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First PSA after Salvage RT

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Posted 6/15/2010 12:21 PM (GMT 0)

I've just finished RT (5 weeks ago) after failed DaVinci and my first PSA (got it today) is 0.21 the same as before start of radiation.

Not sure if this is good or bad news so I need a bit of help from you guys out there.

Cheers

pk5

 

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

PSA before surgery 6.3

Biopsy show Gleson 9 (out of 12 samples 3 were 9, 2 were 7 and 1 was 6)

Staged T2c

DaVinci 8 dec 09

From Biopsy report:

Tumor does not extend to apical margin

Evidence of capsular penetration.

Tumor does not extend to circumferential margins.

Tumor infiltration into the base of the Lt. seminal vesicle.

Bladder neck margin confirm this to be free of tumor.

Eight lymph nodes submitted showing only reactive changes.

Gleason 9 confirmed but stage upgraded to T3b.

First PSA 6 weeks after surgery 0.16

Second PSA 10 weeks after surgery 0.21

Radiation started 16 March and finished 12 May.

First PSA after Radiation 0.21.

Posted 6/15/2010 12:28 PM (GMT 0)

What did Your doctor say?

Have a feeling the guys with experience in this area will say - get another test in a few weeks/couple months.

Posted 6/15/2010 12:36 PM (GMT 0)
PK,

My first test was 6 weeks, I think, and it dropped from around .6 to .44, so I would say it is still a little early for any concern on your part. Wont be tested again until November but hopefully will continue to see a downward trend. Did you Dr. say anything about the result of your PSA?

Michael

Posted 6/15/2010 1:08 PM (GMT 0)
They did my first post srt at 30 days, not much drop, but then again at 90 days out - big drop. at 5 weeks, probably not going to show much drop, so hopefully your next test will give you some good news
Posted 6/15/2010 1:43 PM (GMT 0)
My first PSA came back the same .18 as before IMRT. However, the 6 month came back as 0.00. Relax, give it some time. I was discouraged too. Radiation can work up to two years, I was told by my Rad Doc.
Posted 6/15/2010 2:27 PM (GMT 0)
PK welcome to the forum

I think this is too soon after RT finished to draw conclusions.

My doc said we needed to allow 10 weeks to three months for the RT to have a proper effect. RT does not kill cancer cells overnight; it takes time.

However, that said, I think it is also good that your PSA has not gone up since that earlier 0.21

Alfred
Posted 6/16/2010 5:21 AM (GMT 0)

My Oncologist says the number is in line with expectations and want to see me in 6 mth. for another PSA.

I still have issues with frequent urination (once 1-2 hours) .

Have tried Flomax but it didn't work. Been given referral to Urologist but that won't happen for a month or two. Anything I can do in the meantime?

Cheers

pk5

Posted 6/16/2010 7:09 AM (GMT 0)
pk5

Sorry, but I don't think that 1-2 hours is frequent peeing unless that's at night.
I was peeing about every 20 minutes at one point towards the end of RT, and even now I still can't manage much more than 45 minutes during the day time and 2 hours at night without needing to go. And I don't think I've ever been able to go longer than 2 hours in my whole life without needing to pee.

I tried something like Flomax (different name here in Holland so I'm not sure if it's the same) and that actually made me leak rather than better.

Kegels can still help, but the area near the bladder and the lower section of the bladder will have been really aggravated by RT and will still need a bit more time to heal/recover.

Having just reread your signature I see that you haven't said how old you are.

Alfred
Posted 6/16/2010 7:44 AM (GMT 0)

Once every 1.5 - 2 hours is on a very good day. At nighttime it's more like twice per hour.

I am 60 years old by the way.

cheers, pk5

 

Posted 6/16/2010 4:59 PM (GMT 0)
just a quick comment: i'm still in the salvage RT stage, so i can't speak to how soon the PSA starts to drop.  but the way it was explained to me: the radiation doesn't KILL the bad cells, it messes up their DNA.  so when the therapy is over, a bunch of them are still alive.  but when they try to replicate, the DNA will not function/split/reproduce, and the cell dies.  so after the therapy session, you have to wait until the "crippled" PCa cells try to duplicate, then they slowly die off.

does this match what anyone else has heard ??

bob

 

Posted 6/16/2010 5:28 PM (GMT 0)
Bob,
That description of the demise of PCa cells is the same I was told by the therapists.
Posted 6/16/2010 5:29 PM (GMT 0)
Bob, that matches my understanding as well.
Posted 6/17/2010 6:12 AM (GMT 0)

Just want to say thank you to every body who has replied. There is a lot of clever and caring people out there.

Very happy I found this place.

Cheers, pk5

Posted 6/17/2010 7:10 AM (GMT 0)
Yeah Bob, the DNA effect on replication is what I was told too; it's just simpler to say "Kill" sometimes. And more satisfying!
Alf
Posted 8/6/2010 8:58 PM (GMT 0)
glad i found this thread. i just got back my first PSA after my SRT.  at six weeks after the end of RT, the number is 0.2, which is half the 0.4 when we started the RT.  i knew it takes awhile to go down, but it was good to see other guys' numbers.  apparently, 6 weeks is plenty early, and when i get my next number at 6 months (additional), that should be a much better indicator of what's going on. i of course was hoping for lower, but i'll take my 0.2, and wait a few more months...thanks for hanging your numbers out here so we can compare!

bob

Posted 8/7/2010 9:16 PM (GMT 0)
pk5,

I was always trying to get them to check my PSA after SRT before their firm 3 month time frame...  They always told me no...   They were not interested in results until the 3 month mark and anything before may just cause needless anxiety and worry...   So,  I had to wait...   This being said,  I would indeed wait for the 3 month or greater test as being the better indicator...  And seems like your doctor still considers you inline with expectations...        

God Bless!    

Posted 8/8/2010 2:56 AM (GMT 0)
Sorry about being late in adding my experience, but similar to others my 3 month post SRT psa was .2 down from .3 at the start. I foolishly insisted on getting my psa tested during SRT at 6 weeks and my psa had continued to rise to .4 so my drop at 3 months was either 1/3 or 1/2. My understanding also was the cancer died while trying to replicate and this could continue for a year after SRT. Additionally the RO stated the lower grade gleason cells took the longest to die because they weren't as deformed.

Take care,
Jake
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