PSA levels, post-SBRT

Hello all,
I had SBRT treatment in August 2020, 36.25gy over 5 sessions. I did 4 months of Lupron beginning two months before, with a total dose of 50mg.
My first PSA test was in November of 2020 and the result was 0.15, but I was told that that could be partly influenced by the remnants of Lupron in my system. 3 months later (February 2021) my PSA was 0.64, and then 3 months after that (May 2021) it was 0.94.
This concerned my urologist, who advised me to have another blood draw in mid June. That's fine by me, I'm all for more data points, but I reached out to a RO in my health plan to get his opinion (my original RO is no long with Kaiser). He felt that it is still too early to be concerned with those numbers, and said that as long as I didn't see test results above 2.0 then all was good. He said that it normally takes between 12 and 18 months for readings to stabilize post-SBRT.
From everything I've read on this forum, test results can be a bumpy ride post-treatment so I'm comfortable just riding it out and waiting for more data. However, I'm hoping to get opinions from some of the other Post-Toasties out there on these numbers? Thanks.

I agree with JNF and your radiation oncologist(s).
Most likely your results are not worrisome, but getting more data (every three months is standard) will help to see if the treatment was successful.
I had SBRT as part of my therapy and the PSA has bounced around; perhaps it has stabilized by now, but one can never be sure.

Post-radiation PSA criteria is defined by the Phoenix Definition, which states that biochemical recurrence exists when your PSA is two points higher than your nadir,

Google “prostate Phoenix Definition” for details.

Bob…Steady as you go. My SBRT was a monotherapy so no complications with ADT. My PSA ride has been a little bouncy. I have no knowledge of how the ADT might effect PSA regarding normal bounce. My RA says about a third of his patients experience a bounce. Best wishes going forward. Terry

Hello, PDXBob ~~~

You are doing a good job of tracking your PSA data, following your radiation treatments.

Following my radiation treatments (9 week series of treatments = 45 treatments), my radiologist and oncologist emphasized that I could expect PSA fluctuations --- characterized by upticks and downturns in PSA.

I called this phenomenon "the little roller coaster ride" & my doctors felt that was an apt description!

They emphasized that fluctuations are to be expected ---- and that they would watch for TRENDS. They really coached me on the difference between fluctuations vs. trends.

You're remaining vigilant --- you have consulted with your medical team --- and you and your doctors have had insightful conversations.

One thing I do --- I reflect carefully on forward-looking questions to discuss each time with my doctors, each time.

I see my oncologist each month --- and a meaningful rapport has developed.
He watches over every aspect of my healthcare plan --- and I appreciate his insight and compassion.

Stay the course --- continue visiting the lab on a consistent basis --- keep track of your data --- stay in close contact with your medical team --- and please keep us posted!

Continue to check in --- remain VIGILANT --- and let us know how you're faring!

CYCLONE ~~~ # Iowa State University

I received the result of my latest PSA test: 2.91.
In a conversation with my urologist back in May, he felt that because of the ADT waning off, my real nadir was probably between the .64 and .94 test results, so it appears that this number would represent nadir +2, which is worrisome. I haven't yet talked with him about these results. Seems too high to be a bounce. Opinions?

Thanks Terry, I always appreciate your replies, and have looked at your signature many times as what to expect if a bounce occurs. Let's hope this is what that is. Come to think of it, I had been commuting on my bike most of the week before the test. I did message my urologist this morning requesting another blood draw in one month.
Thanks for the tip on contacting the CC. I'm curious as to why they view your nadir as 2.3 when it's been as low as 0.3?

Thanks Terry, reading your words have really helped my state of mind (and my wife's!).
Ever since this started, and especially after choosing SBRT, I've been telling myself that I'm in it for the long haul, so I guess that this is just part of that road.

Bob, PCa can be a marathon for sure…trending in the right direction is great news. How have the side effects of treatment been for you? At my last virtual visit with CCI they said to consider myself ‘cured’ of PCa and moved my followup PSA checks to once a year. Terry