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Rapidly Rising PSA

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Posted 7/17/2018 12:00 PM (GMT 0)
My PSA started to rise rapidly one year after Cyberknife and ADT. In January, it was < 0.1. in April, it was 0.2. And now in July it is 0.9.

I was diagnosed with Gleason 6 + 6 cancer in 2011 and had brachytherapy on June 20, 2011. My PSA level dropped rapidly to 0.1 until 2016. Then it 2016, it rose to 1.8. I had another biopsy that detected an extra capsular cancerous mass. I was treated with ADT before having cyberknife in January 2017. The last three month Lupron shot was in April 2017. From April 2017 to January 2018 my PSA was below 0.1.
Posted 7/17/2018 1:59 PM (GMT 0)
If you've come off the Lupron and your t-level is recovering, then a rising PSA would be normal. The HT keeps your PSA low.

Likely your PSA will level off soon. If it doesn't, you'll have to go back on the HT.

Andrew
Posted 7/17/2018 4:57 PM (GMT 0)
What is your testosterone level? Although you stopped Lupron shots in April 2017, it can take more than a year for your body to resume T production. I think you should follow Andrew's advice and wait to see what your PSA does with normal T levels.
Posted 7/17/2018 5:09 PM (GMT 0)
My PSA before ADT and cyberknife was 1.8. Currently, it is half of that. What about cyberknife treatment of the extra-capsular mass? Shouldn't that kill off most of the PSA producing cancer cells? My initial treatment with brachytherapy with no ADT dropped from before treatment PSA of 3.4 to 0.6 within six months of brachytherapy and to 0.1 in one year. Now I am one and half year after cyberknife treatment. Isn't the jump from 0.2 to 0.9 in three months significant?
Posted 7/17/2018 5:19 PM (GMT 0)
It is significant. Have you had your T-level tested? The jump could be due to rising T levels. The issue isn't the jump, but where will level off. Only time will tell that.
Posted 7/17/2018 5:55 PM (GMT 0)
My T-level in January was 44. I hope the rise is due to rise in T-level. I will ask for another T-level test. I expected a gradual rise. A sudden jump from 0.2 to 0.9 in just 3 months makes me somewhat concerned.
Posted 7/17/2018 6:34 PM (GMT 0)
Get the T test, I think you'll find that's gone up.

It's a concern, but I think just something to watch for now - no action needed.
Posted 7/17/2018 6:35 PM (GMT 0)
The rise in PSA might be from the cancer, or it might be from benign causes as the T levels return to normal. Radiation does not kill cancer right away - it can take years.
Posted 7/17/2018 7:48 PM (GMT 0)
My husband, with different treatment, recently had a rapid jump in PSA levels from .05, basically undetectable to .98 within months. (He was off Lupron for a year when PSA started ticking up.) His urologist ordered scans at .98 because of the rise. You can see from the signature below where things are now--PSA is at 3. As TA says, it could be testosterone rise or something else. Unfortunately, in my husband's case, it's "something else," but hope your testosterone return is causing the rise.
Posted 7/17/2018 8:18 PM (GMT 0)
Tall Allen, I get your point. I hope it is due T-level returning to normal. But I have my suspicions. First of all, my recurrence was not in the prostate, it was in an extra-capsular mass. MRI in September 2017 showed significant decrease in volume of the cancerous mass from a ball of about 1 inch diameter before cyberknife to a volume about 1/8 of the original volume. Doesn't that indicate much of the cancer cells were killed?
Posted 7/17/2018 9:21 PM (GMT 0)

GFB said...
MRI in September 2017 showed significant decrease in volume of the cancerous mass from a ball of about 1 inch diameter before cyberknife to a volume about 1/8 of the original volume. Doesn't that indicate much of the cancer cells were killed?

Yes, which is good. You also have an intact prostate capable of putting out its own benign PSA. Or it may be systemic. When your T is normal and if your PSA>2.0, you can get a PET scan to see if there are distant mets.
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