How high and long is the PSA Bounce

I think you need treatment. I thought you had radiation treatment but signature indicates not. I may be wrong but a 9.4 unless its a infection calls for treatment. as does a 3+4 gleason. Stay close to your urologist. What does he suggest.

Hi David,

Most radiation oncologists use the "Phoenix" definition of biochemical (PSA) recurrence which is a PSA of nadir +2. So any increase less than 2 ng/ml over your lowest PSA since treatment is officially a bounce. The problem is knowing if your lowest PSA so far is really your nadir, which may not occur for two years or more after radiation. With your history of PSA fluctuations, it may be that you have some recalcitrant prostatitis going on too that may continue to complicate your ability to distinguish a bounce from a biochemical recurrence. I'm two years out and my PSA is still on a long-term declining trend with a few bounces along the way. My RO has a standard line of "let's wait another 3 months and see what happens." It all depends on when those cancer cells come out of hibernation and decide to replicate, at which time the "time bomb" implanted by the radiation will kill them.

I admire how long you've been able to stay on AS -- a lot of good years of symptom-free living. Now that your PSA doubling time is less than a year, I can see why you're considering alternatives. I'm a big fan of HDR brachy monotherapy. What it came down to for me was the bother of two days in the hospital. I finally decided on SBRT, which was modeled after HDR brachy.

- Allen

Unless I am reading this thread wrong, data david hasn't even had radiation, least not from what he wrote, so how could there be any bounce?

david

I thought the same thing Purgatory, but the question was asked by Data david, so the other responders are responding to the specific question, not his specific, in the now, situation. Trust your spirit is staying strong, Brother…..

DataDavid
Did you ever have your HDR brachy treatment, if so how did it go?

Hey David, good to hear from you again. I remember your journey well - you did a fantastic job researching treatment options and did good with your choice - collecting tons of "data" (I remember!) as you went along. Glad to hear things are going well. Don't be a stranger - and please, share your knowledge and experience with the newbies that will come - you are another great example of someone that really did their homework - and others could benefit from your journey........