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Post radiation PSA - slight increase

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Posted 4/28/2011 2:49 AM (GMT 0)

I finished radiation one month ago. DaVinci 3 years ago. My first checkup at one month post radiation I had a slight increase in PSA from .13 before radiation to .18.

I knew not to expect a decrease at one month, but is an increase normal even if the radiation got the remaining cancer? My doctor said it's too soon to tell but he didn't expect to see an increase. He said the 3 month and 6 month checkups would be better indicators. I have been positive through this whole thing, but this just doesn't sound right to me. Anybody else have similar stories?

Posted 4/28/2011 3:10 AM (GMT 0)
sparky,

not to discourage you, but after SRT, the normal rule is that there should not be any rises. 3 different radiation oncologists have told me that locally. I had 2 drops in a row after the radiation ended, and nothing but rises ever since, and the radiation has since been deemed a failure. I hope you see a drop. Hopefully after your next PSA test, you will see some good news.

David in sC
Posted 4/28/2011 7:06 AM (GMT 0)
Sorry your PSA has gone up.
My understanding is also that after SRT there should be no rise, and that it is guys who have RT as primary treatment instaed of surgery who can see their PSA rise at first.

Hope the next PSA test provides better news

Alf
Posted 4/28/2011 12:44 PM (GMT 0)
Thanks guys. I could have sworn that the encologist told me I should see low PSA after the first month but that might not tell us anything. But I can't remember for sure. I just don't see how this can  mean anything other than that the radiation did not produce the desired results and it was all for nothing.

I'd really like to hear from anybody else who has gone through surgery then radiation later after a rise in PSA.

After surgery I went 3 years with <.01 PSA. At time of radiation it had only gone up to .13. I got a second opinion from an encologist before I decided to do radiation. At first he thought my encologist might be jumping the gun a bit in starting radiation, but after calling my doctor, he said he agreed that I should go ahead and do the radiation.

To tell the truth, I'm mad about this. I'm still paying for the 20% that my insurance didn't pay for the radiation and I'm not a rich man. I'm feeling like this whole experience has put me in some kind of a cancer treatment mill. I'm not sure who to even believe any more. If the radiation had accomplished something, great. Money well spent. But to find out now that it might not have accomplished anything, well, I'm beyond words right now.

Thanks for listening.

 

Posted 4/28/2011 3:33 PM (GMT 0)
Hello

You can read my Husbands,not sure if it  help's you.He is due in June for his next PSA test.His Last one was 1.50.

The Waiting Game Sucks

  Good luck

   Deidre

Posted 4/28/2011 4:21 PM (GMT 0)
Sparky,

I just finished SRT and won't get my first test until July. I asked my oncologist his take on this same subject. He said that low to intermediate grade cancers tend to still have a small rise in psa immediately after radiation treatment, so doing a psa test before the three month schedule would not be accurate.

His words...not mine. Personally I think it should drop like the others stated. I will wait the three months regardless.
Posted 4/29/2011 4:21 AM (GMT 0)
Thanks for all the replies. I'll get my positive attitude back, but this is the first time I've been discouraged about it in the entire four years of living with it. Like I said, I'll get it back, I'm just irritated about some of the conflicting answers I've gotten from my urologist and two encologists that I've seen.
Posted 4/30/2011 12:13 AM (GMT 0)
Sparky, perhaps I can add a bit of input to make you more optimistic. Our circumstances are not identical but there are some similarities. My first SRT psa test was during my 6th week (of 8 weeks) of SRT. My psa rose to .4 from a .3 at the beginning of SRT. I asked my RO if I should be discouraged and his reply was "nope, happens only about 1/2 the time for those that go undetectable". At 8 weeks post SRT my psa had dropped to .2 and then to .1 for my 5 month and 8 month tests. Only a couple days ago did my 13 month psa test go to <.1 or undetectable.

His prediction that it would take about a year to go undetectable was either lucky or hopefully from his experience. When my psa did not go to undetectable at 5 and 8 months, I researched books and papers that might indicate how long to expect. The one I like the most (obviously because it gave me more hope) was a book entitled "Advanced Therapy of Prostate Cancer" authored in 2000 by Martin Resnick and Ian Thompson where they summarize a study indicating the average SRT response is gradual between 2 and 48 months with a mean of 12 months.

Some of our members might be able to provide more definitive studies but this one was right for me.

Hopefully yours will follow the same pattern and we and our other friends will have a durable response.

Our best to you,
Jake
Posted 4/30/2011 9:40 PM (GMT 0)
Thanks Jake. That does give me hope. I'm going to give it time, get my body in better shape. (I need to lose about 60 pounds) I know that can't do anything but help.

I guess the thing this did for me is that I've just assumed I was going to beat this. I was always so positive and warrior-like about it that I never considered for one second that I wouldn't. This was kind of a wake up call that there are some things I can't control. But on the good side, there are some things I can. I can go back to what I did when I was first diagnosed where I was more careful about what I put in my body and was trying harder to exercise. I got complacent and over confident that I had already won the war. Where I was wrong was that I had won some battles but the war must go on.

Posted 5/2/2011 12:10 AM (GMT 0)
Sparky, my rad oncologist told me the PSA reading has about a 3 month half-life. Although you can see a drop in PSA sooner (I did), you should not be surprised if it decays gradually: for example, if you start out with 0.4, you might expect it to be at 0.2 at 3 months, and 0.1 at 6 months, 0.05 at 9 months, etc.

The expectation is that it may stay the same for a long while after SRT, or slowly drop, but it should not rise. Let's hope your first reading is a fluke (those can happen), and you get a drop at 3 months. It is also possible the rise happened before the SRT did its thing, and this isn't actually a rise since SRT.

Best regards, Jeff
Posted 5/3/2011 4:56 AM (GMT 0)
Thanks! I'm hoping it was a fluke. I guess time will tell.
Posted 8/8/2011 4:38 PM (GMT 0)
Sparky
I first had the DaVinci surgery in Oct of 07. It began returning in 2010 and began increasing and at 0.55 my urologist recommended radiation.
By the time I began radiation it had gone to 0.65. I began radiation on Jan. 24 2011 and the last treatment was on Mar. 15th 2011. First psa test on July 15th was 0.300. Both the urologist and the radiation doctor, who is excellent, said that the first psa score could be a little high and that the second psa could down.
I began taking Flax Seed Oil regularly on April 15 2011 because a Duke University study found that Flax Seed taken regularly with a low fat diet would slow or stop aggressive prostate cancer cells from solidifying.
Don't know what impact, if any, that will have but it is certainly worth a try.
Hope all is well with you.
God Bless
Deflated
Posted 8/9/2011 6:38 PM (GMT 0)
I just had my three month PSA checkup after radiation. (Actually closer to 4 month)

My PSA went down from the .18 one month after radiation to .08.

The doctor said that was great, that I wasn't out of the woods yet, but that was great news for the three month checkup. He says that the 6 month checkup would be the most accurate test.

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