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concerns about psa increase

Posted 28 Nov 2023 at 15:36

Hi I'm 3 years post radical RT for a T3a G7. Came off hormone therapy in March this year,  so 9 months now.

PSA appears to be on the up.

Gone from 0.02 last December to 0.09 last week. Instead of the usual 12 month blood tests they've asked me back in 2 months. They seem relaxed and stated everything is satisfactory. I'm not sure. Thoughts anyone?

Posted 28 Nov 2023 at 19:48
You still have a prostate so there are no concerns unless your PSA goes above 2.0 + nadir which, in your case would be 2.02 The healthy parts of the irradiated prostate can recover which means some PSA is still produced.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Posted 29 Nov 2023 at 00:06

My hospital doesn't report below 0.1, so everyone of your results I would have seen as <0.1 and I wouldn't be worried at all. My diagnosis and treatment was pretty similar to yours but I'm five years post RT so about two years ahead of you. My PSA has been 0.1 and 0.2 and back down again to <0.1 since I finished RT + HT. Until you have been off HT for about 18 months you don't know what your new normal PSA is going to be. I guess they have gone for 2 month tests to put your mind at rest. 

As Lyn says as long as it is below about 2.1 it isn't going to warrant any attention. 



Posted 29 Nov 2023 at 00:28

It's entirely expected that your PSA will rise when your Testosterone comes back if you still have your prostate. 9 months after finishing HT is pretty typical for that. It does help to see this if they test your Testosterone with PSA when coming off HT. It will hopefully rise to a new stable level. If your lowest was 0.02, then you are fine up to 2.02, but it usually levels out well below that.

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