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PSA spike after Brachy Therapy

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Posted 5/14/2014 6:51 AM (GMT 0)

Hi all,

My count came down to 2.9 after the brachy in April 2013 . Since then it started to climb again. Nov 2013 it went to 3.2. March 2014 it went to 3.6. May 2014 it went to 4.

Saw the Urologist a week ago. He was not convincing in trying to explain the continuous spike.....going from infection(which he treated me a month ago with antibiotics which did not help) to cancer cells not treated with the brachy to hormone theraphy and then to bring my 6 months appointment with the Oncologist forward (who I am seeing on 8 July for the 6 months check up) and then he says not to worry and lets do another test in a months time...***?

Have any of you experienced a spike in the PSA after treatment and did you find out what caused it?

Maars

__________________________________________________
45 years old.
PSA March 2013 6.14, July 2013 2.9
Gleason 3+3
Brachy Therapy done in 24 April 2013

Posted 5/15/2014 10:55 PM (GMT 0)
Maars,

Sorry about your PSA spike, I know you are anxious to get some answers and get on with your life. I'm kinda of surprised that nobody has replied, guess that means for most of those treated here with brachy have had successful results. Have you tried some of the other forum sites, UsToo and Yanow ?

Good luck, and please keep us posted with what is going on with you.

Bob
PowellST
Posted 5/16/2014 10:50 AM (GMT 0)
Thanks Bob. Will try somewhere else. From my research I have done it seems there are different opinions. One opinion indicates that a "bounce" may happen within the first 12 to 36 months after radiation. Another opinion indicates that if there is a spike of 2 levels from the lowest psa since radiation, then in all probabilty the cancer returned, hence my question

Post Edited (Maars) : 5/16/2014 4:53:26 AM (GMT-6)

Posted 5/16/2014 10:52 AM (GMT 0)
Maars,
I have not experienced what you are describing, but I have often heard of a psa 'bounce' which is supposedly quite common and harmless. Hopefully that is what you are experiencing.
Posted 5/16/2014 11:21 AM (GMT 0)
Hi Maars:

Sorry I missed your post and did not respond. PSA "bounce" after brachytherapy is fairly common and usually not something to worry too much about. However, your consecutive increases from a not-very-low-nadir would be concerning to me. I think doing a re-test and moving your oncologist visit forward are prudent. Depending on the theory, 2-3 consecutive increases from a nadir or 2 points increase in PSA from a nadir signal BCR.

Hopefully, the PSA numbers will start to fall but if not this may signal that cancer is still present and that salvage treatments may be required. Let's hope for the best...please let us know.

Jim
Posted 5/16/2014 11:58 AM (GMT 0)
Thanks Jim. Will do
Posted 5/18/2014 2:40 AM (GMT 0)
I think it is too early to know.

My brachytherapist told me that 15% of men will nadir later...3-4 years. The only current definition of primary failure is 2 points above your nadir (4.9).
The next time you get a PSA done, start naproxen 440 mg twice daily for 3 weeks (check with your family physician first to ensure this is safe for you to do). Naproxen is an over the counter medication(Aleve) that may block the inflammation that could be causing your PSA to bounce.

I have a similar problem going on and hope my physician is correct. He is considered one of the best in the world so I trust his judgment.

Paul
Posted 5/31/2014 4:40 PM (GMT 0)
Blood tests done yesterday. See the doctor coming Tuesday. Holding thumbs !
Posted 5/31/2014 10:13 PM (GMT 0)
Hope your results are good.

PSA bounce after brachy is common but I am sure that isn't what you want to hear (no offense).
Posted 5/31/2014 10:28 PM (GMT 0)
Maars, good luck. We'll be looking for your update on Tuesday.

Jim
Posted 6/1/2014 1:03 AM (GMT 0)
Maars,

As you can see from my post, it has taken 2 1/2 years for my PSA to drop significantly. My brachytherapist believes slow drops are more frustrating but often indicate less aggressive tumors. Also, a study done several years ago at the Cleveland Clinic revealed that men with PSA bounces had a lower incidence of reoccurrence of cancer.
What makes a bounce so frustrating is that no one can be sure if it represents cancer or not. The odds are in your favor that it does not represent cancer coming back.

Paul
Posted 6/3/2014 3:15 PM (GMT 0)
What a relief. Count came down to 2.8 - from 4.2 in beginning of May 2014. Hopefully it will continue this trend or remain stable. Seeing the oncologist on 8 July 2014 again so will go for another test just before that.

Thanks for the advice guys. Will keep you posted.
Posted 6/3/2014 3:19 PM (GMT 0)
WOW! Great news. I'm really happy for you and hoping the drop continues.

Jim
Posted 6/3/2014 3:24 PM (GMT 0)
Thanks Jim !!!
Posted 1/7/2015 5:54 PM (GMT 0)
Hi,

Well, now I have no good news or it can be good news depending on the views I get.

My count started to climb again to 3.6 in September 2014 and to 4.77 in January 2015. Went to see my oncologist today who was quite concerned (although the count was relatively low, after brachy and after one bounce it should go down and not up) and he sent me for a bone and organ scan. Both came out to be negative on cancer - the bone scan picked up something different that we will address.

His view is now that it can be a second bounce as there are no evidence of any cancer spreading or contributing to the increased level in the PSA and that if the count increases again there is nothing we can do...........***?

Would appreciate any suggestions/comments

Marius
Posted 1/7/2015 8:03 PM (GMT 0)
Take a look at my stats.
Posted 1/7/2015 8:24 PM (GMT 0)
Bounces are common with seeds. It is also possible to get chronic prostatitis, which wreaks havoc with trying to read anything from the PSA. There is also a big difference between biochemical recurrence and clinical recurrence, which can be diagnosed with a biopsy (possibly mp-MRI targeted). If it should be a clinical recurrence, there are salvage options including focal salvage with more seeds, HDR brachy, SBRT or ablation.

- Allen
Posted 1/7/2015 11:55 PM (GMT 0)
Glad it went down and hope it keeps going down.
Posted 1/8/2015 9:37 AM (GMT 0)
Hi Maars,

Hang on in there. Look at Jeff’s PSA below which has been bouncing around the past 3 years. He has just had his 4 year blood draw and it is finally down to 1.06, his lowest reading so far. Agree with TA there could also be some prostatitis going on, something Jeff’s consultant suggested could be causing Jeff’s to bounce around when Jeff expressed concern about his PSA at his 3½ year follow up.

Keep a keen eye on it and let us know how you get on next test. We are all keeping everything crossed that you will see a good drop next time.

I am sure you know this already but do make sure you are observing the abstention of sex/bike riding etc for 3 days before your next PSA. Jeff had two blood tests a week apart a couple of years ago, one was for the PSA test, his second a week later was for something else but they happened to test for PSA too – the second test result where he hadn’t abstained came back 1 higher than the PSA test.

Wishing you all the best. Stay well.

Susan
x
Posted 1/9/2015 11:43 AM (GMT 0)
Thanks for the feedback. I just hate the uncertainty. Next test in 3 months time - let's see what it is then.
Posted 1/9/2015 12:46 PM (GMT 0)
It's interesting to me to read about how some experience a lot of anxiety while others (including me) don't. I might eventually get the same feelings, but nervousness about the PSA test isn't even in my top few concerns. And I guess that's why I didn't have the same desires to "get it out" as others have.

I could be abnormal for sure, and my wife would be right then, but I guess I'm sort of a 'take/get the results and deal with them'.

This isn't a criticism of anyone just a psychological observation I see; and I very well could be the outlier.
Posted 1/9/2015 3:42 PM (GMT 0)

Maars said...
Thanks for the feedback. I just hate the uncertainty. Next test in 3 months time - let's see what it is then.

Maars, I have not read every post in this thread so forgive me if this has already been covered. First, I don't know a whole lot about the course of PSA over the months and years after BT. But I have previously posted about some studies done on high dose Vit C combined with Vit K (100:1) and one of those studies used homocysteine as a tumor marker,along with PSA. They study's authors claimed that when PCa cells are being killed, they dump their PSA into the blood stream. And that with certain therapies where the PCa cells are dying at varying rates, it was not uncommon to see an increase in PSA from baseline, at least until the total numbers of PC producing cells dropped to a level low enough to over come the amount being dumped by the dying cells.

And sure enough, in their study, homocysteine dropped immediately and at a steady rate for however many weeks the study was for, while PSA increased for several weeks and then began dropping.

If it is true that dying PC cells dump PSA, then I would think it might be quite possible to see some increases at 1st and all along the way as PCa cells die of at varying rates. But then again, I don't really know what I am talking about, it's just a WAG! Just saw your post, and remembered this one study I read, and then thought it might possibly apply to some folks on certain therapies, like you. Unlike me, a surgery guy, for whom any increasing PSA- after my almost immediate drop to <.01, is very unlikely to mean any thing positive.
Posted 5/16/2017 2:53 PM (GMT 0)
Diagnosed aged 61 with 2 x 6 and 1x7 gleason scale tumors in October 2016. Had Brachytherapy 69 seeds implanted on January 12th this year. PSA at time of diagnosis 11.6. Latest PSA 2.9 . Have had problems with urinary retention since trearment. Had cathethers fitted twice and four courses of Valium 5mg plus my perscription for Tamsulosin has been extended for another month. Currently experiencing pain in the perineium. Has anyone else had simular experiences?
Posted 5/16/2017 4:13 PM (GMT 0)
winger,

Welsome. You attached your post to an old thread. If you want more people to see it and respond, start a new thread. Click on the button on top that says "+ Post New Topic," and give it a title like "Retention after brachytherapy."
Posted 5/16/2017 11:36 PM (GMT 0)
Maars: Age 46 and G6 should mean great results from BT. I have seen a lot of crazy bounces on this forum from other BT guys. I sincerely hope that your next PSA reading starts a permanent downward trend. Please keep us posted.
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