Relapse Time

Many thanks, sounds similar to me. My PSA was below 0.1 for 8 years and then rose to 0.16 last September, last PSA was 0.18 in April, next test due 15th July and seeing my urologist 31st July. Will update the post then. 

Well an update, PSA increase from the 0.16 triggered the 0.2 in November 2024 and considered biochemical recurrence. Met with oncologist in December 2024 after having a PSMA PET scan, showed a possible lesion on left posterior bone and metastasis on the superior rectal lymph nodes, either SABT or RT being reviewed. Followup MRI scan 7th February to get another view before commencing treatment. Feeling positive that starting early at PSA 0.2

I think the question is waiting until something is seen in the scan that can be targeted or versus immediate treatment at .2  is whether it makes a difference in the life expectancy outcome. It’s similar to the studies that have shown delaying initial treatment from time of diagnosis by six months has shown no difference in outcomes as to if you started treatment in two months. In other cancers like non Hodgkin’s lymphoma whether you immediately treat the 2cm lymph node or waited until it has reached 4cm is not really going to have an impact on you expected survival outcome, yet significantly has a bearing on your current quality of life until you begin treatment. Two schools of thought from research have evolved over PSA driven treatment or scan driven treatment. It’s not some willy nilly does it make a difference. They are finding similar outcomes and that is why it is becoming mainstream. The old .2 was implemented before any PSMA Pet was even in existence. If a person has handled AS then waiting for scan driven might be more acceptable to their mental health then watching their PSA rise. Now their are always arguments that can be made or examples of why it should get started, but we would not be discussing it unless a pendulum is swinging. Remember AS has continued to evolve and expand where it once did not exist. It’s certainly a decision to again think about obtaining a second opinion, but what you will ultimately be comfortable with. Additional existing quality of life for awhile without additional new side effects of treatment or immediate treatment.

It appears in your case the scans are picking up something 

Bone lesion is questionable, NHS patient, 

Ian , hope it is successful for you. The SABR treatment to my lymph nodes was effective.

Thanks Chris