IS A Post-SBRT bounce similar to primary radiation tx. bounce?

[compiler]

Brief background summary:

DX 12/09. I had a G 4+3 on biopsy.

Had RP. Failed that. Had SRT (IMRT). Failed that. Had HT (Lupron + Casodex). Great response, Enough to do HT vacations after a year. When PSA would start rising, did best scans at the time (C11 Scan at Mayo in 2014; Ga-68 PSMA scan at Umich in 2018). Each scan found 1 or 2 hot ext. abdominal node. SBRT each time. Very succesful in kicking down PSA. Once again, PSA trending up, except for a sudden drop (most recent one). Next PSA in 2-2 1/2 mos. If significant PSA rise, will do the Pylarify-PSMA sczn at U

So, thanks for reading my long-winded background summary. My simple question: We KNOW that post-primary radiation tx. one expects a bounce, maybe after 18-24 months. So what about SBRT in the post- curative bullets SBRT setting?

Oh, here are some recent post SBRT PSA scores. Talk about bouncing! Note most recent one. False hope? In short: how do I interpret this data? Is it just bounce around stuff like primary radiation or is it quit-farting- around-it's-time-for-scan/maybe HT maybe radiation. OR SOMETHING IN-BETWEEN.

06/21/22 PSA: 1.07

04/28/22 PSA: 1.48

1/27/2022 PSA: 0.87

8/27/2021 PSA: 0.47

4/27/2021 PSA: 0.37

11/27/2020 PSA: 0.4

6/23/2020 PSA: 0.38

1/27/2020 PSA: 0.47

11/15/2019 PSA: 0.75

8/14/2019 PSA: 0.59

5/14/2019 PSA: 0.21

Mel

[Tall_Allen]

Bounces only occur after primary RT, not salvage. You are "treating PSA" by only zapping the lymph nodes responsible for the PSA. It is not a bounce, it's the cancer growing somewhere else.

[compiler in reply to Tall_Allen]

TA:

Anyway, how do I explain the up/down bounces? PSA keeps growing and SBRT keeps killing?

Mel

3.06

[Tall_Allen in reply to compiler]

Sometimes metastases put out more, sometimes less.

[Tall_Allen]

Edit is under "More"

[Tall_Allen]

You only get "copy reply link" if you haven't written the post.

[MateoBeach]

After SBRT (and SBRT again) to all the Mets that can be seen on the best PET scans. Then it is time to go after the micromets and remaining PC stem cells that are certainly there. I chose to go after them with experimental form of Lu-PSMA using a very high bonding radioligand called J591 that is a monoclonal antibody to PSMA. You can read my detailed description in my previous posts. You can virtual consult with Dr Nat Lenzo of Theranostics AU /GenesisCare in Perth about it.

Other systemic treatment choices (non-hormonal) include the standard Lu-PSMA treatment, Pluvicto, and chemotherapy.

[NotDFL]

Like Tall Allen wrote, it looks like the cancer is still around somewhere, unfortunately.