Bump

I know; it sucks. They're reportedly a good thing but as far as I'm concerned it's never a good thing when PSA goes up. We don't really know it was a bump unless PSA falls again. It's the meantime that gets to us bumpers.

Your increase does look like the classic bump though. Right on time and the right amount of increase.

I suspect many surgery guys still get a little anxious too when they have their PSA tested. No matter what we do we still have the specter of rising PSA to deal with.

The post radiation bump or bounce is a good thing and is a positive predictor of treatment success. It is basically a lot of the PCa cells giving up their last bit of life together. You should really welcome the bump/bounce.

JNF said...
It is basically a lot of the PCa cells giving up their last bit of life together. You should really welcome the bump/bounce.

I'm afraid that's just speculation. In all the studies I've read on bounces I dont think I've ever seen that discussed as a possible cause, only here on HW. If there is a paper on it, I'd sure like to read it. What I have read says the cause of the PSA bounce is unknown, but the timing of its occurrence suggests that it may be related to inflammation from a late radiation reaction. Of course those of us who have a history of chronic prostatitis can always have a flare up and temporary increase.

hrpufnstuf-
The list of reasons for bounces are pulled from various research studies. To review:

• Prostatitis - either pre-existing, arising after invasive procedures (e.g., biopsy, fiducial placement, or brachytherapy), or induced by radiation.

• Immune infiltration: after radiation releases cancer antigens, T cells are activated to eventually attack the remaining cancer in the prostate.

• Cancer cells that have been dormant, eventually emerge and undergo "mitotic catastrophe."

• Delayed apoptosis (cell death) among late-responding healthy cells

• PSA drops most sharply and consistently in more aggressive cancers because radiation kills the most rapidly dividing cells first.

• PSA measurement variation (e.g., different test kits, different labs, natural fluctuations)

These are all reasonable speculations on the part of researchers (You can buy the full text of the articles I cited to read their theories). But what is undeniable is the correlation between bounces and success of RT:

/pcnrv.blogspot.com/2018/03/bounces-after-primary-radiation-therapy.html

Age may also play a factor in who gets to bounce:
https://www.sciencedirect.com/science/article/pii/S2214388216000023

There seems to be an equal amount of studies saying bounce is good prognosticator, not so good, about the same as no bounces, etc. I suspect some of us look until we find the study that makes us feel less worried and hope it is up to date with a very large test group.

Pratoman said...
a "little" anxious?

Speaking of which...

Ha! Yes, despite science, evidence, theories, etc - the feelings are real and explaining things doesn't always make you feel better.

Some times the best answers is, "yup, it sucks."

Andrew

browntrout said...
There seems to be an equal amount of studies saying bounce is good prognosticator, not so good, about the same as no bounces, etc.

Would you be kind enough to show me any of those that say it "not so good, about the same as no bounces"?

TA: Here is one: http://www.aboutcancer.com/psa_bounce_0108.htm
If you will recall you and Yooper had this debate some years ago with both of you presenting about equal amounts of intel. My post was designed to give both sides of the isle hope and no more.

This contrasts with the findings of Hanlon who found that patients developing a bounce had a significantly lower biochemical disease-free rate (47%) compared with those who did not (66%).

Am I missing something?

I am sorry you can not recall A Yooper's rebuttal. It was akin to dual of the Titans where I learned a lot from both of some of the Forum's very best.

When we read that bounce is a favorable prognosticator on this forum it makes those of us who did not have bounces quite worried as I stated in my post. I, and I suspect many others, begin to research for signs of hope.

I want to believe that both bouncers and non-bouncers will have favorable outcomes. I have encouraged many posters not to be worried about bounce as did "A Yooper". Here is a piece from another study:

But the study showed no significant difference in success rates among patients who had a bounce and those who did not. Among its findings:

Of the men given external beam radiation therapy, 67.5% who had a bounce were alive at 10 years vs. 64.5% of those who did not have a bounce. Cancer recurrence was similar in both groups.
Of patients given seed implants, 66.3% who had a bounce were alive at 10 years vs. 62.5% of those who did not have a bounce. Again, cancer recurrence was comparable in the two groups.

The chance of cancer spreading elsewhere was also similar in both groups.

browntrout-
I don't know what you're quoting because you didn't provide a source- if it was from the days before dose escalation, it's very likely that bounces were prognostic of failure back then - in fact, many people failed RT back then - it was considered appropriate only for older men who didn't have long to live. Using outdated info helps no one.

searching - I tend to see my post-treatment PSA variation as just that -- variation. My RO and I agree that as long as we do not see a turn-around and upward trend forming, we are just going to let our bets ride and watch the game unfold.

I have enough other medical "conditions" to monitor that I don't need another one to panic about.