SBRT 3yr uptick

Hello All , I just had my 3 yr psa , getting them every 6 months . My psa creeped up to 1.22 from a low of .83 . I understand that SBRT takes about 3-5 years to reach nadir , level out , so I guess this might be just a bump in the road . I forgot the magic number that recurrence is happening , was it a total of 2.points of elevated psa ? Otherwise doing well . SemperFi , John

Hello jack thanks for the encouragement . My side effects in 3yrs have been minimal . A little urgency , a little dribble . I have decided to do the tri-mix injection . Actually tonight is my maiden voyage . I want to go down swinging . Thanks John

my money is on a bounce. hang on!

I'm betting on the bounce, too. I am about 6 months earlier in my journey than you, and I've also bounced a bit. I am "just" 2 1/2 years post-treatment, and my PSA is still declining. (Only down to 1.42, from 5.69, so far.)

Our mentor, who used to spend a lot of time on this board, took about 6 years to reach his nadir, so if we are still downward-bound at 2.5 to 3 years post-treatment, I'd say that we're doing just fine.

Don't forget - the research shows that those RT patients who take longer to reach nadir seem to have better long-term disease control and lower rates of future recurrences.

Sorry, Roger, but I am not the expert at finding and linking all the study papers. Another member (not to be named, I guess) was the one who used to refer me to them.

You could try searching the site of the NEW Prostate Cancer InfoLink. IIRC, that was the site that was the repository of these things, going back several years.

As yet another anecdote, my RO quickly agreed with me when I cited the reports, so either I am very convincing, or she has also read the studies.

I guess by the nadir plus 2.0 theory, I would already be in big trouble since my PSA jumped to 3.78 in October. When my RO (Dr. Debra Freeman of the Cyberknife Center of Tampa) saw that, she didn't bat an eye. She told me to relax and expect it to bounce all over the place before settling eventually to nadir. So the next test was in mid- February and my PSA dropped to 1.10. Dr. Freeman also added after the 3.78 that she wouldn't be concerned even if my PSA after the 3.78 had gone even higher. Her explanation had to do with watching for developing trends and with SBRT, according to her, it takes several PSA tests with rising PSA results to cause alarm. So I have tried to be measured in attitude about this PSA testing and take it in stride. So far, so good......or so it seems.

Hey John..... Now that you mention it, Dr Freeman told me about that when I did my initial consultation with her. You and Paxton both were treated by Dr Hirsch and Dr Freeman is very complimentary of Dr Hirsch. I wish you the best with this "thing of ours". I have no regrets about my choice of SBRT either but the main side effect for me is simply having to deal with this dang PSA experience. But as I always think and say, this has been a walk in the park compared to so many other people's health issues. John, please accept my most heartfelt thanks to you for your service to our country. You are the best of the best in my book.

Roger - I'm kind of wired as you are. I don't really worry too much about my PSA. It is whatever it is, and there's precious little I can do to affect it. I try to follow my own advice to heart patients I counsel on another board -- "There's nothing wrong until there's something wrong." As long as it behaves, I won't worry about it.

If or when it acts up, I will react as best I can with the information available at the time, just as I did in choosing my treatment path.

Onward, Post Toasties!!!