Radiation finished and first PSA

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breakthecycle
Regular Member


Date Joined Jun 2017
Total Posts : 42
   Posted 3/7/2018 2:15 PM (GMT -6)   
Wanted to share my brothers progress. He finished radiation about a month ago after a June diagnosis, 3 months of hormones and radiation that began in November.

He was diagnosed as a 4 + 3 with a possibility of 4 + 4. 2 or 4 out of 12 cores positive. PSA of 4.56.
Palpable on one side.

His first PSA results are .01

Is this something I can feel thrilled about? I am so happy to hear the results. Any idea of future possibilities?


Thanks for "listening"

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 8618
   Posted 3/7/2018 3:12 PM (GMT -6)   
That's a good number! You should plan a party.

Since he's been on HT, you can expect that number to rise as the HT wears off. It should still be less than he start with.

At the moment HT is keeping his PSA low, so don't be surprised at a rise in the next test. That would be normal here.
Andrew
I'll be in the shop.
Age 58, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17, .3 10/17
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

Saipan Paradise
Veteran Member


Date Joined Sep 2017
Total Posts : 632
   Posted 3/7/2018 3:56 PM (GMT -6)   
“Thrilled” sounds about right.
Almost the only place to go from .01 is up, so don’t get too upset if you’re less than thrilled by the next result. What Andrew said.
Age 60 at dx
Dx July 2017 after biopsy G8 (4+4), 5/13 cores, bone scan clear
RARP Aug 11, 2017 (Dr Patel)
Post surgery pathology: pT3a, tumor 30% of gland; EPE+, SV- and 3 lymph nodes clear
PSA 1/2016, 2.9; 4/2017, 7.2; 9/2017 (first post-RARP), 0.13; 10/2017, <0.05, 1/9/2018, 0.09, 1/31/2018, 0.10, 2/9/2018, <0.05(!?), 2/23/2018, 0.08.
Eligard start 3/2/2018. Early salvage WPRT 3/12/2018, 75.6Gy

breakthecycle
Regular Member


Date Joined Jun 2017
Total Posts : 42
   Posted 3/7/2018 8:21 PM (GMT -6)   
Thank you. I hope it is not falsely low because of the hormone therapy.

I will try to enjoy and pray for the best.

Best wishes to you all.

Redwing57
Veteran Member


Date Joined Apr 2013
Total Posts : 2413
   Posted 3/8/2018 7:59 AM (GMT -6)   
Lack of testosterone, ADT, does suppress the PSA. It could be considered "falsely low" for that reason in a sense, but it's perfectly ok. You can certainly expect the PSA to pretty much remain undetectable during ADT. When that stops, and the testosterone recovers, the PSA may well go up a ways.

After radiation there is often a PSA "bounce" as it's called, but ADT masks that phenomenon. Once the ADT "releases", the PSA will likely rapidly head up to where it would have been without ADT. That trend can be quite alarming at first, but it will also likely level off and begin to descend as the radiation develops its longer term effectiveness. Radiation isn't an instant "cure" like surgery. It takes time to do its work.

I looked long and hard for studies about PSA trends after radiation and ADT. There is very little published, and mostly the doctors just don't know what that pattern could or should be. They just don't know.

Everyone worries about recurrence, but there are ASTRO guidelines for that. The guidelines make sense to me. In fact, without the guidelines they use now, I might have been considered recurrent and embarked on some (unnecessary) life-altering treatments. However, per the guidelines we waited it out (looking for it to go over 2.0), and my PSA has now leveled out a bit over 0.5 and I'm quite pleased with that.

[Edit: added link]
55@Dx 4/16/13
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3T mpMRI: Bilateral EPE, NVB+, SV-, LN-)

Pre:
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31

Tx:
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex, ended 3/16

PSA <0.1 : 8/13 - 5/16;
0.2-8/16, 0.5-12/16, 0.7-3/17, 0.8-5/17, 0.8-7/17, 0.7-10/17, 0.6-1/18

Post Edited (Redwing57) : 3/8/2018 7:11:53 AM (GMT-7)


Michael_T
Veteran Member


Date Joined Sep 2012
Total Posts : 2812
   Posted 3/8/2018 9:23 AM (GMT -6)   
The .01 PSA is more likely the result of the ADT, but that's a very good thing and shows that he's very responsive to the lack of testosterone. So yes, you should be happy with this even though his PSA will likely creep up after ADT ends.

Good luck to your brother and keep us posted!
Age 57, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
9/17: PSA = 0.1

breakthecycle
Regular Member


Date Joined Jun 2017
Total Posts : 42
   Posted 3/8/2018 3:42 PM (GMT -6)   
That is what I thought. Thank you very much for that information. I do find it hard to find studies that answer questions that I have.

One is a nomogram of radiation instead of RP.

You would think there would be more to find than there is through the internet.

I am thankful to this website. Everyone's information is so helpful.
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