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PSA After SBRT

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Posted 7/23/2018 3:37 PM (GMT 0)
After an year of SBRT, the latest 2 PSAs are 3.3, 2.2. 2.43, 3.74.
MY RO said... continue to watch the trend.
Should I ask him to order scans?
Thanks!
Posted 7/23/2018 3:57 PM (GMT 0)
No. Scans won't tell you anything. Read this instead:

/pcnrv.blogspot.com/2018/03/bounces-after-primary-radiation-therapy.html
Posted 7/23/2018 4:21 PM (GMT 0)
Thank you so much Mr. Allen,
Now, I understand why scans are no telling.
The accurate PSAs:

8/17/17 11/14/17 2/9/18 4/30/18 6/13/18 7/23/18
4.33 2.73 2.60 2.09 2.43 3.74

Should I just wait until another PSA test?
Posted 7/23/2018 6:20 PM (GMT 0)
Yes, or get one in three or six months. Just my opinion, but you don't need to do one on a monthly basis.
I know, it's hard to relax. I am not immune, having had SBRT etc.
Posted 7/23/2018 11:28 PM (GMT 0)
//
Posted 7/23/2018 11:48 PM (GMT 0)
I agree with Sr Sailor- every 3 months is more than enough. Watching it too closely serves no useful purpose and increases anxiety. You are in this for the long term.
Posted 7/24/2018 1:09 AM (GMT 0)
Thank you very very much Mr. Allen and Sr. Sailor for the great advice!
Posted 7/24/2018 2:09 AM (GMT 0)
Hello j , it can be a roller coaster . You have to take the ride . I had a few bounces along the way . You will be fine . SemperFi , John
Posted 7/24/2018 3:17 AM (GMT 0)
get testing every six months and enjoy life more.
Posted 7/25/2018 3:43 PM (GMT 0)
I also realized that there are two PSA testing systems: one is WHS standard, the other is used by my RO.

My family Dr uses WHS system, so the PSA is about ~20% lower than the other.
but the normal range is still defined as 0-4.
Have you experienced this?
Posted 7/25/2018 4:08 PM (GMT 0)
The assay used for the PSA test does differ between labs. Not everyone uses the same. That's why the recommendation is to get all your tests from the same lab. It's one of the possible variability in the test results.

Andrew
Posted 7/25/2018 5:35 PM (GMT 0)
But why the normal range is defined as 0-4 same for both systems?
My latest is 3.74, compared to 2.43 a month ago.
did it bounce too much?
Posted 7/25/2018 5:46 PM (GMT 0)
That range is for men without PC - above 4.0 many doctors would recommend investing prostate problems. Doesn't really apply to you.

You're still kind of close to treatment to be too worried about the numbers bounce around. It is a large bounce, but I think you'd need one more data point before getting too concerned. Lots of reasons for an out of band reading - could be a bad test. Retest in a few months too see.

Andrew
Posted 7/26/2018 6:44 PM (GMT 0)
I too am a little more than a year post SBRT treatment and my post PSA’s continue to drop with checks every three months. At my post treatment check ups with Cleveland Clinic the focus appears to be on the trend rather than the absolute values. I would also mention that some of the variations I’ve experienced in PSA values where lab related.

For some of the experts out there I wonder if PSA values post RT are related to the size of one’s prostate. Does a larger prostate post RT generate a larger volume of PSA even after being toasted?
Posted 7/26/2018 10:49 PM (GMT 0)
For some of the experts out there I wonder if PSA values post RT are related to the size of one’s prostate. Does a larger prostate post RT generate a larger volume of PSA even after being toasted?

I asked my RO this question following my treatment since my prostate was 55 grams pre treatment. I knew that before treatment the prostate size is definitely related to PSA values. His answer was that after treatment there was no correlation to PSA and prostate size. His explanation left me wanting more detail, so I asked on HW when I returned from treatment.

Here's TA's response to that question:

The reason the enlarged prostate puts out more PSA is that BPH makes the prostate cells leaky. BPH is fixed by the radiation, at least to the extent that the cells don't leak much PSA anymore.
Posted 7/27/2018 2:52 AM (GMT 0)
visited with my Urologist today and he said he needs more data to know the trend of the bounce.
I just have to wait until the next PSA check.
Its been a year now since SBRT. I am still experiencing urgency, frequency, not-complete of my urine. Taking FloMax (x2), Vesicare (10mg) daily.
Posted 7/27/2018 1:42 PM (GMT 0)
Waiting and dealing with the uncertainty is a hard part of the PC thing.

Hang in there,
Andrew
Posted 7/27/2018 10:03 PM (GMT 0)
Jon - I'm about 17 months post-SBRT, and my PSA is all over the map, too. As long as the general trend is downward and there is no return to upward trend, my RO and I are fine just hanging along for the ride. It may be a couple more years before mine settles down, so it is way too early to worry about it.
Posted 7/27/2018 11:23 PM (GMT 0)
Dear Paxton,
Will you share with me your post SBRT, PSA values?
You can see that many I had a good downward trend ,
then went up in the last 2 tests.
Thank you!
Posted 7/17/2019 3:24 PM (GMT 0)
After 2 years of SBRT,
1-month:4.33, 4-month:2.73, 7-month:2.60, 9.5-month: 2.09,
11-month: 2.43, 12-month: 3.74; 15-month: 1.42, 18-month:1.07
20-month: 1.35, 23-month: 0.74; 25-month: 1.26

PSAs are bouncing around... is it something I should be concerned?
RO just said: keeping watching the trend.
Thank you!
Posted 7/17/2019 3:34 PM (GMT 0)
PSA post RT is bouncy. Just watch the over all trend. Recurrence post RT is considered 2 + nadir. In your case, 2.74 so as long as you're below that you're golden.

It can take years for it to hit its final low.

so don't worry and go enjoy life.

Andrew
Posted 7/17/2019 3:35 PM (GMT 0)
I agree with your RO...keeping watching the results. Also, be aware of the rule-of-thumb that says never act as a result of just a single unexpected PSA test result.

Furthermore, be aware that D'Amico published a study about 10-years ago that said about 30% of 'so-called' radiation bounces were actually a result of the patient ejaculating within a short period prior to PSA testing, or proctitis. Ejaculation (or other activities in the patient's control which may raise PSA) before PSA testing no longer matters for surgically (RP) treated men, but does affect men who still have their prostates.
Posted 7/18/2019 1:19 AM (GMT 0)
Thank you so much for your advises. Blackjack & InTheShop.
two years after SBRT, can I run my PSA check every 6-month instead of 3-month?
Posted 7/18/2019 4:41 AM (GMT 0)
Yes. Testing every three months is a bit much in your case, but it's up to you.

Personally I did every six months for years.

Andrew
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