psa at three years up half of one percent ?

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Regular Member

Date Joined Apr 2007
Total Posts : 171
   Posted 11/20/2009 5:49 PM (GMT -6)   
My husband had his  annual appointment at his  radiation oncologist and his psa was 0.4.5 His last psa six months ago was 0.4   So, it has gone up half a point. The doctor told him not to worry about it, but I am a little concerned.  I wonder if this could be the bounce that you hear about
Husband diagnosed December of '66
psa 6.6 at biopsy, but had been 7.3
eight of of twelve cores positive
Gleason 7  (all 3+3, except one which was 3+4)
25 IMRT plus a seed implant
psa two years and two months 0.4
psa at three years 0.4.5 

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 11/20/2009 8:11 PM (GMT -6)   
Radiation failure is defined as 3 successive rises in PSA. PSA will flucutate just due to lab differences and your husband still has a prostate which will generate some psa. His doctor is correct.

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 11/21/2009 8:01 AM (GMT -6)   
Don't forget the "wiggle" factor - aka rounding....You can always test again next week or month and go from there..
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Veteran Member

Date Joined May 2008
Total Posts : 1010
   Posted 11/21/2009 10:50 AM (GMT -6)   
Hi Wiggyann,

I chose IMRT as my primary treatment. My PSA history is in my signature. I was told by my oncologist prior to treatment that anything less than a 1.00 after radiation was considered a success. I have also found this reference in some medical articles online. There is most likely some viable prostate tissue and it will produce PSA. As I understood it the normal cells can recover better than the cancerous cells after radiation. The DNA of the cancerous cells apparently suffer more damage from radiation. Thus there may be no or little volume in the way of canerous cells but some normal cells survive.

Also, as Steve noted, any test has varition in it. I am a process engineer and work daily with processes and statistical control. I won't attempt a lesson in this but suffice it to say that there is "normal variation" in any measurment. Depending on the test it can be very low or very high in some cases. The .05 increase is 11% variation. Ask your doctor what the normal variation is for the test.

The "bump" typically occurs within the first two to three years after treatment. I suppose it could happen this far out but have doubts. If the increase has only been .05 after 40+ years I would agree with your doctor. Relax.

Best to you and your husband.
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 
PSA 06/09 .36 or .30 depending on who did the test
PSA 09/09 .33 one year after IMRT and 16 months into hormone

Regular Member

Date Joined Apr 2007
Total Posts : 171
   Posted 11/22/2009 9:42 AM (GMT -6)   
Many thanks to everyone who responded to
my question. :-)   To Ohio State: My husband turned 71 in October. 
He did have the psa test taken six months ago at
his urologist's office, but this time he had it done
at his radiation oncologist's office.  Maybe that could
have something to do with the half percent jump.
Husband diagnosed December of '66 at 68 years old.
psa 6.6 at biopsy, but had been 7.3
eight of of twelve cores positive
Gleason 7  (all 3+3, except one which was 3+4)
25 IMRT plus a seed implant
psa two years and two months 0.4
psa at three years 0.4.5 
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