Question On Post Radiation PSA

I'm approaching a year since my HDR treatment and wondering about post treatment PSA levels.

Just prior to treatment my measured PSA was about 3.5 (though a TRUE level would've been higher, since the Finasteride I was on lowered the measured level). I was a 61 yr old guy, but 61 yr old guys without Pca will often have some benign prostate enlargement and PSA's say above 1. So some of that PSA number is not attributable to Pca, and my radiation treatment I assume does not address that. So all things going well, say a couple of years after treatment when hopefully all bad cells have died out, my PSA will reach a nadir (hopefully not to rise again). But I will still have a prostate and there will be a measurable PSA (and likely not something as low as the 0.0x's the post surgery patients may have).

So if I nadir out at say 1.0, but stay around there with repeated tests over time, is that considered good? The trend being more important than the actual number?

sounds like you're doing just fine. Takes awhile to get to nadir. I am four years out and am likely at nadir.

Andrew

Sorry, I do not understand. Both replies refer to PSA reducing after treatment, but the last PSA listed is 2/15, before treatment?

H-G-

You are right - I misread. I thought the OP was saying his PSA started at 3.5 and had so far reached 1.0 about a year after his treatment. But re-reading, I see he was using 1.0 as a hypothetical number.

Works Out - what is your PSA history since treatment (update your signature!)?

- Allen

Bob-
The nadir I spoke of applies only to guys who have had primary RT, and not to guys like you who have had primary RP. After RP, we want the nadir to ideally be undetectable.

Adjuvant ADT can lower PSA to undetectable levels, so we have to wait for testosterone levels to rise again before we can assess whether the treatment was effective. Or if PSA doesn't ever become undetectable even with adjuvant ADT, that may indicate that some castrate-resistant cells are in there, and it's possible that salvage radiation can kill them over time.

- Allen

It can take years for cancer cells that received lethal doses of radiation to give up the ghost. ADT can help radiation do that. This makes biochemical failure after salvage radiation harder to define in cases where there was significant post-surgical PSA. In a study I just looked at, they used 2 consecutive PSA measurements ≥ 0.5 ng/mL as the definition of a biochemical failure after salvage radiation. In your case, it really doesn't matter because curative treatment options are exhausted.

I can't comment on the article in the new prostate cancer infolink because I don't know which use of ADT the author was referring to (there are several different uses for ADT). Can you provide a link?

- Allen

Trying again to post with corrected date for last PSA of 2/16