psa 0.4, two years and two months after brachytherapy?

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Regular Member

Date Joined Apr 2007
Total Posts : 171
   Posted 6/26/2009 4:16 PM (GMT -6)   
Greetings everyone,
My husband had 25 radiation treatments and a 90
seed brachytherapy two years and two months ago.
psa at one year 0.5
psa at two years, two months 0.4
no 18 month psa was taken
I am thinking he might have had a bounce at 18 months,
but we will never know.  I think I expected his psa
to go down more than one point in fourteen months.
But maybe this is normal.   Would appreciate any comments from men who have had brachytherapy.
husband psa 7.3
8 cores positive for adenocarcinoma
Gleason 7
25 IMRT (radiation treatments) plus 90 seed implant
psa 0.5 one year
psa 0.4 two years and two months

Post Edited (wiggyann) : 6/26/2009 3:26:03 PM (GMT-6)

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 6/26/2009 5:41 PM (GMT -6)   
I am no expert, but in my book, if it goes down, it is a good news. He still has his prostate, so the PSA would not be undetectable.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere+Avastin)

PSA results:            1/8/2008-33.90, 1/11/2008-29.50, 1/31/2008-38.20,

2/21/2008-32.00, 3/13/2008-26.20, 4/3/2008-26.60, 4/24/2008-20.60

RRP at Duke (Dr. Moul) on 6/16/2008

Pathology:              Gleason downgraded 4+3=7,   Duke: T2c N0MX, one positive margin,

2nd opinion at Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009

IMRT to start mid-Aug

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 6/26/2009 6:30 PM (GMT -6)   

Hello Wiggyann,

I did not have the seeds but did have IMRT. At the time my oncologist told me that anything under a 1.0  and steady was good results for radiation. The bounce, if it occurs, is usually between 18 and 24 months but can be as far out as three years according to some sources. One research paper indicated that post radiation nadir below .5 and two years to nadir had the best results for long term. Based on that I would say things look good for your husband.

As Geebra stated, and as my oncologist noted, there is still some viable prostate tissue after the treatment and it will express PSA.

Here's hoping for continued improvement and good health to your husband and you.


Diagnosed 04/10/08 Age 58 at the time
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear and chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
PSA 02/08 21.5 at diagnosis
PSA 07/08 .82 after 8 wks of hormones
PSA 10/08 .642 one month after completion of IMRT, 6 months hormone
PSA 03/09 .38 six months post radiation and nine months into hormones 

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 6/26/2009 6:50 PM (GMT -6)   
The Squire is putting out a call for Bro. Tudpock!
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 6/26/2009 8:58 PM (GMT -6)   
The longer the PSA takes to reach it's nadir (lowest point) the less chance of a reoccurrance. Those numbers look real good to me and I hope I can achieve them.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July


Forum Moderator

Date Joined Sep 2008
Total Posts : 4277
   Posted 6/26/2009 9:41 PM (GMT -6)   
Dear wiggann:
Sounds like you hubby is just fine.  He may indeed have already had his "bounce", though not everyone has one.
And, every patient has a different nadir.  I think his results look good.  The time to worry is if, post bounce, you get 3 consecutive increases from the nadir.  Sounds like you are fine for now...just keep checking each year.
As JT said, I hope I do as well.
Take care,
Age 62
Gleason 4 +3 = 7
PSA 4.2
2 of 16 cores cancerous
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 6/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

Veteran Member

Date Joined Apr 2008
Total Posts : 1132
   Posted 6/27/2009 8:34 AM (GMT -6)   
My brother had the seeds implanted and there is something called the 2 year bounce. His PSA went up at 2 years and then back down. You may want to google PSA after brachytherapy or the 2 year bump after seeds.
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better

Regular Member

Date Joined Apr 2007
Total Posts : 171
   Posted 6/28/2009 5:03 AM (GMT -6)   
A special thank you to everyone who posted.

Geebra, Don 826, Purgatory, John T. Tudpock 18 and

I feel much better after reading all of your posts :-) and
am very grateful to all of you.


Veteran Member

Date Joined Apr 2008
Total Posts : 832
   Posted 6/29/2009 9:08 AM (GMT -6)   
Why don't you ask your doctor?

Regular Member

Date Joined Mar 2006
Total Posts : 355
   Posted 6/29/2009 3:01 PM (GMT -6)   

You're doing fine - at least in my opinion.  We survived the dreaded bounce and as you can see from "our" results, we're continuing on as usual until we have reason not to.  This whole thing has given us new reasons to celebrate things "just because".



Husband diagnosed in December 2005
PSA of 3.74
Gleason 6
Brachytherapy (91 stranded seeds) April 2006
PSA of 0.39 - November 2008 - whoo hooo!
PSA of 0.31 - May, 2009 - whoo hoo again!

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 6/29/2009 4:17 PM (GMT -6)   
Greetings, Wiggyann.  Sounds as if you and your husband are headed in the right direction.  Anytime the PSA is dropping it seems to me to be good news.  As we all do, be vigilant in monitoring but it seems like you are doing well.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

Regular Member

Date Joined Apr 2007
Total Posts : 171
   Posted 7/5/2009 2:17 AM (GMT -6)   
A special thanks to Chris R., Just Julie and CPA for posting.

I appreciate all of you. The urologist told my husband to

phone his office in two days for the results of his two year

PSA test. He did and the nurse told him what it was 0.4

We were happy it had dropped one point, but for some

reason I wondered if it should have dropped more.

Thanks again to everyone who posted.


husband diagnosed 12-2006
psa 7, stage T1c
25 IMRT and a 90 seed implant April 2007
psa one year 0.5
psa two years 0.4

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 7/5/2009 7:20 AM (GMT -6)   
I to think you are doing great. Start writing the next chapter in the book of life. Have fun, build relationships, never take people for granted, stop and smell the roses, and give new meaning to the word love.
Life is a blessing

peace and love
My PSA at diagnosis was 16.3
age 47 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
Testosterone keeps rising, the current number is 156, up from 57 in May
T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores

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