Dad's prostate cancer seems to be coming back after surgery + radiation. Has anyone been through something similar? Need Help

Hi everyone,

I'm writing this because I'm honestly terrified and hoping someone here has been through something similar or has some advice.

My dad is 53 years old and was diagnosed with what the doctors described as a moderately aggressive prostate cancer. His PSA wasn't extremely high, but it was enough to investigate, and the biopsy confirmed cancer.

He had a radical prostatectomy, and after surgery we were told the pathology showed the cancer hadn't breached the prostate capsule. We were over the moon and thought we'd beaten it.

Unfortunately, around 5 months later, his PSA started rising again. It doubled and then continued to increase, which was devastating.

He was then fortunate enough to be enrolled in a Cu-64 SAR-bisPSMA trial at St Vincent's Hospital in Sydney. Prior imaging hadn't been able to identify where the recurrence was, but the Cu-64 scan found residual cancer in his prostate bed, allowing him to undergo around 30 sessions of salvage radiotherapy.

After radiation, things looked incredibly promising. His PSA kept roughly halving with each blood test until it reached 0.13 ng/mL, and we finally started to believe we'd beaten it.

Yesterday he had another routine PSA test after waiting four months, and it came back at 0.39 ng/mL. I know that's still a low PSA, but seeing it triple has absolutely crushed us. His oncologist has arranged another PSA test in a few weeks to see whether this is a real upward trend.

One of the most frustrating parts is that he can't simply have another Cu-64 scan. The trial he was on has finished, and we're now trying to find out whether there's any way he can access another one if it's needed.

Has anyone else had a PSA rise like this after salvage radiation? Did it end up being a temporary fluctuation, or did it mean the cancer had returned?

If it did return, what treatments were offered next? Has anyone had success with hormone therapy, newer medications, or other treatments?

I'm also wondering if there's anything we should be asking his doctors about or pushing for at this stage.

To be honest, it feels like my world has come crashing down. He's not just my dad—he's my best friend. He's only 53, and I'm trying everything I possibly can to help him. If anyone has been through something similar, or has any advice, hope, or even just their own experience to share, it would honestly mean the world to me.

Thank you for taking the time to read this. I really appreciate it.