3 mo. PSA after RT?!?!

In the home stretch of my RT and conversed with RO over protocol and the next step. He mentioned a 3 mo. f/u PSA. He told me not to be alarmed by the PSA reading as it sometimes may be higher etc. This first PSA test is just a barometer that they use to help track PSA going forward. I was kind of surprised as I assume most newbies envision a PSA reading after treatment of around "0". Guess I was delusional and naïve?! Comments from the vets?

When I finished my RT I had PSA on last day of treatment and was told it might be higher than when I started. Same reason for taking it as you were told; to get baseline. Doc said after all those radiation treatments the prostate has been assaulted and it is not uncommon for PSA to increase. Some decrease too he said but it means nothing. Mine fell quite a bit and when he asked me if I was pleased with it falling I said no, you said it didnt matter.

Just note that my PSA didn't go below 1 for almost a year and I didn't hit .3 for 5 years.

It's a long slow trip.

Enjoy the scenery...

My PSA didn't hit 0.1 for about 5 years. It rarely disappears entirely, and count on bounces along the way.

Apparently, radiation kills higher grade cancer faster. If PSA falls very fast after RT, that could be an indicator of higher grader cancer even when the diagnosis was lower grade cancer. I believe something like that happened to me.

In 2011, I was diagnosed with Gleason 3 + 3 cancer in 2 cores with 10% invlovement. I had brachytherapy in June 2011. My pre-treatment PSA of 3.4 fell by September 2011 to 1.1 and to 0.6 by December 2011. By December 2012, the PSA dropped to 0.1. I had a small bounce to 0.2 in June 2013, which fell back to 0.1 by December 2013. Then started the rise: May 2014:0.2, December 2014:0.3, July 2015: 0.6, July 2016: 1.5. Second biopsy found recurrence in an extraprostatic mass. I had ADT from October 2016 to April 2017 and Cyberknife in January 2017. My PSA dropped to undetectable (<0.1) by June 2017 and remained there until January 2018. Then it started rising April 2018: 0.2, July 2018: 0.9. I am waiting for another PSA test end of this month.

Post RT PSA is more of a bouncy house...

Tudpock18 said...

Tall Allen said...
My PSA didn't hit 0.1 for about 5 years.

Well, it took me six years. Perhaps this is the only way I can top Tall Allen!

Jim

Silly Jim...no one can top TA! LOL!

Stan1961 said...

dbell said...
Sorry to hear of your reoccurrence "Brachy"! Thanks for the responses guys. I see that a PSA rollercoaster ride may be in my immediate future!

Don’t mean to pry ....prostate seems very large ...I thought there was a cutoff for the size ..do you or did you hsve uninsured problems

Stan, not sure what the question is, but I will try to answer. Not sure if you are asking if I should of had surgery rather than RT?? My insurance carrier did not have a preference! Nor should they!! My Prostate was 120cc it is now 73cc after months on Finestaride. Because of my large Prostate I could not have SBRT and was told by my RO to have IM/GRT - 26 treatments. I think there is a cut off for size in terms of SBRT (High Dose).....cutoff is around 60cc (off the top of my head) per my RO at MSKCC.

Also, I had a huge fight with insurance carrier who would not allow me to go to NY (out of state) for a rectal spacer. MSKCC only does the "spacer" in NY (not NJ). Another reason why my RO thought IM/GRT was a better choice for me than SBRT (no spacer). Meanwhile, I have little to NO SE, ED etc. and hope things stay this way! We made the right choice with our RO's and MSKCC's guidance (at least at this point)!!

Everyone is different here. I had few SEs near the end -urgency and some bowel issues. Two years post RT I had radiation proctitis that had to be treated.

and my T-levels dip a bit.

But that was it.

Andrew

I had some urgency, small issues with "holding" it and not much else In general, everything was short lived. Long term, today I only pee at about 60-70% of my previous flow, which is not ideal but manageable. But I take a Rapaflo every 4-5 days and that seems to do the trick and I'm back to >90%. All in all, I think I'm fine.