Yes, PSA bounce can be scary, but in many cases it is not a cause of concern. I finished my proton radiation therapy in April 2007 and do not have any experience about
PSA bounce. I did, however, two interesting articles on PSA bounce below. I don't want to draw any conclusion about
your personal situation from these articles, because you should discuss your PSA bounce with your doctor. It is true that most of the members here opt for surgery, but there is now a small group of members, including myself, who have been treated with either photon (x-ray) radiation or proton radiation. I hope to stay here for a long time so that readers of this forum can chart my progress with me. You can read all of the books in the world on prostate cancer and they can't give you the great insight into personal experiences of PCa patients here who have been treated by either surgery or some form of radiation. I hope and pray that your PSA bounce is just a false alarm. Good Luck!
DavePSA "Bounce" No Reason For Concern
May Indicate More Cells Dying
Article date: 2002/12/03
Man continues healthful activity after prostate cancer treatment.
A passing rise in blood levels of PSA after radiation therapy for localized prostate cancer doesn't necessarily mean cancer is coming back, say researchers in the Journal of Urology (Vol. 168: 2001-2005).
If PSA rises but then returns to the level it had just after treatment, that movement may be a "PSA bounce."
"Our study shows some patients can have an elevation in their PSA after external beam radiotherapy that is not a sign of cancer progression" said Louis Pisters, MD, at the MD Anderson Cancer Center in Houston.
The researchers feel that the bounce is not a sign of cancer growth and may be caused by death of damaged cancer cells that then release their PSA.
In fact, patients who have such a PSA bounce less than two years after treatment may be less likely to have cancer return later, said Pisters.
Link To Lower Recurrence Risk
Pisters and colleagues studied 964 patients treated with radiotherapy for localized prostate cancer between 1987 and 1998 to see if a link existed between PSA bounce and likelihood of recurrence.
Checking PSA levels every three to six months after radiotherapy, they found about
12% of the 964 patients had such a PSA bounce.
Although Pisters worried that a PSA bounce meant the cancer was more likely to recur, he found just the opposite. Five years after treatment, about
82% of men whose PSA bounced were free of signs of cancer, compared to about
58% of those whose PSA did not bounce.
A bounce usually began with less than a one-point rise (less than 1 ng/ml), because larger rises were less likely to drop back to their starting points, Pisters said.
Most bounces happened within two years of treatment; later rises were less likely to be part of a bounce, Pisters said. In their study, 80% of men had their bounce within two years and by two and one-half years, that number rose to almost 90%.
Hard To Identify In Advance
Unfortunately, the researchers found no way to predict whether rising PSA would later fall back to its starting point, becoming part of a bounce, said Pisters.
But more study may help scientists be able to make such predictions, which could be very useful to patients and to doctors planning their treatment, Pisters noted.
It's understandable why those with a bounce had less chance of recurrence. Men whose first rise after treatment didn't go back down to pre-treatment levels by definition didn't have a bounce, and may have been having a recurrence, Pisters said.
But the new definition better describes what a real bounce is and helps highlight that not all rises are recurrences, said Pisters.
Expert Calls Report Reassuring
The study is reassuring, and shows patients shouldn't "overinterpret" small rises in PSA by assuming they signal the return of cancer, said Timothy D. Gilligan, MD, a genitourinary oncologist at Dana-Farber Cancer Institute in Boston."We need to be careful about how we interpret PSA right after radiotherapy, so we don’t jump in with unnecessary testing or procedures prematurely, before it's clear that rising PSA means residual disease rather than just reaction to treatment,"
Largest PSA Bounce Study Eases Worry Of Prostate Cancer Returning
Science Daily — Prostate cancer patients who have a temporary rise in their prostate specific antigen (PSA) levels after radiation therapy - called a PSA bounce - are not at an increased risk of their cancer coming back any more than those who don't have a temporary rise, according to the largest study of its kind presented November 8, 2006, at the American Society for Therapeutic Radiology and Oncology's 48th Annual Meeting in Philadelphia.
External beam radiation therapy and radiation seed implants are two of the main treatments for prostate cancer. Since these treatments are minimally invasive, have short recovery periods and often help men preserve their sexual and urinary function, many men with prostate cancer prefer radiation over other treatments, including surgery. The PSA bounce is common in half of all men who have radiation treatment for prostate cancer. Increased levels of PSA, which is a protein produced by the prostate, may be a sign of prostate cancer.
"I believe the results of our study should help reduce the stress and uncertainty for men who experience a PSA bounce after radiation knowing that this doesn't represent a recurrence or put them at increased risk for cancer coming back later on," said Eric Horwitz, M.D., lead author of the study and clinical director of the radiation oncology department at Fox Chase Cancer Center in Philadelphia. "This study significantly impacts the clinical practice for both radiation oncologists and urologists. Clinicians should consider additional PSA tests after the initial bounce to see if the PSA levels return to normal before concluding that cancer has recurred and recommending additional treatment."
The study involved more than 7,500 men in 19 institutions who were treated for prostate cancer with either external beam radiation therapy or radiation seed implants. Findings show that over a 10-year period, there was no difference in cancer recurrence between those who had a PSA bounce and those who did not.