If PSA is Suppressed by Doublet ADT, Will Salvage IMRT Cause a PSA Rise?

[103532]

Hello everyone, My husband is nearing completion of his extended pelvic salvage IMRT with boost to retrocaval lymph nodes. His radiation oncologist said it may take several months before the psa calms down, so he would like to see him in July. My question is that, since he is already undetectable due to Lupron/Abi/Pred, would the radiation treatment cause a psa rise despite being on the hormone therapy.? We last tested psa in early March just before the radiation started and it was undetectable. I know I am going to be worried if I see a psa rise. Would shedding dead cancer cells cause this.? I am worried about what to expect. Thank you for your help in this.

Stephanie

[street-air]

psa bounce after radiation happens (not always) a median of 12-16 months after treatment and may be an oscillation of the immune system, post radiation, fighting the cancer. apparently it is more common with younger patients and is a good rather than a negative sign as it may reflect healthy immune system activity. (it looks like the bounce from nadir is incompletely understood, this is just one theory). Since most people are on adt when and after they get radiation and still document bounces I do not think it would be a bad sign to see a psa rise from zero? But note that a normal bounce in psa upwards takes a while to show up.

[103532 in reply to street-air]

Thank you!!! I appreciate the explanation!

[Chasbearcat999]

I did not have ADT and (appear) localized. 2 months after SBRT my PSA was higher than my original diagnosis. Both RO and MO said they often see inflammation for the first few months. Tested one month later it had dropped. Different situations, but same principle I think.

[103532 in reply to Chasbearcat999]

Thank you for sharing that!

[j-o-h-n]

Well Ms. Zipcode,

Better change your UserId to Ms. Worry Wart.........(take some deep deep breaths or you'll drive yourself crazy )...

Good Luck, Good Health and Good Humor.

j-o-h-n

[103532]

I admit this whole thing has made me worry way more than I used to. Deep breaths are happening!