PSA on ADT but post EBRT

[ChloeSS]

Hi everyone! Just wondering if anyone has any info to share regarding psa after radiation but while still on adt. My dad who is stage T3b started Eligard in August 2022 (2 year course) followed by high dose brachytherapy in December and 23 sessions EBRT Dec-Jan 2023. His psa in Oct 2022 (pre-radiation) had dropped from 6 to .24 and psa done a couple weeks ago (post radiation) was .02. Basically I’m wondering if psa at this point is any indicator of outcome or will we not know until he discontinues the adt treatment in August 2024? I appreciate any information you can provide!

[Tall_Allen]

No,it isn't any kind of indicator now. As long as it doesn't go up above 2.0 in Aug 2024, it's all good.

[Hidden]

Welcome and Hello ChloeSS! … I’m sorry that your father has this . My dad got it at the same age . That’s the normal age for this . Doesn’t make it good . However , psa <.02 is excellent ! Now to keep it there for many years . I think it’s the best outcome , so far . Pc is a long winded bastartdo bent on putting us all under . It can hide for years inside of us . My hope is at the two years he’ll still be under ? If so , at that time I’d reconsider staying on what’s working for more years ? Often guys dislike adt so much that they can’t wait to ditch it . I hated it too . After who years I did the orch to drop the lupron shots . I continued on a now defunct test adt drug tak-700 that halted adrenal t production for over seven years before finally dropping it 9 months ago . Was dad stage#4? ………If so , the best that we can hope for is a long remission . If #3 ? A cure is possible ? QOL IS MOST important . Anything to make him more comfortable in his suffering is good! Some members have survived for 20 yrs and more . No two of us are exactly the same . It’s a convoluted disease that really hasn’t been figured out yet . Your love and compassion are the best meds now . Try to help him to keep active and moving . Good job looking out for him . This is the greatest love all. Thank you ! 🙏🏼❤️

[Don_1213]

FWIW: @ 6:50 in the video - the definition of remission for people treated with radiation/ADT, after the conclusion of the ADT - their PSA should be around 0.5 (not 0.05).

I believe he later misspeaks at 10:22 in the video - using the 0.05 number. I believe that's where the confusion comes in. ALL of my MDs have stated either I'm "cured" (IMHO - we'll see about this in about 3 more years) or in "remission" with a steady PSA of 0.2 (+/- 0.04) for the past 20+ months.

Again at around 13:00 - in a discussion about focal treatments and PSA, he again mentions the PSA number of 0.5 as being the limit for remission.

My PSA while under ADT was generally <0.1 (the limit of the PSA tests I had). It rose to the current level as my T recovered. It doesn't exactly track my T (IMHO a good thing) - my T goes up and down more than the PSA number (T goes from 270-380, sort of in waves.. that's low-normal to normal for my age range.)

[timotur in reply to Don_1213]

lt depends on the study… here’s one that says <0.06 is a strong predictor of BFS.

Nadir PSA at 0.06 is a strong independent predictor of BFS in patients with intermediate or high risk prostate cancer treated by definitive EBRT and ADT.

ncbi.nlm.nih.gov/pmc/articl...

[ChloeSS in reply to timotur]

Thank you!

[Don_1213 in reply to timotur]

As you said - it depends on the study. This one is dense with numbers, but a few stuck out. The average radiation dose given was 72Gy. More than half that radiation was given with the now obsolete Conformal 3DCRT techniques. For G9/10 patients now it's common to see in excess of 83Gy, given as IG/IMRT.

The ADT duration ranged from 3 months to 36 months - and it didn't appear that the length of ADT was taken into account (although the numbers were so dense it might have been mentioned somewhere - it wasn't on any of the charts that I saw.)

And the paper noted other papers that had much different conclusions. So we have a study with obsolete radiation treatments and unknown lengths of ADT reporting on survival based on PSA reads.

Meh.... it depends on the study, this one I don't give a lot of weight to.

[Mischa1111111]

Off to a good start .02 is excellent . almost approaching one year on ADT and my PSA is .01 .6 months ago it was .02 also. My current T is also low.13nm/mL. I believe excercise and walking has helped a lot .

[Jack54]

Hi Chloe,

I had Biopsy 13 of 16 cores positive, Gleason 4+5, PSA 54. Tumor covered 3/4 of prostate. Doctor gave me a Stage T3b also. Began treatment June 2020. Did 18 months Lupron along with Bicalutamide. August 2020 Began 45 sessions of EBRT. December 2020 PSA .01. Since there was no evidence of metastasis Doctor allowed me to begin TRT because my testosterone level was 2.5. My last PSA was .24 back in October 2022. Next PSA is scheduled for June 2023.

It’s been 16 months since I finished ADT and my PSA is still low even though I’m doing TRT. From what I understand there is a PSA bounce that can occur as much as 2 to 3 years later. My Doctor told me that he will not be concerned until my PSA goes above 1.0. So far I’m feeling great. Only time will tell if. I’m not the least bit concerned. God is in control.

[j-o-h-n]

Time....

youtube.com/watch?v=8tI1_Kl...(Not working as expected?)

j-o-h-n <===<<< Senior management is about to spike my spikes....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 04/08/2023 11:37 PM DST