A. Unfortunately, the problem you describe for your husband is not too uncommon post prostatectomy and implies treatment failure with recurrent disease. It is important to try to determine if the recurrent disease is local (i.e. in or around the prostate bed) or distant metastases. This will help determine the best treatment options. Your husband’s PSA has slowly increased (less than a 0.2 ng/ml increase from Jan to Sept. of this year) which suggests, although is certainly not diagnostic, of recurrent local disease. The PSA is still very low so there is likely very low volume or microscopic disease present. It is difficult with any imaging method to detect this level of disease. We have done many multiparametetric 3T MRI prostate exams on patients following radical prostatectomy and other treatments that have a slowly rising PSA with detection of very low volume recurrent local disease. There are other studies that have shown similar results. I agree that it will be difficult to detect recurrent disease for your husband given the current low PSA level. However, I would recommend a properly performed and interpreted multiparametric 3T MRI to try to localize recurrent local disease. If this can be detected, your husband’s disease may have a more favorable outcome and with less complications with targeted treatment.