New Nadir

Hello all. After my PSA rose to nearly 9 in 2019 I elected to have SBRT/Cyberknife treatment in Oct 2020. Over the course of the next year it declined to about 0.68 and then jumped up to 1.46 18 months after the treatment. After talking to many doctors around the country for next-step treatments (a whole story in itself) one told me it was a radiation bounce, which my local urologist and RO did not mention.

So with some encouragement from this forum and concurrence from the local docs I nervously held off any treatment decisions and three months later it started to decline, to 1.09 and as of yesterday 0.23. I get uber-stressed every 6 months when I have to go for the blood draw but it is looking good now.

Here are my historical notes FYI. I'm a retired engineer and a guess sort of a data nerd:

2/19/19 PSA: 6.3
2/21/19 Biopsy, report available, 3+3=6, high volume
6/15/19 PSA: 6.9
7/17/19 PSA: 7.3
8/1/19 PSA: 8.7
8/7/19 PSA: 7.7
8/9/19 Contrast MRI, PI-RADS 1, report available
6/26/20 PSA: 6.75
8/13/20 Biopsy, report not available (lost), but I recall also 3+3 and high volume
8/28/20 Biopsy 2nd opinion by Dr. Epstein at JH, upgraded 3 of 6 cores to 3+4=7, report available
9/16/20 PSA: 7.9
Oct/Nov 2020 SBRT - CyberKnife, 5 sessions, 36.25 Gy total dose
1/25/21 PSA: 0.84 (Doctors Hospital)
8/5/21 PSA: 0.68 (Doctors Hospital)
2/9/22 PSA: 1.10 (Doctors Hospital)
3/22/22 PSA: 1.46 (Doctors Hospital)
4/15/22 PSMA Scan, nothing outside of the prostate, faint shadow in the prostate, uptake 3.5/5.
4/25/22 Contrast MRI, PI-Rads 2, report available
5/16/22 Biopsy, 2 of 6 cores had cancer, 20% and 80% volume, "with radiation effect", report available
5/16/22 Biopsy 2nd opinion by Dr. Epstein at JH, 10% (down from 20%) and 80%, "with radiation effect", report available
6/13/22 PSA: 1.09 (Doctors Hospital) [checked at "Any Lab Test Now: 1.40 and Labcorp: 1.2]
10/3/22 PSA: 0.66 (Doctors Hospital)
4/6/23 PSA: 0.67 (Doctors Hospital)
10/17/23 PSA: 0.21 (Doctors Hospital)

This forum has given me a lot of great information as well as encouragement, even though I don't feel I have much to contribute except for my history, which so far has been I think as good as I could expect. I don't know what the current thinking is on outcome comparisons between surgery and radiation but right now I'm a believer in SBRT/Cyberknife. We'll see what I think in 6 months, and then 6 months and again...

Vic, congratulations, it looks like the treatment is working for you. Live your life to the fullest and don’t sweat the check ups.
Jack

Vic, that's great news. And your post is an important one as it gives extra hope to those radiation guys who may be experiencing the "bounce". It does happen frequently and your case shows that the later chapters of the story are good ones.

Jim

P.S and BTW, even if you don't feel you have particular expertise to share, simple encouraging words or congratulations are always welcome posts.

I've not had any adverse side effects really. Sexual function is off a bit but it works and anyway I'm 74.

As far as the question about cancer in the latest biopsy reports, I believe that the pathologists still see it but they are cancer cells that are or were in the process of dying. Both reports refer to "radiation" effect so it's clear to them that I've gone through radiation treatments.