PSA Bounce?

Hi all,

I've went through 2 HDR, 33 IGRT and 6 months Lupron. It all ended with my last shot of Lupron on 08/21/2023

On 09/24/2023 - annual blood works with my primary care doctor psa: 0.52

On 12/04/2023 - first 3 months after treatment: 0.29

On 03/11/2024 - 6 months after treatment: 0.40

I supposed my last shot of lupron was 08/21/2023 should wear off by 03/24 and expecting psa be rise a bit.

My question is this look like a psa bounce?

Does 0.40 good indication or it should be less then 0?

My Doctor seem like not to concern about 0.40 from 0.29

Thanks for your input!

Post Edited (dave1803) : 3/14/2024 8:38:32 AM (GMT-8)

With radiation the target nadir is 0.50 and you were less, but somewhat influenced by the ADT. As Stephen says recurrence after radiation occurs when PSA equals nadir plus 2.0, so, for you 2.29. You are a considerable amount from that.

Is it a bounce? Could be. They usually occur between 18-36 months after treatment. The only way to know is to continue testing and develop a long term trend. If the PSA goes up and then reduces, it would indicate a bounce.

If the PSA continues to go up, it could be perfectly normal as you still have a prostate that is expected to express PSA. It could indicate inflammation from the radiation or it could indicate PCa that was not eradicated by the treatment. With any of this, the best course now is to continue testing and see what PSA does. If the trend is only up and approaches 2.0 I would be in favor of doing some scans looking for PCa. If the scans are negative and the PSA continues up then more scans and at some point potentially treatment.

I suggest you do what you are doing; test quarterly and discus the results with your PCa specialists, your radiation oncologist and urologist. I trust they are receiving the PSA test results. If you have a recurrence or are getting close, the PCa specialist will be the one to guide you.

Dave, since I have been off Orgovyx my PSA has gone up twice. The first PSA reading was .041, the second test was .074. My Uro was not worried with those results. However, his cut off to start looking again is a PSA reading of 1.5 not 2.0. He expected the PSA to rise after getting off ADT. Just keep getting your PSA checked and stay positive. My best wishes to you,
Jack

Generally after treatment physical pressures on the prostate do not affect the PSA in the way it might with an untreated prostate. Even then, the change is generally less than a 15% factor. Now you can bike, exercise and have all the sex you want without it significantly affecting your PSA expression.