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2 questions regarding post IMRT sessions

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Posted 10/7/2013 8:08 PM (GMT 0)
Hi Team:

1- PSA was 5.5 before prostate surgery

2- Gleason is 5/3:  Total Gleason of 8

3- Surgery performed June 5, 2012

4- Pre-surgery PSA was 5.5

5- Post Surgery PSA was .02 as measured August 2012

6- PSA in December 2012 was .02

7- PSA measured in May 2012 was .15

8- IMRT performed July1st through August 2nd, 34 sessions; location was surrounding tissue where prostate was removed.

9- PSA reading on October 1 was .14

Questions:

1- If IMRT were truly effective, would the PSA have declined further within the 2 month period following IMRT?

2- How long does it take for Prostate Cancer cells to die?

3- Doctor stated that he has seen some men's PSA take 6-12 months before reaching 0?  Why is this?

Posted 10/7/2013 9:24 PM (GMT 0)
Prostate cancer cells take a long time to die after radiation. Radiation doesn't really kill the cells, just disrupts the DNA so they can't reproduce. All cells in our body regularly get replaced - radiation stops this process and the cancer cells stop reproducing.

My RO told me it could be 18 months to 2 years before I get to the lowest PSA post treatment. 2 months after is a little too soon to know for sure if the RT did its job. All you can do now is to track a downward trend. Wait for the next test before you get concerned. At the six month PSA you should see a better result.

IMRT is a slow process.

Andrew
Posted 10/7/2013 9:59 PM (GMT 0)
Thanks Andrew, I read articles that were similar to your response; it's nice to know that this appears to be pretty solid information. Reading some of the other postings, one person had a 50% reduction, but that may be due to radiation directly on the prostate versus post-removal and Stage 3 leakage here. Thanks again, John
Posted 10/7/2013 10:26 PM (GMT 0)
It should continue to go down, but if it was salvage radiation, at no point should it ever move up, not even by a small amount. Any rise would be a quick sign that recurrence is happening, and that the radiation failed or the cancer was not in the area being radiated.

and yes it could take 6 months to a year or so to go as low as it will go.

david
Posted 10/8/2013 12:29 AM (GMT 0)
Good info from Purg. and I also did this but with ADT3 drugs and charted psa every month or more, and nadir (lowest) psa was 6 months out. Yours may vary.
Posted 10/8/2013 1:01 AM (GMT 0)
Thanks David, I'll monitor any upside to the PSA as a red-flag. Looks like we have a good consensus of information regarding waiting until 6, 12, 18 months for maximum drop of PSA. Thanks Purg also!

John
Posted 10/8/2013 1:45 AM (GMT 0)
"It should continue to go down, but if it was salvage radiation, at no point should it ever move up, not even by a small amount. Any rise would be a quick sign that recurrence is happening, and that the radiation failed or the cancer was not in the area being radiated."

I understand there would be no PSA bounce as in primary RT , but couldn't a small rise using the ultra sensitive test be noise or normal variation just as in the case of post prostatectomy without salvage RT?
Posted 10/8/2013 10:12 AM (GMT 0)
I don't know. My doctor stated that I should wait at least 6 weeks (which I did) before having a PSA, post Salvage Radiation. He said the bounce would occur during that waiting period. Thanks, John
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