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Is this a good result for first post-radiation PSA?

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Posted 1/18/2016 11:25 PM (GMT 0)
DH finished 44 sessions of radiation one month ago -- right before xmas. Today was his first PSA since. It came in at 0.9.

The oncologist said (of course) the next PSA will tell us far more. But I'm wondering if this was a good first number for a G9? His last PSA was 9.1 (before Casodex, Lupron and IMRT).

FYI, this is also his first PSA since starting Lupron at the beginning of October.

Knowing that radiation takes a while for full effect, is there still a chance he could go undectable?
Posted 1/19/2016 12:48 AM (GMT 0)
That is a pretty good drop, but ideally you will want to find a low point (nadir) that is undetectable (<.1). That will show the ADT is working. It takes a coupe of years for the radiation to get the cancer taken care as measured by PSA. But since you are on ADT (and had chemo) it works more quickly than the radiation. Thus, you really can't measure the success of the radiation in the short run. You are now looking at getting to an undetectable PSA and then staying there. How long do you expect to stay on Lupron?
Posted 1/19/2016 12:56 AM (GMT 0)
Had a psa 3 weeks after 39 radiation treatments, it was 1.98, today after 3 months dropped to 1.18. Dr was very happy, try in another 3 months.....I do take 1000mg a day of Ginger Root and Tumeric.....not sure if it helps but still going to take them.....
Posted 1/19/2016 1:05 AM (GMT 0)
I agree with JNF...right now the number reflects that his HT is working. (In fact, I was told that radiation temporarily stirs up the PSA and I didn't actually have PSA tests until three months after I had finished the radiation.) This is a good PSA number, but unfortunately doesn't tell you much about the radiation at this point.

The fact that your husband had a clean bone scan and you're treating aggressively is certainly good. Hope he (and by extension, you) are tolerating the HT okay!
Posted 1/19/2016 1:26 AM (GMT 0)
Thanks guys.

JNF -- We were thinking of staying on adt 18 months and then seeing what happens.

This makes me wonder how long it will take for the psa to reflect the radiation.

Michael -- HT is going better than we thought it would. What was your psa at 3 month point?
Posted 1/19/2016 1:56 AM (GMT 0)
Just looked it up: three months after my IMRT (I also had HDR brachy), my PSA was 0.09. By that time, I had been on HT for six months. Six months after my radiation and throughout the balance of my HT it was either 0.01 or 0.02.

After I finished my HT over the next six months it rose to 0.15 and it has remained stable there for the past year. My oncologist told me he wanted it to stay below 0.5 and so far so good.

I would guess that your husband's will continue to go down after everything that has been stirred up by the radiation subsides.
Posted 1/19/2016 2:37 AM (GMT 0)
As long as he is hormone sensitive his PSA should be undetectable. Once he comes off ADT you will see how successful the initial treatment has been. If the PSA starts back up you will know that cancer was all ready outside the radiation area. Then he will look at further ADT or Provenge, etc. Of course we are hoping he has a long and durable remission with no additional treatment.

I am five years out from my initial radiation treatment and two years off ADT. So far I am still undetectable. I have always thought my risk of recurrence will be in the 7-10 year range. Compared to your husband I had a lower G but much higher PSA.

It looks like to me he is off to a good start and the aggressive initial treatment is suitable for his risk level.
Posted 1/19/2016 1:51 PM (GMT 0)
Here's my husband's signature showing all PSA tests. He finished radiation in June, 2015. The docs semi discounted the very first PSA after radiation since it was too soon.
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