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Posted 3/15/2024 5:45 PM (GMT 0)
Hi

I thought I would start a new thread on my resutls since the"update" thread I had been using was getting cluttered.

anyhow had my latest draw this morning, lab is Nordx and the std PSA test.

The results showed an increase from 0.22 4/2023, my Nadir to 0.364 3/2024 today, about a year apart. Note I did not have ADT in my treatment.

Have any of the folks who had radiation as primary treatment, had some fluctuation in their PSA 4 or 5 yrs out or more. I dont have a feel for the kinetics of PSA as time increases, will it always trend down or is there some fluctuation due to lab accuracy/repeatability, still having a prostate etc.

I will discuss with my GP and ask to contact my RO for comment, I am guessing they wont be too concerned. I will push up my next test to this fall at 6 month out to see if there is a trend or not.

I posted earlier in the "update" thread I created a few yrs back, sorry for the repeat but though breaking it out in a new thread would get more responses than the old one.

Hi

I just had my yearly PSA, I was at .22 ng/ml last year 4/2023 which is my nadir. Was at .36ng/ml 7/2022 9 months before.

Had the blood draw this morning and results climbed to .364 ng/ml for 3/2024. So increase sad
My RO went out of the picture after I got below 1.0 at the end of 2020 and told me to monitor the PSA thru my GP, which I have done. I dont know wether to be concerned and other than talk to my GP and perhaps retest in the fall at 6 month out, not sure what else to do other than look to see if there will be a trend upward or not.

I knew that at some point the readings would fluctuate, was just hoping it would of continued down. I really dont have a feel for what others see who have had similiar treatements. Note I did not have ADT, just the HDR and IMRT.

have other folks on here who have had some form of radiation had fluctuations or once it stops going down, it will just t rend up??

Not sure if my bio will show in the post but results/history: HDR Boost, 2 9.5Gy fractions 12/17, 25 fractions 1.8GY for 45GY IMRT finished 2/18. Gleason 3+4 with 10% 4, PSA 8.1 pre treatment, T2A, Post Treatment: 6.9 +3 months, 2.7 +9 months, 1.24 + 1 yr 9mo 11/21, 0.95 + 2yr 9Mo 11/20, 0.55 +3yr 10mo 12/21, 0.36 +4yr 6mo 7/2022, 0.22 +5yr 1mo 4/2023 Nadir, 0.364 +6yr 3/2024
Posted 3/15/2024 6:46 PM (GMT 0)
It is very usual for some fluctuation particularly when you use the thee decimal test. Most men use the single digit test following radiation as primary treatment to eliminate the noise the three digit tests can cause. You still have the prostate and can expect some PSA expression. You can still experience inflammation, infection and enlargement all of which can increase PSA expression, though much less than an untreated prostate. Most radiation men show PSA decrease for a couple of years, then the bounce, then decrease or stabilization for a long time. The post treatment nadir target is 0.50, so you did really well from that regard.

Regarding the recent increase, it could be indicative of a bounce, though that is more common in the 18-36 month range indicating a mass die off of radiated PCa cells. Many radiation men don’t achieve nadir until the fifth year. Any movement upwards isn’t a concern until it shows steady progression approaching nadir + 2.00, when recurrence may be indicated. I agree with more testing frequency ( even quarterly) for a while to track the post nadir trend.
Posted 3/15/2024 7:11 PM (GMT 0)
Hi JNF

I am not using the sensative PSA test that the RP folks use. So unsure of the accuracy, they report to the 3rd decimal, Nordx lab here uses the Electro Chemiluminescence method with Roche Cobas 8000 instrument. All my test have been with the same lab and method. Have tried to control what I can in that regard.

I have been looking thru the forum here at peoples signatures/history to see if anyone with radaition as treatment sans ADT, had similiar PSA fluctuation especially 4 or more yrs out. But not many who have had primary radiation of any form seem to put all the results in their signatures, but then again I guess they have either moved on, a good sign or dont put the detail in anymore. Although I havent found many who have had BCR who have posted long term results, if they do it seems to happen early within first few yrs.

Hopefully it will decrease when I get tested again.

Maybe some other folks will chime in if they have had similiar results long term.
Posted 3/15/2024 11:11 PM (GMT 0)
Turboz - I have been here since 2018 and some men who had RT of various flavors do have recurrences, some are diagnosed as 3+4 also. My Dad made 13 years after LD brachy before recurrence so recurrence time frame is pretty loose as cancer is evil and sneaky.

Basically, your PSA went down fairly slowly and finally had a little bump up. What does it mean? Not much. I doubt any doctor is going to go crazy and tell you do much at this point. I might be inclined to stay on your testing schedule and the results will be what they will be. I am not a fan of testing anxiety. Given your PSA needs to be over 2 to be considered a recurrence, I would think that a doctor and insurance would have a tough time rationalizing a PSMA scan so early (about the only thing you can do next) when results are not very good at low numbers and you are not there.
Posted 3/16/2024 1:02 AM (GMT 0)
Turboz, I locked the previous thread, and provided a link to this one, so as to avoid confusion. If you would prefer that both threads remain open , let me know and I’ll unlock.

I don’t have enough knowledge to address your issue, otherwise I would
Posted 3/16/2024 1:59 AM (GMT 0)

Turboz said...
Hi

I thought I would start a new thread on my resutls since the"update" thread I had been using was getting cluttered.

anyhow had my latest draw this morning, lab is Nordx and the std PSA test.

The results showed an increase from 0.22 4/2023, my Nadir to 0.364 3/2024 today, about a year apart. Note I did not have ADT in my treatment.

Have any of the folks who had radiation as primary treatment, had some fluctuation in their PSA 4 or 5 yrs out or more. I dont have a feel for the kinetics of PSA as time increases, will it always trend down or is there some fluctuation due to lab accuracy/repeatability, still having a prostate etc.

I will discuss with my GP and ask to contact my RO for comment, I am guessing they wont be too concerned. I will push up my next test to this fall at 6 month out to see if there is a trend or not.

I posted earlier in the "update" thread I created a few yrs back, sorry for the repeat but though breaking it out in a new thread would get more responses than the old one.

Hi

I just had my yearly PSA, I was at .22 ng/ml last year 4/2023 which is my nadir. Was at .36ng/ml 7/2022 9 months before.

Had the blood draw this morning and results climbed to .364 ng/ml for 3/2024. So increase sad
My RO went out of the picture after I got below 1.0 at the end of 2020 and told me to monitor the PSA thru my GP, which I have done. I dont know wether to be concerned and other than talk to my GP and perhaps retest in the fall at 6 month out, not sure what else to do other than look to see if there will be a trend upward or not.

I knew that at some point the readings would fluctuate, was just hoping it would of continued down. I really dont have a feel for what others see who have had similiar treatements. Note I did not have ADT, just the HDR and IMRT.

have other folks on here who have had some form of radiation had fluctuations or once it stops going down, it will just t rend up??

Not sure if my bio will show in the post but results/history: HDR Boost, 2 9.5Gy fractions 12/17, 25 fractions 1.8GY for 45GY IMRT finished 2/18. Gleason 3+4 with 10% 4, PSA 8.1 pre treatment, T2A, Post Treatment: 6.9 +3 months, 2.7 +9 months, 1.24 + 1 yr 9mo 11/21, 0.95 + 2yr 9Mo 11/20, 0.55 +3yr 10mo 12/21, 0.36 +4yr 6mo 7/2022, 0.22 +5yr 1mo 4/2023 Nadir, 0.364 +6yr 3/2024

i did have fluctuations (see signature) but by five years my PSA had settled down. i think you are most likely OK but maybe test every six months for awhile. good luck man!
Posted 3/18/2024 5:10 PM (GMT 0)
Last PSA was 1.06
That was June. I see oncologist on the 27th so I will have blood work done.
Fingers crossed!
It's over two years since SBRT

Glen
Posted 3/18/2024 9:08 PM (GMT 0)
I meant to post this link on article on brachy therapy showing longer term prediction of success at 10 yrs, no BCR versus the nadir the patient has at 4-5 yr range, may have to paste in your browser, author is Dr Juanita M Crook, has youtube video showing presentation

https://grandroundsinurology.com/a-biochemical-definition-of-cure-following-brachytherapy-of-prostate-cancer/
Posted 3/18/2024 11:40 PM (GMT 0)
https://grandroundsinurology.com/a-biochemical-definition-of-cure-following-brachytherapy-of-prostate-cancer/
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