Radiation Patients Time to Nadir

Hi Folks:

We have had a couple of threads lately asking about the timing of PSA declines after primary radiation treatment. So, I'm just curious about how long it has taken us to get to our PSA nadir. Mine was 6 years! Anyway, please complete the poll if you are so inclined. Round to the nearest year. Happy Sunday!

Jim

Gary, the poll cannot be edited and there were only 6 options anyway. If you have interest in a post-surgery poll it's probably a good idea to start a separate one....since that info is likely to be measured in months rather than years like us radiation guys.

Jim

Tudpock18 said...
....since that info is likely to be measured in months rather than years like us radiation guys.
Jim

Really

Post surgery radiation nadir is most likely months, not years???

That's news to me!

This should be limited to only those that used radiation not surgery. Surgery teaches a nadir within about 90 days by definition. SRT following a failed surgery does not apply here and will only confuse the radiation men who have an interest in this.

Additionally it should exclude men like me that also used a long term of ADT. The drugs knock the PSA to undetectable in about 90 days. This completely masks the results of the radiation and including it here again will add confusion and bad data.

Mine's probably around 4-1/2 years. Once ADT released at 3 years, my PSA went up quickly to 0.8 over a few months, but has slowly been settling since. I think what happened was a quick recovery to the post-radiation trend line that would have happened without ADT.

Since last summer it has been very slowly declining, to 0.6 in Jan 2018. In April, I'm expecting maybe 0.5 if the trend holds. This is just fine, as it's the durable remission zone we were expecting at the outset. With luck, this could hold for a long time.

Radiation therapy is not for the impatient!

Garyi,

When the prostate is removed there is no further PSA expression unless cancer or some prostatic tissue was left behind. With the half life of PSA in the blood stream being about 5 days (as I remember) , the PSA should be undetectable within 90 days if all the prostate and cancer was removed. Undetectable would clearly be a nadir. That is why 90 days is the standard for the first post-surgical PSA test. If PSA is detectable at that point it is indicative the surgery was probably not successful and additional treatment may be needed. It may be the nadir has been reached and PSA will start increasing as we have seen with many men on this board who had unsuccessful surgeries.

Remember the nadir is the low point. Some never reach undetectable PSA as their nadir. Some reach it, but than suffer recurrence as PSA starts rising. So using surgery most men should reach that low point in a few months since the prostate is gone and hopefully all the cancer with it. With radiation, the prostate is intact will often continue to express PSA. We have discussed how the radiation kills the PCa over time and thus there will continue to be PSA expression until this process is complete. That can take years, never months. Just the opposite of surgery.

Again, this poll is for radiation as a primary treatment. It should not include anyone that used surgery. That SRT may also have been used is irrelevant to this poll and will only distort the results and confuse the men who used radiation as their primary treatment.

Radiation therapy is not for the impatient!

Red Winged One........You got that correct. And I've only just begun the "wait" and can't stand it some times already!

I'm concerned what to think about where my nadir should land considering I have Very high risk -low PSA producing PC.

I agree with Redwing, this is not for the impatient. I was on Eligard for 28 months. I had the last shot almost three years ago. PSA is always <.05 which is great. Problem is my T score is only 35 as of last week. I am doing ok with the low T, but a little concerned. MO keeps telling me I am cured. So that is what counts and I like that.


Best wishes everyone

Carl