We're calling this a Bounce. . .

Well, I just got back my 14-month PSA results. Here's the history:

Pre TX 5.69
3 mos 4.75
6 mos 3.03
9 mos 2.86
11 mos 2.15
14 mos 3.02

When I got the results, I had a detailed conversation with my RO (Dr. Arica Hirsch). She was quite impressed that I was already thinking as she was. I am not going to be one of those patients whose PSA drops like a rock immediately after treatment. Mine is going to be a long-term recovery, and may be a bumpy ride along the way. Part of this is simply the luck of the draw, and part of the "noise" in my numbers may be related to the fact that I have remained on TRT before, during and since treatment.

Dr. Hirsch and I are on the same page in that we will not strongly react to either the slope of my trend line or any single reading. We are assessing the long-term trend, and as long as that is downward with no lasting reversal, we will stay the course.

Doc was also impressed that I was aware of the research (thanks to TA) showing that slower PSA declines and PSA bumps among radiotherapy patients seems to bode well for better for long-term outcomes.

All of this, along with my relatively low-risk initial biopsy results allows me to remain calm and accept this as a bounce, with a re-test scheduled in 3 more months.

Until then, I'm just. . . Stayin' the course.

Level-headed and well-reasoned as always, Paxton!

Paxton, sounds like you and Dr. H are approaching this is a sensible manner. I'm sure she knows what she is doing with 3 month PSA checks but I suspect such frequent testing can lead to seeing the bounces and, for some people, worrying about them. I didn't know any better but my doctors (uro and RO) did a PSA test at 6 months, another at one year and then annually thereafter. It may be that I had some bounces and never know about them. And, if you had a similar testing schedule you would be seeing 5.69 to 3.03 to 2.15 (11 months) and would be as fat, dumb and happy as I was with this reduced schedule!

Anyway, I'm sure all is fine and time to nadir may be a long stretch...mine was 6 years to nadir!

All the best,

Jim

I have been reading a lot in the past few days about bounces after RT since I have had two now. Everything I read would strongly suggests your increase is a classic bounce. The timing and magnitude of the increase are both right in line with the findings I have seen.

For those of us who have had a bounce(s), the main concern is this increase a bounce or an early indicator of disease recurrence. Is there a way to distinguish between a bounce and the beginning of a recurrence? Some studies suggest the interval to occurrence and the magnitude of the elevation offer some clues to help answer this question.

My 2nd bounce comes at 3 years post treatment—problematic if I am to believe the studies I have read recently.