PSA post salvage radiation

[Silverlings]

My husband, at diagnosis had 3+4 on a couple of samples and chose to have surgery. He had clean margins and reached undetectable PSA after Prostatectomy. Near the end of 5th year after surgery his PSA became detectable. I’m confused, If clean margins how would cancer be outside the prostate?

He did salvage radiation at .09 PSA. His PSA went down to .08 after 3 months and to .03 after 6 months. Does salvage radiation work similarly to when someone has radiation as first treatment where PSA goes down over a long period of time? I know everyone is different but is it still possible that he could get back to undetectable?

It’s my first post so I’m not sure if I’m in the right group but really appreciate your thoughts as I remain cautiously optimistic. We’ll celebrate his 60th Birthday next month!!

[Justfor_]

Radiation results, good or bad, are slow in manifesting.

[Tall_Allen]

"If clean margins how would cancer be outside the prostate?" Cancer does that. it becomes able to travel and live outside the prostate (i.e., the cells become metastatic). The metastatic cells were probably already there when he had his prostatectomy. They are very slow to grow at first.

"Does salvage radiation work similarly to when someone has radiation as first treatment where PSA goes down over a long period of time? I know everyone is different but is it still possible that he could get back to undetectable?" 0.03 is very low - for all intents and purposes, undetectable.

[tango65]

Is he on ADT?

[Silverlings in reply to tango65]

He did the Decipher test and the doctor said it came back as ADT not needed or recommended, I don’t recall exactly, so he is not on that.

[tango65 in reply to Silverlings]

The radiation has been effective and his PSA is very low, Most people would consider that a PSA of 0.03 or lower is "undetectable".

[daleboy3]

I don’t have prostate Cancer but I have a large prostate that aches I use Tamulosin to shrink it, then I found a alternative method on the Internet where they stated take one heaped tea spoon of Bicarbonate of soda put it in a glass 🥃 add one tablespoon of honey then mix with two tablespoons of hot water stir & drink, well I followed this recommendation & believe it or not my Prostate stopped aching in fact it shrank I was was Gob Smacked as to how effective honey & bicarbonate of soda was so effective as it lowers the acidity in the body putting the body into a Alkaline state

[j-o-h-n in reply to daleboy3]

Also can be used for getting rid of ants........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/31/2023 11:27 AM DST

[Teufelshunde]

Yes, and many labs <0.03 is as low as they can test, so considered undetectable. It took mine about 6 months to get to 0.06, at 10 months was 0.02, and at 13 months <0.02 (lowest Quest post prostatectomy test goes). Coming up on a year at that level in a couple months. Looks like your husband is on track.

[Hidden]

you might research micro-metastasis and discuss with your oncologist.

GD

[j-o-h-n]

Can or would you update your husbands bio....all voluntary but helpful for you and to us... Thank you.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/31/2023 7:07 PM DST

[Silverlings in reply to j-o-h-n]

I’ll try

[j-o-h-n in reply to Silverlings]

Now don't go crazy updating his bio......... As I tell my wife "little by little"...... cut one blade of grass a week.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/31/2023 8:41 PM DST

[Hidden]

.09 PSA. His PSA went down to .08 after 3 months and to .03

Please confirm those numbers.

Maybe 0.9 0.8 and 0.3 I would agree to salvage.

Usual PSA test would read <0.1 as undetectable.

[Silverlings in reply to Hidden]

yes, .09 just before SRT, 3 months later it was .08 and three months after that .03 which was last week.

[RMontana]

This is only one study and its underpowered (small patient size) but it dovetails with other studies I have read. Salvage Radiation Therapy (sRT) has a significant impact on BPFS, MFS and ADT free survival (check out the study for what these acronyms mean)...

healthunlocked.com/active-s...

It is very odd that GS of 3+4 would be spread outside the prostate gland when the margins were clear; typically I read that you need GS of 5 to spread by blood...the only explanation may be that the biopsy did not find all the cancer that was there and that there was some higher grades present, which do spread by blood...no matter at this point.

He got sRT at very low PSA levels as well...I moved on mine with PSA of 0.13 which is still low, but your husbands were very low...going forward make sure he keeps an eye on the three legs of the recovery stool and does not focus on only one; treating the cancer. The three things to focus on are Treatment-Incontinence-Erectile Dysfunction...they should be considered together at the same time as we move foward...I made the mistake of being very aggressive with my treatment, did not look at all three aspects of recovery and now regret some of the side effects which I could have avoided...I only make that comment because you moved to sRT with very low PSA...watch out for all three aspects of recovery. See my personal story on my account if you want to know what I would have done differently...good luck. Rick

PS if he has not done so look at some genomic testing to see what cell types he has...for me GS is the type or class of PCa you have and the genetic make up of the cells are how aggressive they will be as they grow...one is the type of car that the PCa uses to travel with and genomics will let you know how fast it can travel...see this link for the best mapping I have seen on what's out there. Even if he had no genomic testing this tissue sample is stored for years and can be pulled for testing ever after the fact (sorry, dont know if he got any of there tests; I did a Decipher test)...without knowing the genetic make up of the cells it harder to make the correct decision as to how aggressive the treatment should be...

healthunlocked.com/active-s...

[Silverlings in reply to RMontana]

Thank you so much! So far he’s been doing well with the other two legs of the stool. Occasionally has to remember to do Kegel. He did do the Decipher test, I need to learn more about the results and will refer to your post for additional help. They said as a result of that test, ADT wasn’t recommended or needed (don’t recall why). He’s Brca2 positive with most of his uncles, aunts, and father now passed from some form of cancer. It was decided to treat early given his age at diagnosis, 57.

Thank you again!

[RMontana in reply to Silverlings]

This article can explain why ADT was not recommended...glad to hear he is watching all three parts of the recovery; I was not and was focused only on treatment and missed some opportunities.

healthunlocked.com/active-s...

He should think about an implant at some point as the truth is vast majority of us will never recover natural erections...I wished I had moved on mine a year earlier...the longer he waits the more atrophie will ocur...Rick