PSA HIGHER AFTER SRT

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Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 209
   Posted 6/30/2010 2:41 PM (GMT -6)   
Had first PSA test 19 days after 38 SRT sessions.  At start of IMRT, PSA was .3 and is now .6.  Doc says the 3 month and particularly 6 month PSA test will tell if the IMRT was effective although he was not pleased with the .6.  Should I now be looking at hormone therapy and have any of you had a rise in PSA after completion of IMRT.  Looks like I might have some big decisions to make.   The Old Sailor
Dx 07/09 Age 67  -  28 core saturation biopsy w/5 positive  (2 gleason 8, 2 gleason 7, 1 gleason 6)
RRP 8/13/09 Mayo Clinic Jacksonville
Path report upgraded gleason to 4+5=9
Negative margins/extraprostatic extension/seminal vessicles/ lymph nodes but perineural invasion present.
Two month post surgery PSA 0.022
Five month post surgery PSA  0.081
Seven month post surgery PSA 0.190
Eight month post surgery PSA 0.217
Started 38 sessions IMRT at Mayo Jacksonville on 4/12/10,  completed 6/4/10.  Few side effects except urinary urgency and  frequency during the day and some rectal discomfort near the end of therapy. 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/30/2010 3:26 PM (GMT -6)   
The first one doesnt sound good, but you PSA could have still been rising even as you start SRT. Your next one at 3 months will be critical to watch, there should either be a big drop, or else unfortunately it didnt work. Can only hope your next reading goes the other direction. Good luck
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2243
   Posted 6/30/2010 3:56 PM (GMT -6)   
Old Sailor,
I agree with David although it is easier said that done to not be worried about the rise. I had a 6 week PSA test after my SRT so not sure why you would have a 19 day test. The 3 month and 6 month will be more telling and hopefully you will see a downward trend.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 6/30/2010 4:23 PM (GMT -6)   
I agree with David and Michael.
Hang in there.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
pcabefore50.blogspot.com


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 6/30/2010 7:31 PM (GMT -6)   
that seems a bit unusual that the doctor would do a PSA 19 days after IMRT. At my 3 month my PSA was still over 1 but after 6 months it had finally come down. I can't say not to worry because you already have the test result but do your best to stay positive. I bet the next test is better.

peace to you
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

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
Casodex
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
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11
PSA Jan 15th 2010 is .13
PSA April 16th of 2010 is .16
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
92%
80%
37%
28%


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 447
   Posted 6/30/2010 8:41 PM (GMT -6)   
Old Sailor...

The others have given you good words of advice... I agree with them in that 3 months seems to be the more normal time to check your PSA... My doctor told me anything earlier could just cause anxiety and not be of any true real value if the treatment worked or not...

Lets just pray that those PCa cells have now been damaged enough by the radiation where they will not be able to replicate and DIE....

God Bless,

pasayten
After 3-4 years of annual PSA 4-6, biopsy recommended
59 y/o
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)
11/10/2009 Discussion indicated biochemical reccurrence and need for salvage radiation treatment. 
1/21/2010 Another PSA test at 34 months...  0.14
1/26/2010 IMRT Salvage Radiation Treatment started
                  32 sessions for 64 gys total.
3/12/2010 Finished 32 sessions...  No side effects to date except a little
tiredness.  Slight changes in bowel movements the last week...  
4/8/2010  Some rectal prostitis, but no change in urgency.  No urinary effects at all.  Now just waiting for the upcoming PSA test in June.
6/7/2010 First 3 month PSA result after SRT = 0.02   WAHOO!  as good as could ever be expected at the 3 month mark!  Thank You Jesus!
 


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 6/30/2010 9:37 PM (GMT -6)   
Sailor,
I had a PSA the last week of IGRT, but it was because that was my three-month interval established after DaVinci. My "official" post-IGRT PSA will be end of July.

My numbers have been undetectable all along, so I'm not much of a litmus test, but I can sure feel the anxiety, and I can just reiterate what the others have said, the post-IGRT PSA needs 6-9 weeks to settle.

bsjoplin
Regular Member


Date Joined Feb 2010
Total Posts : 308
   Posted 7/1/2010 10:35 AM (GMT -6)   
HEY, OLD SAILOR:
i don't remember hearing of anyone who had a followup PSA after RT, as EARLY as 19 days.  i'm in that mode right now, and my doc recommended 6 weeks (and even that seems earlier than most other guys).  the bad cells do not die immediately (and can even grow some, as you found out) during the radiation sequence.  it will take weeks/months for the now-crippled cells to die off, and it's not a fun journey, but you gotta let nature take its course, and not let it get you down in the process.  you think you have some decisions to make soon, but actually, decisions are still a long ways down the road.  HANG IN THERE, and enjoy the day!
bob

Age@dx: 55

5/05             PSA test 1.8  --12/19/07  PSA test 3.7  --7/25/08    PSA test: 4.7

8/26/08        1st Prostate Biopsy: 3 samples out of 6 have irregular cells

11/25/08      PSA test: 6.5

12/11/08      2nd Prostate Biopsy :  of 12 samples, 3 are cancer, and all other 9 are irregular.  original NJ lab sent samples to Johns Hopkins for special reading.  Gleason 3+3=6.  now:read book, and think about options: radiation, surgery, etc

1/22/09        Radical Retropubic Prostatectomy.  main issue was use of BOTH pre-donated units of blood during surgery, and then required 2 additional units in recovery, before going to room

1/25/09        Released from hospital. No drive, no lift >5 lb

1/28/09        Pathology results from removed tissue:  Cancer was seen on 10% of gland, lymph nodes & SV were benign, nothing seen outside of the prostate.  One area of cancer extended right up to edge, but not beyond.  Gleason was re-typed as 3+4=7, staged T2c

2/13/09        PSA=0.1

3/6/09          6week appt, start back to work Monday, 3/9.  script for Cialis

6/8/09          PSA=0.1

10/9/09        PSA=0.1

2/10/10        PSA=0.3 discussed possibility of radiotherapy and/or hormone.

4/7/10          PSA= 0.4  Recurrence of the cancer is probable. Referred me to RO

5/4/10                   First RT.  RO is recommending 37 treatments x 1.8Gy=66.6 Gy

6/25/10       Final RT. ended up w/ 36 treatments, 64.8 Gy


Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 209
   Posted 7/1/2010 2:58 PM (GMT -6)   

I appreciate all the advice and positive attitudes of all of you.  This is what makes HW so valuable, it gives us a place to turn because we know that "you've been there and done that."

The doc asked if I wanted a PSA shortly after SRT and I said yes.  He also said that only after the 3 month test and particularly the 6 month test would he make recommendations for further treatment etc.  He said that if the PSA stayed about the same or actually decreased shortly after IMRT, that was a very good sign but it doesn't always happen.   

 


Dx 07/09 Age 67  -  28 core saturation biopsy w/5 positive  (2 gleason 8, 2 gleason 7, 1 gleason 6)
RRP 8/13/09 Mayo Clinic Jacksonville
Path report upgraded gleason to 4+5=9
Negative margins/extraprostatic extension/seminal vessicles/ lymph nodes but perineural invasion present.
Two month post surgery PSA 0.022
Five month post surgery PSA  0.081
Seven month post surgery PSA 0.190
Eight month post surgery PSA 0.217
Started 38 sessions IMRT at Mayo Jacksonville on 4/12/10,  completed 6/4/10.  Few side effects except urinary urgency and  frequency during the day and some rectal discomfort near the end of therapy. 


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 7/1/2010 3:07 PM (GMT -6)   
Agree with others on this, not enough time to know. In case you didn't know radiation especially as first line treatment, takes quite a while to kill PCa cells, messes up the DNA and they slowly get the axe, it is not the radiation ray gun idea like on t.v. and they die instanteously zap-zap your dead (LOL)  nono   I charted my psa tests atleast monthly after radiations, took 9 months thereafter to achieve nadir, lowest psa ever, the following month it went up some, so mine was around 9 months. In first line treatment it can even take much longer, so with salvage 19 days even though no prostate gland around, the lingering cells still are not all dead yet is the message, takes alittle time, no ray guns. (laugh) Hope you enjoy the dumb analogy. turn
Youth is wasted on the Young-(W.C. Fields)

Post Edited (zufus) : 7/2/2010 6:12:01 AM (GMT-6)


Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 209
   Posted 7/1/2010 7:05 PM (GMT -6)   
Zufus, the analogy was not dumb, it was perfect and the Old Sailor understood it.  Thank you
 
(Sure would be neat if they actually had a ray gun wouldn't it?)

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 789
   Posted 7/2/2010 7:21 PM (GMT -6)   
Hi Old sailor, I am one of us that radiation made no difference to my PSA, as you can see on my signature my PSA has hovered around 0.5 ever since the RP, it was 0.6 last time.

On the 30th of July this year, it will be 3 years since my operation, my PSA has changed little in that time, next PSA is 26th July...fingers crossed, hope your next PSA goes well for you, think 19 days is too soon.

Regards Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)
PSA 11th March 09 0.5
PSA 3rd August 09 0.6
PSA 25th November 09 0.6 (I am now 69)
PSA 18th Jan 10 0.6


Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 209
   Posted 7/2/2010 9:43 PM (GMT -6)   
Mal, if your psa continues to hover around the .5 range I would think your doing OK.

I sincerely hope you do well on 26 July. I'll keep you in my prayers and thoughts. The Old Sailor
Dx 07/09 Age 67  -  28 core saturation biopsy w/5 positive  (2 gleason 8, 2 gleason 7, 1 gleason 6)
RRP 8/13/09 Mayo Clinic Jacksonville
Path report upgraded gleason to 4+5=9
Negative margins/extraprostatic extension/seminal vessicles/ lymph nodes but perineural invasion present.
Two month post surgery PSA 0.022
Five month post surgery PSA  0.081
Seven month post surgery PSA 0.190
Eight month post surgery PSA 0.217
Started 38 sessions IMRT at Mayo Jacksonville on 4/12/10,  completed 6/4/10.  Few side effects except urinary urgency and  frequency during the day and some rectal discomfort near the end of therapy. 

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