PSA after Brachytherapy

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RayPat
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Date Joined Apr 2010
Total Posts : 104
   Posted 3/15/2011 10:09 AM (GMT -6)   
I had my 9 month PSA test this morning. The test after 3 months had cut the PSA in half and the radiologist seemed pleased with that. What number should I hope for when I get the results tomorrow?
From what I've read seeds take awhile to get to the magic zero number.
Age 63

01/26/10 ...PSA 9.1....Referred to urologist
02/26/10 ...Met with urologist ...DRE normal but wanted to do biopsy
03/26/10 ...Biopsy: 14 samples...3 positive on right side...all 11% Gleason 3+3
4/26/10 Met with radiologist. Decided on Brachytherapy.
6/22/10 Brachytherapy ...needed catheter for a week
9/14/10 First post BT PSA 4.7

John T
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Date Joined Nov 2008
Total Posts : 4223
   Posted 3/15/2011 10:18 AM (GMT -6)   
There is no absolute number, but many doctors consider .2 to be number to shoot for. There have been many patients who have had consistant psas of 4 that have remained stable for years. The only thing you don't want is to see the psa start moving up 3 times in a row.
JT
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.

RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 3/15/2011 10:25 AM (GMT -6)   
Thanks John.

Post Edited (RayPat) : 3/15/2011 10:53:16 AM (GMT-6)


Tudpock18
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Date Joined Sep 2008
Total Posts : 4149
   Posted 3/15/2011 10:55 AM (GMT -6)   
Ray, amen to what John said.  It is a little early for PSA bounce so you probably will see some more gradual decline.  One study I read said the median time to nadir after brachy is 44 months...meaning half of us will go even longer than that before reaching the low point.
 
So...please let us know the results and good luck!
 
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:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 3/15/2011 11:00 AM (GMT -6)   
Thanks Jim. You and John have provided me with enough information so I won't panic if the number isn't super low. I'll have the results tomorrow but don't meet with the radiation doc until next week.

mjluke
Regular Member


Date Joined Jan 2009
Total Posts : 189
   Posted 3/15/2011 6:05 PM (GMT -6)   
Hey Ray:

Here are my numbers

April 2009 3.4
May 2009 Brachy
Nov 2009 1.9
May 2010 1.1
Nov 2010 2.4
March 2011 1.9

I may have experienced this PSA bounce which apparently may be related to inflammation of the prostate from the trauma to the prostate from the procedure- usually accompanied by burning on urination and ejaculation (I have had both and still do from time to time)- not all men get this bounce but it is fairly common and my oncologist wasn`t concerned.

Good luck!
 
63 years old-tumor discovered on digital exam- biopsy December 2008-
4 of 12 samples positive-all on right side
Gleason 3+3=6
PSA-3
Otherwise excellent health.
Brachytherapy- May 19, 2009 -so far, so good.
 
  "There may come a day when the courage of men will fail, but it will not be this day."

RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 3/15/2011 6:13 PM (GMT -6)   
Thank you for the info mjluke. Not sure what I'll get but but at least I won't freak out if it's not super low.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/16/2011 6:38 AM (GMT -6)   
John T and Tud- have answered this for you

Note like Tud mentioned nadir achievement time levels are various in patients, the psa bounce effect might happen in like 33% or less patients with this (time span varies alot). Usually (bounce) it is a noticeable increase in PSA level of which you would freak out if experiencing...the good news is it is followed by a nice decline not long after...so maybe 1-2 months after such a rising nasty looking PSA, compare to further PSA's not long after. Plus with bounce it doesn't happen again, from what I comprehend...someone correct me if that is not the evidence. Radiation messes up the PCa cells DNA(faster growing than normal cells) and thus it takes time for them to get total apoptosis or the axe, I presume is the message for us.  Domo Arigato for the radiation  methods.  (-:
Dx-2002 total urinary blockage from PCa, higher end stats...I think I must have been abducted by aliens probably near Area 51 and Roswell cause this disease is to alien to believe.(LOL) So I zapped at it.

Post Edited (zufus) : 3/16/2011 6:41:41 AM (GMT-6)


F8
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Date Joined Feb 2010
Total Posts : 3800
   Posted 3/16/2011 7:54 AM (GMT -6)   
my doctor told me that the chances of a bounce are 15%.  he also said he wants to see my 9-month PSA below 2.
 
ed
 
 
age: 55
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 3/16/2011 9:23 AM (GMT -6)   
Will men on HT also experience a bounce in PSA? My intuition says probably not but have not seen any studies on the subject.

Sancarlos
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, 11/2009 + IMRT on Novalis, 45 gy, 3/2010 + ADT3 (Lupron + Casodex+Avodart)

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 ; 11/2010 -- 0.013; 3/25/2011-- 0.005

GOP
Veteran Member


Date Joined Dec 2010
Total Posts : 657
   Posted 3/16/2011 9:40 AM (GMT -6)   
My psa was 6.1 when I had brachy. At my six week post-treatment checkup, the doctor said that anything under 4.0 would be considered good. Mine was 0.24. I was and remain ecstatic.

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/16/2011 10:12 AM (GMT -6)   
Santana-Carlos  cool   hope you like the added title humor added) to answer your rockin question:

This phenomena is only on radiation methods, a type of radiation induced prostatitis it has been called by some docs, do I know the how and why....(H-no). Not happening on HT therapies, and you know alot of that phenomena and even first hand. It is wild n crazy on PCa, and exceptions exist....e.g.....low or very low psa and yet agressive PCa, the good news is that is very rare type and a good onco-doc would be able to ascertain via other testings they do, like in Strums book P. 35 (2nd edition). Hey who's the  dude on the inside front cover 3rd photo down...some dude endorsing the book...looks just like me and same  city and state.(LOL)   I would prefer to have the photo of the first guy Howard W., almost a hollywood type photo shoot, cowboy hat and all that, very cool shot and he posted on another forum recently, so doing ok.

Post Edited (zufus) : 3/16/2011 10:21:50 AM (GMT-6)


Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 3/16/2011 10:33 AM (GMT -6)   
Sancarlos said...
Will men on HT also experience a bounce in PSA? My intuition says probably not but have not seen any studies on the subject.

Sancarlos
 
Your intuition is correct, Sancarlos.  PSA bounce is a phenomenon which occurs in roughly a third to half of men treated with RT radiation therpy (either seeds or external beam). 
 
Men who simultaneously undergo HT and RT experience PSA bounce at the same frequency as those who undergo RT alone...re-stated in other words, if you recieve HT and RT the pattern of PSA decline may not be steadily downward (and also the time it takes for your PSA to decline may be prolonged).
 
Bounce is not associated with HT alone.
 

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 3/16/2011 11:02 AM (GMT -6)   
Sorry my question was not clear, but it should have been, will men who have had RT and are also on HT experience a bounce in PSA? Casey indicates they will, and if that is indeed the case perhaps I should be looking for it soon as I am at this point about 17 months out from seeds. I have read that the average time for the bounce is 24 months after radiation begins, though Tudpock gave a figure of 44 months on average, which seems a lot higher than any I have seen.

I also recall reading somewhere that the bounce, ironically, is an indicator of better long term prognosis. Not sure why that would be so but I am certain that I read it some study.

Sancarlos

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 3/16/2011 11:10 AM (GMT -6)   
If you find a link to the bounce producing better prognosis do post it. I would say Casey knows his stuff, but you could always look for more info. The time line does vary and it might be shorter with combo HT, S.W.A.G.: cause more cells get the axe sooner...but that is my dumb logic and not worth admission to DisneyWorld even at 99% off. tongue

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 3/16/2011 11:20 AM (GMT -6)   
Sancarlos said...

I also recall reading somewhere that the bounce, ironically, is an indicator of better long term prognosis. Not sure why that would be so but I am certain that I read it some study.

Sancarlos, perhaps you read this study:  LINK
 
I would be cautious about drawing too many conclusions out of this small-sized study.  There is other literature out there that says that survival rates are not significantly different for those who do or do not experience PSA bounce after RT.
 
 
 
 
 
edit:  changed the LINK to a more recent update of the same study previous linked

Post Edited (Casey59) : 3/16/2011 11:29:04 AM (GMT-6)


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4149
   Posted 3/16/2011 11:49 AM (GMT -6)   
Sancarlos, just so I'm clear...the 44 months I quoted was NOT median time to a radiation bounce.  It was median time for the PSA to fall to its' nadir (low point). 
 
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:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 3/16/2011 7:53 PM (GMT -6)   
Here are some of my PSA figures:

04-25-09 6.1
05-21-09 5.35
08-05-09 5.37
10-27-09 6.93
12-29-09 7.34
02-06-10 6.09
Took Casodex for about five weeks, then got a 3 month Lupron shot to reduce size of Prostate.
03-17-10 5.00
04-24-10 0.7
Received Brachytherapy @ Westmont, IL on 5/26/10
08-31-10 0.12
01-06-11 0.24 (Taken at local Hospital here in Colorado)
02-16-11 0.281(Tested at VA Hospital in Albuquerque)

The Doc who did the seed implanting is very pleased with my PSA numbers.

erbob
Regular Member


Date Joined Jan 2010
Total Posts : 281
   Posted 3/17/2011 6:54 PM (GMT -6)   
Thought sure we'd have more Brachy guys furnishing their figures. Oh well.....

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 3/21/2011 4:56 PM (GMT -6)   
The following article offers some pretty interesting information about PSA bounce after radiation.

http://www.psa-rising.com/med/ebr/psabounce1004.htm

It seems that one theory of the bounce is that it is due to an inflamed prostate, which sometimes manifests itself as a burning sensation during urination. I wonder if any radiation patients have experienced a burning sensation during urination in a time schedule that would correspond more or less to a bounce in PSA?

Sancarlos
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, 11/2009 + IMRT on Novalis, 45 gy, 3/2010 + ADT3 (Lupron + Casodex+Avodart)

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 ; 11/2010 -- 0.013; 3/25/2011-- 0.005
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