Just got my first PSA results after Brachytherapy.

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Regular Member

Date Joined Jan 2010
Total Posts : 281
   Posted 9/1/2010 6:31 PM (GMT -6)   
Today I received the news that my PSA is 0.12 this being three months after receiving the seeds. I have been assured that the first PSA results after the procedure are usually not extremely low but will drop lower with the next few PSA tests which will be taken in another 3 months and then 6 months periods. Hope that is correct and I really hope that the figure 0.12 is acceptably low for the first three months of the seed radiation. Can anyone assure me that the above is correct. Thanks.
Bob in Colorado

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4170
   Posted 9/1/2010 6:39 PM (GMT -6)   
Anything below 1 should be considered good.

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.


Regular Member

Date Joined Apr 2010
Total Posts : 104
   Posted 9/1/2010 6:42 PM (GMT -6)   
Bob, that sounds great. Congrats. I've got my three month test coming up in 3 weeks. Hope I come in as low.

Regular Member

Date Joined Nov 2009
Total Posts : 485
   Posted 9/1/2010 6:49 PM (GMT -6)   
erbob,  In another thread, Casey provided this link  http://www.auanet.org/content/GUidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf  to a paper with very good info on PSA guidelines.  Scroll down to page 39 for some very interesting and surprising (to me anyway) info on PSA after Brachy.  I'm glad to see you have had a very good outcome.

Diagnosed 2/2008 at age 71, PSA 9.1, Gleason score 5+3, stage T1c.
Robotic surgery 5/2008, nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA <0.1 at 26 months and at all tests since surgery.

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 9/1/2010 7:01 PM (GMT -6)   
Congratulation, sounds like a real good post-seed PSA report to me, hope it continues downward for you.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Veteran Member

Date Joined Feb 2010
Total Posts : 3771
   Posted 9/1/2010 7:21 PM (GMT -6)   
carlos -- thanx for the info.  so how would the doc know if you are having a benign bounce or recurrence?

New Member

Date Joined Feb 2009
Total Posts : 8
   Posted 9/1/2010 7:33 PM (GMT -6)   

WOW erbob, nice number but where did you start from. Mine seems to drop in half every three months. Each of us is different and should expect different results, but I would be very pleased if I were you.

age 60, gleason 3-4, t1c, psa 4.2, 5 of 16 cores cancerous, 26cc, brachy dec 29th 2009, 76 iodine 125, catheter out after six days.
3 month psa 1.87
6 month psa 1.06
8 month psa 0.77

Veteran Member

Date Joined Aug 2007
Total Posts : 1015
   Posted 9/1/2010 8:35 PM (GMT -6)   
Congratulations, Bob.

What a great start! yeah

Surgery: Da Vinci; July 31, 2007; 54 on surgery day;
Pathology: PSA: 4.3; Gleason: 3+3=6; T2a; Confined to Prostate;
Post RP PSAs: 09/'07 <0.04; 12/'07 <0.04; 03/'08 <0.04;
06/'08 <0.04; 12/'08 <0.04; 06/'09 =0.06; 09/'09 <0.04; 12/'09 =0.05;
3/'10 <0.04; Latest PSA 6/'10 <0.01

Veteran Member

Date Joined Jan 2010
Total Posts : 2832
   Posted 9/1/2010 8:52 PM (GMT -6)   
Wishing you all the best erbob - I am still learning what is what here - and that seems like a good result for starters ... here's to lower numbers and an upcoming membership in the zero club -
Age: 54 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB - hooorah!
Next PSA: Sept 23, 2010 -TBA

Forum Moderator

Date Joined Sep 2008
Total Posts : 4045
   Posted 9/1/2010 9:05 PM (GMT -6)   
Bob, not only is that "acceptably low" but it is excellent.  You should be very pleased!!!
Tudpock (Jim)
Age 62, Gleason 3 + 4 = 7, T1C, PSA 4.2, 2 of 16 cores cancerous, 27cc
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 4/10/10.  6 month PSA 1.4 and now 1 year PSA at 1.0.  My docs are "delighted"!

Regular Member

Date Joined Feb 2010
Total Posts : 242
   Posted 9/1/2010 9:08 PM (GMT -6)   

That is a great number if you are not on hormone therapy.

If you are on HT, or were on it to reduce the size of the prostate before the seed implant surgery, the number would be less meaningful. I don't know what to make of my own numbers. The medical oncologist seemed very pleased with the latest reading but my understanding is that it needs to go down to 0.02 or lower for a more favorable outcome. And even in that case I believe the subsequent rise after nadir is potentially more significant.

Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative

Treatment: brachytherapy (103 palladium), 100 gy, 11/2010 + hormone therapy (Lupron + Casodex) + IMRT on Novalis, 45 gy, 3/2010.

PSA: 7/2009, At time of diagnosis -- 11.9
10/2009 -- 5.0
12/2009 -- 0.56
5/2010 -- 0.15
8/9/2010 -- 0.06

Post Edited (Sancarlos) : 9/1/2010 9:13:54 PM (GMT-6)

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 9/2/2010 9:46 AM (GMT -6)   
F8 your question:
carlos -- thanx for the info. so how would the doc know if you are having a benign bounce or recurrence?

Here is the basic answer as I understand it, you monitor you psa's consistently, usually a bounce is a significant psa rise (like a radiation induced prostatitis is mentioned). This phenomena can happen 6 months out post radiation or maybe up to 2 years+ post radiation. (If bounce)This sudden psa rise is also followed by a siginificant psa decline right afterwards (somewhere with in those types of time frames). Thus psa history and monitoring it the key, if it doesn't drop somewhat soon afterwards, that is recurrence issues. If this were to happen 3-4 yrs.+- out most likely is recurrence.

Post Edited (zufus) : 9/2/2010 9:51:33 AM (GMT-6)

Regular Member

Date Joined Oct 2009
Total Posts : 420
   Posted 9/2/2010 10:14 AM (GMT -6)   
Looks like a great start....congratulations! Be sure to take a look at the link included by Carlos above. It's important for BT guys to understand the "bounce" effect about 18 months out (See pages 39 and 40). Regards,

Regular Member

Date Joined Jan 2010
Total Posts : 281
   Posted 9/2/2010 1:26 PM (GMT -6)   
In a post above, Sancarlos said, "That is a great number if you are not on hormone therapy.
If you are on HT, or were on it to reduce the size of the prostate before the seed implant surgery, the number would be less meaningful."

His thoughts on this are certainly appreciated and I suddenly got more than a little concerned about the accuracy of the current PSA reading.
I just got back from the three month follow up visit with my Urology Doc (a prostate cancer surgeon for over 25 years) and furnished him with my PSA score of 0.12. He indicated that this figure is very good and was happy to see it. I asked him about the number not being quite as significant if Lupron were used to shrink the prostate before my brachytherapy. He checked my records and saw that I had the Lupron six months ago. Said that since it was a three month shot on a one time basis, that drug would be well out of my system now six months later so the 0.12 should certainly still stand. So, I felt much better after hearing his views.
Many thanks to all who sent their congratulations for my LOW PSA number. Now, I'll strive to keep it that low or lower. :-)

Veteran Member

Date Joined Feb 2010
Total Posts : 3771
   Posted 9/2/2010 1:47 PM (GMT -6)   

erbob -- i will be on lupron for 9 months.  one of my docs says my psa will be accurate 9 months after my last 3-month shot but like you said you only had one shot.


Veteran Member

Date Joined Dec 2008
Total Posts : 672
   Posted 9/2/2010 2:05 PM (GMT -6)   

From what I've read, that is a great number. Congrats and may you have many more lower!


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