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Post SBRT -Should I be concerned ?

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Posted 12/9/2017 1:30 PM (GMT 0)
Without going into too much detail I had a PSA of 7 and was a Gleason 3+4.
Chose SBRT with Dr Zelefsky at MSKCC.
Completed tx the end of Feb. 2017.
First PSA 06/2017 - 2.13
Repeat PSA 12/2017 - 2.44

Have a follow-up appt with Dr Z on Monday but I'm concerned that the latest PSA is not lower than the reading in June.

Thoughts ?
Posted 12/9/2017 1:35 PM (GMT 0)
It could be a bounce, a temporary rise in PSA. about 36% of the patients experience this bounce at some time after SBRT.

George

Prostate specific antigen kinetics following robotic stereotactic body radiotherapy for localized prostate cancer

Post Edited (George_) : 12/9/2017 6:53:25 AM (GMT-7)

Posted 12/9/2017 2:27 PM (GMT 0)
It is my understanding that an occasional "bounce" along the way to your nadir is quite common and generally to be expected. A trend in the wrong direction might be cause for concern, but you certainly do not have that at this time. I notice you seem to be testing on a six month basis. I finished SBRT 5 months behind you and have been advised to have the PSA done at least for a while at 3 month intervals. In any event, you will need to be tested again and my guess is that your PSA will then be headed back down again. Nothing much you can do about the PSA concern except to try to ignore it and just enjoy life. I suppose Dr. Zelefsky might not be opposed to your next PSA test at the three month point rather than six. Call and find out. In the meantime, try not to think about it much because it likely is nothing more than a typical and pretty predictable "bounce". Just part of the SBRT "experience". I wish you the best.
Posted 12/9/2017 3:37 PM (GMT 0)
I have my follow-up appointment this Monday and will wait to hear what he says. I am sure you are correct about the "bounce" but wanted to hear what others think since your mind can play tricks on you.
Posted 12/9/2017 3:57 PM (GMT 0)
I am still testing on a 3-month interval. (RO says 6 months is fine, but I just want to watch more closely). I have not yet experienced a true bounce, but I did have one case in which two consecutive readings were almost the same. We didn't do anything except test again in another 3 months, and the next time I had another significant drop.

My RO and I are in agreement that we are watching the trend over the next few years, and will not let any single test bother us too much, as long as the result is not crazy off the charts. Radiation is a long term process.
Posted 12/9/2017 6:35 PM (GMT 0)
Learn to love your bounces (the alternative is to drive yourself crazy). I think of them as cancer cells dying.

And it may be because you are such a stud:

/pcnrv.blogspot.com/2016/08/another-reason-to-love-your-bounces_30.html
Posted 12/9/2017 8:43 PM (GMT 0)
Very interesting observation and thank you for sharing......this just what I needed to get me through the weekend smile
Posted 12/9/2017 9:45 PM (GMT 0)
Feeling bounce envy.

Tall Allen said...
Learn to love your bounces (the alternative is to drive yourself crazy). I think of them as cancer cells dying.

And it may be because you are such a stud:

/pcnrv.blogspot.com/2016/08/another-reason-to-love-your-bounces_30.html

Posted 12/10/2017 1:23 AM (GMT 0)
Well TA I was going to compliment you on your turn to the humorous.........But after reading the link you posted I see once again you are spot on with the studies and stats.
Posted 12/12/2017 11:56 AM (GMT 0)
Saw Dr Z for my follow-up visit yesterday and he was not alarmed at the "bounce" that I experienced. He stated that 40% of patients will experience this.
He wants me to retake the PSA in 3 months and will continue with 3 month checks at this time.
I'm glad that he wasn't overly concerned but I find myself feeling very anxious going into the holiday season.
Posted 12/12/2017 2:11 PM (GMT 0)
It's hard when we bounce. I was freaked out no matter what anyone said.
Posted 12/12/2017 4:34 PM (GMT 0)
Hello Bosco , ive had 2 bounces and yes I was bothered by that. My Ro said not to worry. I was on a 3 month psa draw but even after my last bounce she said lets go to 6 months. Its a waiting game ,so dont fret ,enjoy the season and enjoy your family. SemperFi,john
Posted 12/12/2017 7:12 PM (GMT 0)
Hi 0311- thanks for the confirmation and words of encouragement....happy holidays to you and yours as well !
Posted 3/17/2018 11:55 AM (GMT 0)
Hello again -

Wanted to post regarding the repeat PSA I just had done this week.
It is 3 months from my last PSA and 1 year from completion of my SBRT.
I am happy to report that it has gone down to 1.66
History has been 7.0 > 2.13 > 2.44 > 1.66.
Thanks for all the previous words of encouragement.
Hopeful that the downward trend will continue.
Posted 3/17/2018 6:00 PM (GMT 0)
Bosco-

You may be interested in the thread I started about bounces.

https://www.healingwell.com/community/default.aspx?f=35&m=3990423
Posted 3/18/2018 2:38 PM (GMT 0)
be like Tigger - he loves to bounce.
Posted 3/18/2018 3:39 PM (GMT 0)
Boinnng!
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