At what PSA level would you consider restaging a patient who was treated with ADT and radiation and had undetectable PSA?
At what PSA would you become suspicious for biochemical recurrence and pursue restaging? Is there a threshold value?
What imaging modality would you use for restaging - PSMA PET or Axumin PET or CT and bone scan?
2 Answers
Mednet MemberInvited Expert
Medical Oncology · Duke University School of Medicine
Answered on
The criteria for defining PSA relapse after radiation therapy remains the Phoenix criteria (see Roach et al., PMID 16798415), which is essentially nadir + a 2 point rise in serum PSA. Thus, a patient who achieves an undetectable PSA on ADT/RT but then experiences a PSA rise would not meet PSA relaps...
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Mednet Member
Radiation Oncology · The Oregon Clinic-Radiation Oncology West
Answered on
After radiotherapy and androgen deprivation, I order testosterone with surveillance PSAs until the testosterone level plateaus after recovery from androgen deprivation. PSA will rise as testosterone recovers, and more often than not, PSA rises are benign. In my opinion, there generally is no need fo...
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