
05-30-18 0.007 (nadir)
...
10-07-24 0.118
10-15-24 0.12 (Duke Labs) – Initial consult with R.O
11-08-24 0.123
01-07-25 0.153
02-05-25 0.143
03-04-25 0.174
04-08-25 0.142 (6 mo. visit with R.O. on 04-15-25)
05-14-25 0.185
06-11-25 0.174
07-07-25 0.156
08-04-25 0.181 (8 yr. visit with uro on 08-20-25)
09-02-25 0.213
09-17-25 0.182
09-29-25 0.187
10-14-25 0.198 (1 yr. visit with R.O. on 10/20/25)
Djin
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.213 (8 yr)
Post Edited (DjinTonic) : 10/22/2025 9:29:06 AM (GMT-4)
I had my visit with my uro today. Last PSA (uptick to 0.234) was two weeks ago. I think I'll check again in a month. With input from my R.O., we've decided to schedule a PSMA-PET when I reach 0.3. (I asked my uro if he had to bet, is his hunch that this scan will be negative of positive at 0.3, and he said negative.) My R.O. counseled for not doing the scan at 0.2 and waiting until I reach 0.3.
My uro said that it may be a question of only a couple of months before Veracyte's GRID report is validated for clinical use/treatment decisions (it has been officially "for research purposes only"). We'll probably rely on it to some degree for the upcoming difficult decisions, such as my SRT field size and whether or not to add ADT. I strongly recommend that anyone getting a Decipher test request the supplementary (free) GRID report.
Djin
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.234 (8+ yr)
My uro said that it may be a question of only a couple of months before Veracyte's GRID report is validated for clinical use/treatment decisions (it has been officially "for research purposes only"). We'll probably rely on it to some degree for the upcoming difficult decisions, such as my SRT field size and whether or not to add ADT. I strongly recommend that anyone getting a Decipher test request the supplementary (free) GRID report.
Djin
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.234 (8+ yr)
Post Edited (DjinTonic) : 11/24/2025 7:01:51 PM (GMT-5)
PSMA PET/CT detection probability in the lower PSA range is equally, if not more, influenced by PSADT. Years ago, I drafted an Excel sheet based on statistical data published in a Heidelberg paper estimating the detection probability from 4 parameters including age, PSA, PSADT and another one that escapes me now. I have abandoned it now because the cohort then (10 years back) comprised men with advanced stages. Off the top of my head, a PSADT of less than 6 months weighted more than a PSA of say less than 0.2. Out of mere curiosity I calculated your latest 13 months PSADT that came out as 19.9 months with a (high) regression coefficient of 0.909. Under this light I would have waited for 0.3 projected in late 2026.
In the past 6 weeks my PSA went from 0.234 to 0.242. Since we've decided to wait for a PSA of at least 0.3 for my (first) PSMA-PET scan, my Uro and R.O. each replied that thy are fine with my suggestion to retest next at my scheduled uro visit in about 9 weeks. According to the AI I'm using, my doubling time is either 17.8 or 14.5 months, depending on the size of the data set used. The point is that it's definitely >1 year and not <6 months.
Recent PSA:
08-04-25 0.181
08-20-25 8 yr. post-RP visit withUro
09-02-25 0.213
09-17-25 0.182
09-29-25 0.187
10-14-25 0.198
11-10-25 0.234
12-22-25 0.242
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.234 (8+ yr)
Recent PSA:
08-04-25 0.181
08-20-25 8 yr. post-RP visit withUro
09-02-25 0.213
09-17-25 0.182
09-29-25 0.187
10-14-25 0.198
11-10-25 0.234
12-22-25 0.242
69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx
2013 TURP for BPH (90-->30 g) no PCa
6-6-17 Nodule (R) + PSA on finasteride: 3.6-->4.3
Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM, nodule neg
Bone scan, CTs: neg, 8-7-17 open RP @Duke, neg frozen sections, nerves spared
SM EPE BNI LVI SVI LNI(16): neg, PNI+, pT2c pN0 R0 MX, G9 (4+5) 5%, 64 g
Decipher 0.37 Low Risk, PSA 0.010 (3m)…0.234 (8+ yr)
Post Edited (DjinTonic) : 12/24/2025 11:57:17 AM (GMT-5)
how do you know AI is right or even close?
Mayo Clinic has a calculator you can plug your numbers into...
https://www.mskcc.org/nomograms/prostate/psa_doubling_time
it showed 11 months for the data you listed...
MSKCC shows 10.91 months for your data
https://nomograms.mskcc.org/prostate/psadoublingtime.aspx
Mayo Clinic has a calculator you can plug your numbers into...
https://www.mskcc.org/nomograms/prostate/psa_doubling_time
it showed 11 months for the data you listed...
MSKCC shows 10.91 months for your data
https://nomograms.mskcc.org/prostate/psadoublingtime.aspx