Post radiation PSA

[warrior22]

Full pelvic rad done ( 6 weeks ) just 3 weeks ago. Still have Lupron.

Repeat PSA went from pre of 2- post rad 3. MO wants to add Zytiga. Articles say give the radiation 2-3 months before repeating PSA as those cells excreted antigen and can expect a slight increase.

Anyone else have an experience that can be shared or thoughts

[PabloK]

yes - that is also my understanding. These things take some time.

[Tall_Allen]

2 years of Lupron+Zytiga are needed. PSA tests are meaningless while on ADT.

[Papillon2 in reply to Tall_Allen]

Would it be wrong to use PSA tests periodically while on Lupron to see if one has become castration resistant?

[Tall_Allen in reply to Papillon2]

One does not become castration resistant when using ADT as an adjuvant therapy with radiation.

[Papillon2 in reply to Tall_Allen]

What if one has chosen long-course therapy with ADT plus radiotherapy after surgery. (pcf.org/news/18-month-adt-o... ) We have the options of using 6,12,18 or 24 months.

[Tall_Allen in reply to Papillon2]

4-6 months ADT is the SOC for adjuvant ADT with salvage radiation.

[Papillon2 in reply to Tall_Allen]

Thnx Big Guy. Wish us all the luck in the world. We already got the second shot. We are during 12 months.

[CharlieBC in reply to Tall_Allen]

I am on ADT + Xtandi. The barometer of effectiveness is the PSA. I know I am castrate resistant. Am I relying on the PSA to show my reaction to Xtandi a good thing?

[Tall_Allen in reply to CharlieBC]

You are probably not using it the same way as the OP, as an adjuvant to radiation.

[CharlieBC in reply to Tall_Allen]

Thank you.

[EdBar]

I recently had SBRT to a spot on one of my ribs. I’m hearing the same 2-3 month period to hopefully see a drop in PSA. Both of my oncologists have told me to continue PSA tests in the meantime. My local MO ran one yesterday when I saw him, the next one is in 6 weeks. Then I’ll run the next one prior to traveling to see Dr. Sartor at Tulane in May.

Ed

[Tall_Allen in reply to EdBar]

But, unlike the OP, this is not whole pelvic radiation.

[EdBar in reply to Tall_Allen]

I am sharing my experience with warrior 22, no need to reply to my post, thanks. I’m not a doctor so I’m not qualified to give give advice, I can only share my experience.

Ed

[timotur]

PSA isn't meaningless on ADT-- it gives you an idea how you are responding to ADT, but on the other hand, it is not an absolute indication of disease progression. More important is the trend of PSA, which could give an indication of when castration resistance occurs.

youtube.com/watch?v=aUXnlnc...(Not working as expected?)

[Papillon2 in reply to timotur]

👍 Thnx.

[warrior22 in reply to timotur]

This is awesome and very encouraging. So, only 3 weeks out we should not be so worried that it went up a point. Hoping over time, the trend will start downward.