Small PSA rise after radiation: should I worry?

[Arcticfox44]

I finished five sessions of stereotactic radiotherapy of two pelvic lymph nodes on May 12, 2021. The first blood test a couple of weeks later showed a PSA rise to 20 from 16. Doctors said this was probably "flare". Then more than two months later, on July 14, PSA had risen just two points -- to 22. I'm not sure whether this is worrying or not. PSA might still go down. As previously reported, I discontinued Zytiga and prednisolone in early March 2021, having started them in April 2020. I have weight loss, loss of appetite, back pain and stiffness, swollen feet and ankles, and easy bruising of skin, especially on tops of my hands and on forearms. These symptoms do not appear to be abating. However, my most recent PET scan before the radiotherapy showed no "hot spots" apart from the two pelvic lymph nodes, right-side and left-side. I welcome your thoughts.

[GP24]

I think they radiated not all mets that you have. With a PSA value of 16 or higher, an Axumin scan and better yet a PSMA PET/CT will show additional mets.

[Arcticfox44 in reply to GP24]

Thanks. You may well be right.

[Justfor_]

The PSA test has a 20% variance for same lab and same method. You are within this, so only a repeat test, say a couple weeks later, can answer your query.

[Arcticfox44 in reply to Justfor_]

Thanks. I will be retesting of course.

[Tall_Allen]

Expected rise after discontinuing hormone therapy. Certainly better to get all pelvic lymph nodes - you already may be having more growing.

prostatecancer.news/2020/12...

[Arcticfox44 in reply to Tall_Allen]

Thanks.

[Arcticfox44]

Thanks. I agree.