PSA right after adjuvant radiation

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alicomp
Regular Member


Date Joined Feb 2010
Total Posts : 40
   Posted 7/17/2010 6:51 PM (GMT -6)   
My husband will be finishing with his radiation (after surgery) in a week and a half. He is due to have his 6 month PSA a couple of weeks after that, but we are thinking of moving it up as we want to go on a much-needed vacation and would like to have the PSA results before we go. I seem to remember reading that there is sometimes a PSA-bump after radiation. I don't remember where I read it and don't know if it applies to adjuvant radiation or to salvage, or both. Does anyone have any information on this? Thank you.
Husband dx 12/09
Age 60
PSA 4.5
Biopsy 8/12 cores positive; 5% - 50%
Gleason 3+3
DaVinci at UNC 3/9/10
Gleason 3+4 with tertiary 5
% of prostate involved with tumor 20%
Not confined to prostate; surgical margins positive for carcinoma, left mid prostate
Perineural invasion extensive
pT3A
pNx
pMx


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 448
   Posted 7/17/2010 7:22 PM (GMT -6)   
A PSA right after radiation does not mean very much. For SRT, they had me wait 3 months before taking a PSA. From what I have read, the radiation messes up the DNA in the cancer so it cannot re-produce... So you need to wait til the old cells die off before it is worth taking a PSA.
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!
 


SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 7/17/2010 7:38 PM (GMT -6)   
I will be finishing my SRT next week and my doc also said that we will wait for three months before getting another PSA. Before then, it is not worth much. I plan on taking a three month break from cancer and worry about nicer things. Squid.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*ED - Yes 
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.
*03/15 - Cath #4 out. Great urine stream. Unfortunately, incontinence back to post surgery level.
*04/14 - Six month PSA .21.
*05/15 - Incontinence basically under control.  99% dry.  Wear pad daily at work "just in case".
*06/10 - Started IGRT.   39 treatments scheduled.
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 7/17/2010 8:08 PM (GMT -6)   
I agree, there's no point in having a PSA done that close to ending radiation as a secondary treatment. It takes a while for the drop to take place if it is working. The classical PSA bump has to do with people that have radiation as a Primary Treatment, not a secondary treatment. I would wait at least 2 to 3 months after his radiation ends. No point adding needless worry to what you both have probably been through. Good luck.

David in SC
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 cath #6 - 41 days, 8/9 2nd corr surgery, 8/9 cath #7 - 38 days, mapped  9/9, 10/1 - 3rd corr. surgery - SP cath, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12 ,Cath #11 - 21 days,  Cath #12 - 41 days, 3/2- Corr Surgery #5, Cath #13 - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, Cath #17 - 39 days, 7/2 - Corr Surgery #6, Cath #18 - 13 days, Cath #19 still in place


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 7/18/2010 3:37 AM (GMT -6)   
I agree too. When the uro sent me to RT he said no point in a PSA test until 3 months after RT finished. My RT docs and nurses also said several times, "don't go having a PSA test till at least 3 months".

My RT finished in June, but as it happened July was going to be 1 year after surgery, so before they decided I had to have RT they had already given me an appointment for a PSA test for July. There was no point in having that July test so I simply asked them to cancel it and reschedule it for September. (Even the receptionist who rebooked it knew there was no point in having a PSA test so soon after RT)

And as for the phenomenon of "PSA bump", well that is what might happen at the 3 month test, so that it is very likely that it will be the 6 month test that shows more about what the RT has done.

I know you will be feeling anxious, but have the vacation anyway. (Carpe Diem: I have a message permanently visible in the corner of my screen that says: "If I have less time then I must do more of everything I enjoy" so it's really Carpe Dies!)

Alf
Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking of urine
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc. but...
Nov 17th 2009 PSA = 0.1
Can still get erections okay, and almost no leaking of urine, but since December 2009 I don't have orgasms, instead I just have intense pain in place where prostate used to be.
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)
June 11th 2010 finished RT - main side effect tiredness, but also the occasional small leak
June 27th My 50th Birthday - feeling better but still not 100% okay

Post Edited (English Alf) : 7/18/2010 2:40:53 AM (GMT-6)

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