Rise in PSA post RT and HT 5 years ago

Hello, mate.

I'm not medically trained and have no experience of RT and HT, I had surgery. However, it seems that your PSA was stable at about 0.7 for the first three years, then there has been a rise for the past two, which has nearly doubled in the past 6 months from 0.91 to 1.7.

As francij1 says, normally your nadir +2 (the Pheonix criteria) triggers further investigations, however you have had three consecutive rises, they plus the sharper rise last 6 months, could start prompt earlier tests and scans.

Some are saying that the Pheonix criteria is now outdated:

The Phoenix criteria no longer align with the capabilities of current diagnostic and prognostic tools. Redefining BCR using dynamic PSA metrics and advanced imaging could facilitate timely salvage treatment in patients at a high risk and allow surveillance strategies in those unlikely to progress. Prospective validation is warranted to inform future clinical guidelines.

https://pubmed.ncbi.nlm.nih.gov/40620052/

As you says it might be BCR. In your bio you also mention a dodgy lymph node which appears not to have been completely ruled out of the equation?

I suppose another reason for the rise, dependent on how long you were on HT, could be a testostetone recovery rise, causing a benign rise in PSA from the healthy prostate tissue left behind. 

It seems you no longer liaise with those who initially treated you. Perhaps, just to be on the safe side, it would be worth going to your GP and see if he/she thinks you should be refered back to them?

Whatever you decide, I wish you the best of luck. 

Edited by member 01 Nov 2026 at 07:26  | Reason: Add link

In my situation following RT, my PSA remained pretty stable for up to about 3 years (I didn't have HT following RT). However, PSA began increasing at a persistently higher figure. I was referred to UCLH where a significant tumour was located by MRI and was given HIFU in 2015 which reduced the PSA down to 0.39 (from memory) - see my profile/bio for histology. PSA began to increase again similar story and had a second application of HIFU in 2021. Seems to have stabilized since and I am now told that I am 'In Remission.'

In Jonnopfc's situation, I would certainly ask to be referred back to Urology/Oncology. Men with failed RT, and this increasingly looks like that could be the case here, might be offered Focal salvage treatment if cancer is identified in the Prostate or a short course of high intensity radiation which could go further depending on his suitability and previous RT. He really needs imaging to help determine and maybe biopsy to be decided by his consultants.

Do let us know what transpires.

So you need to know if the area that has the tumour was previously irradiated and to what level.

Hifu is not radiation so if it can be safely delivered it could be used as in Old barries case.

Focal treatment is used to kill cancer cells by hitting them with Heat (HIFU), Ice formation (Cryotherapy), Electricity (Nanoknife or Electroporation) or Laser (FLA). The medium used depends on an individual's suitability and the preference of the person administering the treatment but does not use radiation for the treatment.