Brachytherapy three month PSA test: what do you think?

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Regular Member

Date Joined Sep 2010
Total Posts : 23
   Posted 12/17/2010 4:09 PM (GMT -6)   
On September 9, 2010 I had the last of a series of pre-procedure PSA tests: the number came in at 5.54. (I was dianoses as t1c; four cores positive out of 12, gleason 6 in late June).

I had brachytherapy (108 iodine seeds) on September 28th.

On November 1st I underwent a bunch of blood tests on an unrelated matter at the hospital. They tested my PSA at the request of my prostate cancer team just to see how things were going: it came back at 7.88.

On Wednesday I reported to the Prostage Cancer Centre for a third-month check-in. PSA test done again, carefully and on schedule this time. I got the results this morning: 4.54.

I asked my doctor what to make of these results, and specifically what to make of the relatively high number in November. In summary, he said that the November blood test was not to be relied on, since the radioactivity was at its peak inflicting trauma on the still alive-and-kicking prostate and that was artificially increasing the PSA number. This would likely to still be true for some time to come.

He predicted this week's number would be lower (as it was) and would therefore be moving in the right direction. He said as long as that is true there is no reason for concern. Things are going according to plan as long as the number does not spike upward or keep going upward. See you in March for the six month test.

Anyone have comparable experience or a view on this?

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4170
   Posted 12/17/2010 5:17 PM (GMT -6)   
As long as it is moving sown there isn't a problem. Idodine has a much longer half life than pladium 105 and should take longer to work. There are many men on Brachy that have seen reductions of up to 4 years before seeing the nadir. many claim the longer it takes to reach a nadir the less chance of a reoccurrance.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Regular Member

Date Joined Nov 2010
Total Posts : 264
   Posted 12/17/2010 5:51 PM (GMT -6)   
When I finished my IMRT treatments I asked my radiation oncologist what PSA numbers to expect after the seed implants were in and we waited 6 months. He said in my case if we were at or around 3 he would consider the treatments to be working. If the number was around 30 then he would think that the treatments didn't work. We all want the trend to be downward.

Best wishes on your next test.
age 57 2/2010
PSA Feb 8.2
biopsy 2/2010 - 2 of 8 left & 2 of 8 right positive, Gleason 3+4=7
attended support group - advised to get a second opinion
second opinion on pathology from Johns Hopkins 4+4=8
PSA 15 4/2010
5 weeks IMRT 4/2010-6/2010 at Copley Hospital in Aurora, IL
91 palladium 103 seeds 7/2010 at Chicago Prostate Center, Westmont, IL
PSA Oct 3.97, Dec 2.78
no ED or incontinence

Forum Moderator

Date Joined Sep 2008
Total Posts : 4045
   Posted 12/17/2010 6:16 PM (GMT -6)   
Brian, interestingly enough my docs (both urologist and radiation oncologist) wanted to wait a full 6 months post brachy before doing a PSA.  I was Iodine also and that was part of the logic.  At the 6 month time they wanted to see the PSA cut in half before they would be "delighted".  As JT said it can take years before you reach your nadir and as long as it's heading in that direction you should be fine.  I have read at least one study (that I can't put my hands on right now) that quoted the median time to nadir as 40 months.  Obviously then it could be much longer.
I think your PSA test might have been a bit early but the PSA is heading south and that's what you want.  Continue to enjoy life and assume the best...let us know at 6 months...chances are you'll continue to drop.
Best regards,
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:

Regular Member

Date Joined Sep 2010
Total Posts : 23
   Posted 12/17/2010 6:18 PM (GMT -6)   
Very reassuring! Thank you all and all the best for the season -- including, I hope, better sleep at night.

Veteran Member

Date Joined Jul 2010
Total Posts : 3596
   Posted 12/17/2010 8:47 PM (GMT -6)   
My R-doc, a man of considerable stature in the field, says 6 months is soon enough for the first post-treatment PSA...Radiation works slowly, PSA anxiety is bad enough as it is..

In my case, the RT is being combined with HT so it becomes very difficult to determine which treatment is responsible for any dramatic drop in PSA if indeed there is a drop....I'm more concerned what my PSA will be in two or three YEARS not 2 or 3 months...Living for that next PSA test is no way to live...If tomorrow looks like it's going to be a good day, then make a good day out of it!

Veteran Member

Date Joined Feb 2010
Total Posts : 3771
   Posted 12/17/2010 9:05 PM (GMT -6)   
>>In my case, the RT is being combined with HT so it becomes very difficult to determine which treatment is responsible for any dramatic drop in PSA <<
i get my next PSA test in February, which is about five months after my last shot of lupron.  i had BT in april and i finshed IGRT late august.  my doc says if my PSA is above 2 that there's a problem.
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
received 3rd and last lupron shot 9/14/10

Veteran Member

Date Joined Dec 2010
Total Posts : 657
   Posted 12/19/2010 9:04 AM (GMT -6)   
I had brachy on Oct. 4, 2010. I go back on Jan 6 to check the PSA. I would rather wait longer...much longer, but that is what the doc wants.
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