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Triple play ADT , RT , HDR boost first PSA test post treatment

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Posted 4/15/2021 2:10 PM (GMT 0)
Hello
My first visit to site in some time, first PSA test after treatment. PSA 0.2 , T=627 my urologist said he thinks it’s high(last shot was 8/20)Then said, don’t worry now we’ll talk in four months. Trying to understand what he’s talking about. PLEASE HELP
Thanks
Posted 4/15/2021 3:30 PM (GMT 0)
Unless I'm missing something, this looks pretty good to me. You finished ADT last year and your PSA would be expected to rise at that point, which it did. But at 0.2, it's still really low--my doc told me he wouldn't start to get concerned unless it reached 0.5, which it never did. FYI, I also had the Triple Play and my PSA peaked at 0.20, before trailing down to 0.03, which is really low considering I still have a prostate.

Also, your testosterone number is incredible at 627. Mine took quite some time to recover and even then it only barely reached 300. Of course, mine was only in the 364 range before I started.

In general, this looks pretty good and when you get a few more post-ADT PSA tests under your belt, you'll see what the pattern is and get a better idea of how you're doing overall.
Posted 4/15/2021 4:54 PM (GMT 0)
Hello Michael thanks for your response, I thought the same thing, considering where I started. I’m pretty sure my urologist thinks I had my prostate removed. Sad because I’ve been going there for about 2 years, I had to stop them from giving Lupron after 36 months because he thought I was palliative treatment even though I told him every time I talked to him, the comment was “he’s refusing the treatment. I said “well if you know of a treatment that requires more than 36 months I’ll be glad to take it” of course they got me right out there. He’s probably angling to attempt to put me back on Lupron.SAD
Posted 4/15/2021 9:14 PM (GMT 0)
That's an excellent result (T and PSA) for a 'triple play' patient;
maybe your urologist should take some time off to regain his medical acumen.
Posted 4/15/2021 11:05 PM (GMT 0)
Thanks for your response
Yes that’s what I thought but my urologist is over 70 years old and probably is not up on newer treatments. I’m definitely looking for a new urologist.
Posted 4/16/2021 10:38 AM (GMT 0)
Get a new doctor. Did he mean the PSA is too high or the Testosterone?
Posted 4/16/2021 11:08 AM (GMT 0)

JNF said...
Get a new doctor. Did he mean the PSA is too high or the Testosterone

Thats what I thought as well.
Posted 4/16/2021 12:25 PM (GMT 0)
Can you send your Uro a message via MyChart? Ask him what he meant?
Posted 4/16/2021 1:34 PM (GMT 0)
Thanks for your response
Yes, he said my PSA was too high I don’t think he cares about the Testosterone. I actually chose my treatment based on advice from this site. Michael _T , JNF , Tall Allen , at the shop and many others I was horrified by my diagnosis and was scheduled for RRP surgery but the wait time was over 3 months. In that time I came across this amazing site.When they called to schedule my surgery I said I’ll elect the tri-modal approach. I know everyone’s case is different and my journey is just beginning but I don’t know where I would be without you guys! I believe this place saved my life or at least extended it.
Thank You 🙏
Posted 4/16/2021 1:44 PM (GMT 0)
Duck2 thanks for your response,
No, I don’t have no way to communicate with my urologist . I’v basically been on my own, been so from the beginning , except for the advice I received from this site no one was telling me the whole truth.
Posted 4/16/2021 2:45 PM (GMT 0)
I did not get radiation, but my understanding of things if your primary treatment was radiation is that a recurrence is officially defined as your lowest PSA after treatment plus 2.0. You still have a prostate so you would expect some PSA

For those that had their prostates removed it is 0.2 or higher, although many take action long before they reach 0.2.
Posted 4/16/2021 3:36 PM (GMT 0)

Stephen S said...
I did not get radiation, but my understanding of things if your primary treatment was radiation is that a recurrence is officially defined as your lowest PSA after treatment plus 2.0. You still have a prostate so you would expect some PSA

For those that had their prostates removed it is 0.2 or higher, although many take action long before they reach 0.2.

Just to clarify, the phoenix definition (a PSA 2 ng/mL above one's post-RT PSA nadir) refers to biochemical failure, not clinical recurrence, and a PSA of 0.2 ng/mL and still rising after an undetectable post-RP PSA refers to biochemical recurrence (BCR) -- also not clinical recurrence. Only a portion of men with BCR go on to clinical recurrence; although many choose to have salvage therapy to prevent it.

See also Biochemical recurrence after radical prostatectomy: what does it mean? (2018. Review, Full Text)

Djin
Posted 4/16/2021 5:06 PM (GMT 0)
Since you still have some of your prostate and it may be somewhat functioning, you should expect to have some PSA. The first objective of radiotherapy is to get the PSA under 0.5, which you have done, since there is no longer any effect of the ADT left.

Stay calm, test every three months and look for a trend. Your one test result of 0.20, in and of itself, is relatively meaningless. You have to see a trend establish to determine anything. For a while I strongly suggest quarterly testing.
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