PSA on the rise

Hi Lexi

I refer you  back to my previous post last year. You need to push for a PET scan which is what I had. My PSA was up to 1.2 and the PET scan showed cancer cells in a bone in the pelvic area. I was referred for SABR treatment that pinpoints where the cancer is. Only 3  sessions this time last year. I suffered with fatigued following this but nothing too problematic.  I am still on 3 monthly PSA tests and my latest was 0.16 so all good. These days you have to be really pushy and make your case so do not take no for an answer! I think I am  fortunate as my oncologist has been brilliant and so in tune.

Good luck.

Lexi, sorry to hear this news. I was in a similar position a few years ago and I was heading for HT for life. The oncologist changed his thinking and it was PSMA scans and SABR treatment to single lymph nodes. There is a limit to what the NHS will treat and private SABR treatment is very expensive.

I am also a fan of Dr Kwon,and even if people are not, his videos are quite interesting.

Thanks Chris 

Hi, Sorry to read that.   This might be answerable by someone on here but going from <0.1 to 0.2.  Could it be that they only measure to one digit.   I would have thought it might be say 0.16 or something to 2 digits. If the increase was less it could make a difference. 

If it's only one digit a reading of 0.2 could be anything from 0.16 to 0.25 or 0.11 to 0,2, I don't know how they do it.  As said elsewhere 3 monthly psa readings should be done.  But I'd prefer readings to 2 digits and perhaps a repeat test now to check it's correct.

I’m in this position: following a RARP in December 2022 my PSA rose to 0.2. The specialist nurses referred me back into the system immediately. My oncologist told me a PET scan wouldn’t achieve anything as the cancer cells would be too small to be picked up.

I’ve had 20 fractions of radiotherapy and was put on hormone treatment for 6 months. Following a telephone consultation yesterday the hormone treatment will be continued for 2 years as the current thinking is that the longer period will reduce the risk of a further recurrence.

The radiotherapy is not an issue and I’m coping well with the hormone treatment with few side effects.

The first point of call has to be your oncologist who will advise, but at this stage this is very treatable.

Lexi, it sounds like they don't offer any curative options at this point. I would check if that is the case, and then consider transferring to somewhere which does. Obviously, I don't know his medical history, state of health, etc, but the standard of care at this point would be to check for mets (which can only really be done with a PSMA PET scan), and if it's no more than 3 (and providing they're not in some less likely places), to offer SABR. Hospitals which don't have PSMA PET scanners or SABR capability usually don't refer you to somewhere which can, but (if you live in England) you can get referred to any NHS hospital in England which is prepared to take you.

Lexi, my oncologist was described as a bit of a maverick. PSMA and SABR to local hot spots is probably a more modern approach.

Agree the single low PSA does not meet the criteria for PSMA scan. 

Ulstermans PSMA scan can found something at ten times lower , CJ did not spot anything untill it was around 200 ?  Not sure about paying for a scan at this point. My nurse said the original plan was to wait for the PSA to reach 1 , the oncologist had a higher figure in mind. PSA velocity or reaching 3 seems to be the factors to decide my next step.

Thanks Chris 

At identical situation,  a PSMA PET was considered the best and logical option. The insurance didn't cover so husband payed from the pocket. It worked. Little  spots were spotted and treated. I  hope nowadays that test is not at such a high price as it was 3 or 4 years ago, or NHC or insurances decide bearing the cost.

Good luck!

Edited by member 03 Apr 2025 at 16:22  | Reason: Not specified

He first started HT. 2 months later,  RT to the spots and also, as a prevention, to the pelvic area was added. Once finished RT,  continued HT. 2 years in all. The  length of HT differs according to oncologists' criteria.

Right now we happen to be on our way to the hospital for his periodical check. Last one, six months ago his PSA was considered undetectable (O.O-), don't remember exactly.

He's fine now. 

Push to get the PSMA.

Whatever you want asking me, feel free to write or post me.

Good luck!