No surprise here. In my spreadsheet, I put a placeholder value of 0.50 ng/mL for this PSA test based on the previous trend, and the actual result came in slightly higher at 0.52 ng/mL.
The PSA Doubling Time is dropping as well. Using the last five readings and the Memorial Sloan-Kettering PSA Doubling Time calculator, my PSADT was:
- 6.7 months on 6 December 2023
- 6.2 months on 19 January 2024
- 5.1 months on 1 May 2024
It seems safe to say that the salvage radiation therapy failed to do the trick.
I am trying to describe my reaction to this hour-old news. I guess words that I might use would be: numb, indifferent, resigned. I don’t know. It’s a bit weird. I certainly had zero expectation that my PSA would go down or even hold steady given the previous trend.
You may recall the conversation with the medical oncologist suggested that we monitor and do another PSMA PET scan in six months, which would make it August. The question now is, based on these results, do we stick with that plan? Or do we move to the discussion on the type of androgen deprivation therapy and the timing of ADT?
I did ask the phlebotomist if he was drawing blood for a testosterone baseline test and he said yes. I don’t see the results posted online yet (my record is still going through its once-a-day update as I type this).
Well, it’s after midnight. I’ll sleep on this and perhaps I’ll be a tad more focused in the morning after having processed this.
What’s next:
- 9 May – Appointment with primary care physician (annual physical)
- 14 May – Appointment with urologist
Header Image: Scenes from San Diego Bay, San Diego, California
Dan's Journey through Prostate Cancer 
Hey Dan, keep the faith. There are plenty of treatment options ahead. For you it is still (relatively) early days. Nine years ago my PSA was 310, I was in palliative care, and the outlook was grim. I am still here, living a pretty normal life. Stay strong in mind and body. Keep good people around you. According to my onco cancer is now considered a chronic illness, not a terminal illness. Stay positive and live your life as best you can. You can do it! Cheers, Phil
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Hey Phil,
Thanks for the words of encouragement. I may have been a bit over-dramatic at midnight last night. I guess my sense of resignation comes from the fact that curative opportunities at this point are pretty much out the window, and I’ll just have to move forward regarding this, as you said, as a chronic illness.
I know I’m early in this next chapter and that there are plenty of good years ahead if we manage things correctly.
Thanks again!
Dan
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It seems reasonable to go for another PSMA scan (and possibly address any identified location via radiation). Going on ADT will most likely drive your PSA back down to 0.05 which is a good thing but may preclude PSMA scan success. FWIW I believe pelvic lymph nodes are the second (after prostate bed) most common location for port-prostatectomy prostate cancer reoccurrence.
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Hey Rob,
Thanks for your comment, and I agree on pretty much all points.
I’m in favor of doing the scan but my only question is the timing. Do we wait another 2-3 months for my PSA to get closer to 1.0 ng/mL (where scans have a much better chance of picking up lesions), or do we leap into it now? I’d be inclined to wait until the PSA is above 0.7 ng/mL, but we’ll see what the doctors say.
Stay tuned for more.
Dan
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Hi Dan,
Hang in there our prayers are with you. Ron went for his PSMA at MSK in March and it came out negative. He is in a holding pattern as the Doctors felt best not to treat yet and keep PSA testing. His PSA actually went down from .2 to .18 this round. My husband is dealing with this since March of 2018 and based on Gleason Scores they did a radical prostatectomy. He had recurrence after about a year and a half at which time he did hormone therapy followed by radiation of the prostate bed. He had another recurrence in late 2022 with watching the PSA every three months. Thank God he has not had to have any new treatment yet. Hopeful and prayerful. Louise and Ron
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Hi Louise and Ron,
Thanks for your support and sharing your experience. It seems as though Ron and I are on similar paths. Even though my PSA is increasing more rapidly, I really want to pause and make sure that the next steps are the correct steps (as much as they can be in the ever-changing world of prostate cancer) before taking action again.
All the best to both of you.
Dan
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