Salvage Radiation

Does anyone know the general timing of psa tests when it comes to salvage radiation after a prostatectomy?

Once radiation is decided upon, is a final psa test generally done immediately before radiation begins?  Are any done during the 7-9 weeks of treatment?  At what point is one done after radiation is complete?  Does it make a difference if it is ibrt or ebrt or other?

Thanks for any experiences you can share!

I had no PSA tests during adjuvant IGRT, nor any out of the "every 3 month" schedule in "preparation". My first one after RT was +30 days, then back on the 3 month schedule.

Since RT does not kill the cancer cells directly, PSA can remain at the same level for a while, and may actually increase in the short term. The RT damages the dna in the cells, so that they can't reproduce. Lower PSA comes with time, as the cells die off their natural cycle.

 

I had a PSA done the day before I started salvage radiation. My first post-SRT PSA test was 90 days after the last treatment. It was 0.1. At 6 months post-SRT, it was undetectable on the standard test (below 0.1) where it has stayed ever since. I'm now 5 years out.
I did not have hormone therapy.

It is becoming more and more apparent that combining RT and HT greatly increases the effectiveness of salvage radiation...In the past, they usually wanted you on HT for 2 or three years, a tough pill to swallow. But the most recent studies have shown that shorter duration HT treatment is just as effective and avoids the worst of the HT side-effects...

Yes, the HT will drop your PSA to undetectable (hopefully) making it hard to determine if the RT was effective or not..So what! Isn't that the idea here, to have an undetectable PSA? How that is achieved is unimportant. When the HT is stopped, you will know soon enough if the RT was successful...

Thanks for all the information. My husband is the patient - not me, but, because every psa test he has ever had has had less than ideal results, I'm hoping they don't do any for a while. All it will do is cause panic. I wasn't sure if they would do one before treatment. It sounds like it depends on the doctor.

I clearly have nothing to worry about though because, even though he is only 42, that committee has determined that he won't die from this and should never had has his psa taken.

about the type of radiation - IMRT, IGRT, EBRT, proton, whatever beam thing they stick you in front of. I haven't seen anything that clearly puts one method of delivering radiation is better than another. It's all about focusing radiation on the prostate and avoiding the surrounding tissue as much as possible. Personally I think it has more to do with the skill of the RO and the technicians doing the daily treatments than the kind of machine.