Rising PSA: How Soon Should You Get a Scan? | Thomas Hope, MD & Mark Moyad, MD | 2021 PCRI

The recently FDA-approved PSMA PET scan can locate prostate cancer recurrence in some patients with a PSA as low as 0.2. This has opened the door to new treatment strategies, but it has also raised a number of questions, especially at the present moment, when the scan has yet to become widely available and covered by insurance. Many patients wonder, for example, if they should maximize the value of the scan by waiting for their PSA to rise to a point when it is sure to detect a recurrence. Here, public health expert Mark Moyad, MD, MPH asks radiologist Thomas Hope, MD that question. In the near future, the scan is expected to become widely available, affordable, and patients can consider having the scan at a low PSA knowing that a subsequent scan will be more feasible if the first one fails to detect the location of the recurrence.

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[maxthemagition]

In August 2007 I got a private health check and my PSA was 5.64. Early this year 2023 I visited the local doctor complaining about my frequent visits to the toilet during the night and the doctor took a blood sample for a PSA test which was found to be over 10 at 11.5.
So my PSA went from 5.64 to 11.5 over a period of 15 to 16 years during which I have been very healthy other than the frequent visits to the toilet during the night for a wee.
Anyway this was followed up from early this year ...scans, biopsy etc to find that I have localised intermetiate cancer (Gleeson 4/3) and now I am on Hormone therapy for 6 months during which I will receive radiation therapy over 3 weeks. My testostorone level is going down and I feel aged, body sweats and fatigued, which is normal for this treatment. (Chemical castration effectively).
I read that my PSA should come down to near zero after Ratiation Therapy, but if it goes up slightly, I could be back to square one as it indictes that the cancer could still be present.
Is there no escape for this nightmare?
I live in hope that the cancer will be cured and I get back to my normal life.
I will be 77 years old soon...
I read that 80 year olds, have an 80% chance of having prostate cancer at some stage of growth.
To treat or not to treat is down to the choice of the individuals

[dwt]

Thanks, Doctors. This is a great series of videos.

[charlesblumenstock]

Yes the trus test is usefull for density and risk. Psa teats are easy 4:21 4:22 4:23 4:24 4:24 4:25 4:25

[zed]

This was very helpful. I had a radical prostatectomy in January 2011 when I was 53 and my PSA was undetectable for 54 months. In September 2015, it became detectable at 0.05 and has been slowly increasing ever since. This month, it hit 0.21 for the first time. My prostate came out cleanly (3+4) and my PSA doubling time is about 4.5 years.

We've chosen to monitor for that time because of the long PSADT, but think it's time for a PSMA PET scan and a decision on salvage radiation therapy. This video was very helpful to me. Thanks!

[cooperjdcox]

How many ways is PSA measured? Mine has always been whole numbers?

[elitetrader]

I agree. I'm post RP and my PSA now is 0.12. I'm proceeding with salvage RT next week. My PSMA PET was negative.

[RodolfoMegliorino-jv]

Dr said it won't show up on images at 3

[billjacobi]

DO NOT PSA STARTS RISING GET AN M.R.I. I WAITED AND HAVE 4 STAGE CANCER BECAUSE OF IT.

[stevenvalett]

What about rising PSA after radiation???

[miketony]

at 67 my PSA was 0.42 today I'm 69 and it was 0.46. Is there any reason to be concerned?

[deepakgaur]

My father had a prostatectomy on 25th feb 2023 and he had a PSA test on 27march and the score is 0.052 and he had a Grade 5 prostate cancer should i be worried?

[enkoART]

Hi, Thanks for Educating and Helping People !
I was just diagnosed after prostate biopsy with Gleason 9 (4+5) PSA 8.6, no metastasis find on bone and CT scanners . 67 years old. Before I start any treatment I want to have a PSMA pet/ct for more precise diagnosis... but doctors here are telling me that PSMA test is not necessary ? Can you help to find a place where I can get it ?… I live in Colorado .

[novascotianinfj]

psa was 5 in late october this year, now it is 9 as of april

[OnTheOnlyShipButHalfWannaSink]

OK, but how was I targeted for this vid?