Updates and Seek Opinions

My husband visited his RO on 19Nov for a post ART check. There is nothing special. When my husband told the RO that the urologist has requested him to do a post ART 1 month PSA check, the RO chuckled and commented that our urologist is famous for being a super prudent doctor. He did not think the PSA reading at this point will have any significance.


Today we went to our urologist to review our post 1 month ART PSA. It reads 0.069. The urologist said it is good that there is a downward trend from post op @3 weeks 0.24 --> @ 6 weeks 0.17 --> @4.5 month (post ART 1month) 0.069. He said that he did not think it is necessary to start HT now. The satisfactory reading will be 0.01. He said even if the reading cannot reach that low, but if it stays constant, it is still good and no need to add any treatment.

He asked my husband to do another PSA test 4 months later. We asked whether anything we should avoid, like travelling aboard, etc. He told us just live normally.

We are a little bit disappointed that the reading @4.5months are not 0.01, though it is good that the reading is heading downwards. It proves that there are still some cells left in the prostate bed (we hope it is the only place where they have been).

My questions are:-
Does ART contribute anything to the reduction in PSA reading at this stage, that is, post 1 month ?
When will the ART be effective and the PSA reading to be taken seriously ? 3 months, 6 months ?
Is it normal to test PSA at 4 months interval ? We are actually expecting a more frequent check.

So for the time being, my husband will continue to take Chinese medicine and supplements. No dairy, no meat (except seafood) and stick to Asian cuisine with lots of soy and vegetable.

We pray that the next reading will be 0.01 or less.

Happy thanksgiving holiday to those living in US !!

Radiation takes awhile to completely do it's thing. There have been patients that have been biopsied 18 months after radiation treatment and the biopsy came back positive. But then after another biopsy after 24 months post-toastie, the biopsy came back negative. The important thing is that PSA decreases after treatment.

But about 25% of patients will experience a PSA "bounce" between 16-24 months, or so.  This is true for CK or IMRT.

With CyberKnife treatments, Dr. Katz reports after 24 months a median PSA of 0.4 , but he says anything less than 1.0 is just fine. Eventually they would like to see a nadir of < 0.5 .

Interestingly, there is a study that suggests a more durable long term result if it takes LONGER to reach nadir.