HealingWell
Search Close Search
☰

Post-radiation and hormone therapy PSA Levels

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/27/2017 9:52 PM (GMT 0)
Hi,
I am new to this forum and never found my situation with an outside search. What is normal or at least acceptable PSA level following Radiation and 6 months of hormone therapy (Firmagon injections)?

Briefly, DX PSA= 6.73, Biopsy positive in 2 of 12 cores. Gleason was 3+4 in one core and 3+3 in the other. Had 45 radiation treatments plus hormone injections for 6 months starting in Jan. 2017. Radiation completed 4/3/2017, last hormone shot was 6/30/17.
First (three month) PSA test was 7/13/17 and was at .18. Just got the results from the six-month post-radiation PSA and it was .24
It rose by a third but is still very low. The first post-treatment PSA was done only two weeks past the last hormone shot.

I am a natural worrier and know about PSA bounce, but does this small rise indicative of anything?

Oh, the test was a Beckman-Coulter Access II immunoassay, since I read another thread that says there are significant differences in the readings between tests.

The doctor's nurse responded that, "it did rise and we will closely monitor you in the future" but that is not as helpful as I would like.

GregHal
Posted 10/27/2017 10:29 PM (GMT 0)
Welcome to HW.

As the HT wears off, you can expect your PC to rise. At some point it will stabilize and likely come down slightly. RT is a slow treatment and it can take a couple of years to get to nadir (lowest PSA).

So far I'd say you're doing just fine. Keep monitoring.

Andrew
Posted 10/27/2017 10:52 PM (GMT 0)
In the shop is right on the money...As your testosterone slowly returns to a normal figure (you should monitor it too) your PSA is bound to rise a little. After all, you still have a prostate gland, mostly destroyed but not completely..After a year or two, your PSA should stabilize at some low number...
Posted 10/27/2017 11:18 PM (GMT 0)
Thanks to In the Shop and Fairwind for replying. In the Shop, your diagnosis, Gleason and treatment plan seem to match mine very closely. I saw that your PSA never rose but post treatment was at 1.9 while mine was .18. My six month is similar to your Nadir point. Hope this means I am worrying over nothing.
Fairwind, you mentioned. Testosterone levels being monitored, and my Urologist did test it this time and it is very low. FreeTestosterone was 2.8 and normal is 4.4 to 24.7. Overall, 121 when 200-800 is normal.
He said we would monitor this as well. Radiation was easy, hormones suck, but except for zero libido and probable ED with some fatigue thrown in seem to be the side effects. Is normal testosterone level probable without further expensive treatment?
Posted 10/28/2017 12:21 AM (GMT 0)
It's likely your T levels will recover on their own. Might take awhile, but you'll get there.

You're doing fine.

Andrew
Posted 10/28/2017 1:29 AM (GMT 0)
It sounds perfect - Lupron is wearing off, so PSA will rise for awhile. If it ever gets over 2.0, you can discuss next steps then. Meanwhile, enjoy your favorable response.
Posted 10/30/2017 12:52 AM (GMT 0)
TallAllen,
Thanks for the words of encouragement. My Urologist finally got back via email today, and I am not sure how to take it. "While we are concerned about the rise it is still in a good range for post radiation and hormone treatment PSA. If it rises again, we may need to talk about some more injections, but I am optimistic it will level out and decrease."

In all of your opinions, a rise of .06 from 0.18 to 0.24 a serious issue or cause of concern? Especially with radiation and hormones driving my testosterone down so low, not to mention the PSA numbers below 0.25

GregHal
Posted 10/30/2017 5:55 AM (GMT 0)
I can only repeat that I wouldn't be concerned unless PSA got over 2.0. I think you are reading too much into what those clinicians are saying. Sometimes they just want to show that they sympathize with your worrying, and don't want to minimize your emotions. They'll let you know if you have to take any steps.
Posted 10/30/2017 3:23 PM (GMT 0)
Your PSA rise is pretty consistent with mine after I stopped my hormone therapy. It gradually drifted up to 0.2 and then leveled off (actually went down a touch). I'm no doctor, but I don't think there's anything to worry about based on your pattern so far. Just keep testing until a longer term pattern emerges. Based on your biopsy results, you have excellent chances of doing well.
Posted 10/30/2017 4:01 PM (GMT 0)
I agree with TA - you've got a doctor who's sensitive to your emotional needs and is just trying to reassure you that they're watching closely and have a plan if things don't go right.

You're in good hands there.

Andrew
Posted 10/31/2017 8:36 PM (GMT 0)
Thanks to all for their calming words. I guess that as a 56 year old man who had no symptoms nor any indicators that anything is wrong and was in excellent health and normal function in every area to a year later having low T, no libido, impotence, divorced and now see a potential need for more of the same makes me question everything.
Sort of was hanging my hat on how the future was bright and this six month PSA would be close to 0.0, and I would feel normal and start a new wonderful life with full vitality in the near future.
The rise in the number and the doctors mention of more hormones just sounds bad. Maybe it is, as all of you said....calm down, everything is fine for now, and we got this under control if it does not settle down.
Guess the situation including the low T has been pessimistic, when maybe it is all under control and right where the PSA should be.
GregHal
✚ New Topic ✚ Reply