About that SBRT bounce -- and now a bump in the road!

I keep reading about the SBRT bounce. Is this only for primary SBRT??

I have been fighting PC since 2009.
Surgery didn't work and neither did SRT.
However HT has worked VERY well.
I have been able to go on 3 HT vacations, thankfully.
During these vacations, I would get C11 choline scans.

Anyway, I recently did a Ga68-PSMA scan. Each scan, taken when my PSA went up at the end of my HT vacation, showed a lymph node light up. We did SBRT on the node. My latest PSMA scan showed 2 small nodal PC involvements. Once again, I'll be doing SBRT (whack a mole, basicaly).
We finally get to my question:

Is a PSA bounce expected in such circumstances? My gut feeling is no, but I'm not sure.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
And now the bump part. Umich did my simulation:

Last week I had my simulation at Umich in preparation for my 5 radiation
sessions. We were expecting a call from Umich to schedule the
treatments. We got the call today, but it was to let me know that they
will need to schedule another CT-scan. Apparently, something showed up
unexpectantly (lymph nodes further down, I think). It took me by
surprise so I didn't think of what to ask. It just might be that they
need more information to do the right radiation plan. Is this a likely
scenario?

As I said, it surprised me and I didn't know what to ask. The
glass-half-empty part of me wonders: could this be another cancer?

Anyway, I expect to schedule it this week and get a call-back soon after

Mel

Post Edited (compiler) : 1/7/2019 9:18:30 PM (GMT-7)

as far as I know, the bounce is part of primary SBRT treatment, and not when used as a secondary treatment. It's not used for SRT without a prostate. Without a prostate, they fallback to IMRT/IGRT.

when zapping the nodes, I wouldn't expect PSA to be bouncy, but I don't know that for sure.

and hopefully it's not another cancer - just some PC that didn't show on earlier scans. You have enough to deal with.

Andrew

Radiation bounce is for men that had initial radiation treatment, but not surgery. So, external beam, brachytherapy, or the combination of the two. about 65% of those men experience the bounce sometime between one and five years out with most in the two to three year time frame. While the exact cause of the bounce hasn't actually been determined, most experts surmise that it is a lot of the PCa cells that were damaged by the radiation but initially survived are finally dying as a group and giving off an increased amount of PSA at once. If they died gradually over a period of time the PSA would reduce, but there would be no bounce event. That is why some men do not exhibit the bounce.

As you were a surgery guy the bounce wouldn't be relative. Now you are using palliative radiation to treat mets and that treatment may reduce the PSA that was being expressed as the met is reduced in volume. If then you have a subsequent PSA increase it would signal PCa growth somewhere, either from the met growing back or from some other area, but wouldn't be the bounce.

Mel, it is good to see that you continue to have positive treatment response. Best wishes.

BUMP resolved!
See my post RE: poor communication.

Mel