My first PSA after EBRT

[RenoPatient]

What kind of score when I get my 6 month followup PSA after 45 sessions of EBRT?My previous score was 7.8 with a Gleason 3+4.

[Tall_Allen]

Mine was about half. No set pattern - just down over time.

[RenoPatient in reply to Tall_Allen]

Thanks Allen! I am Howard Hertz' brother by the way--he is in Berkeley and I am in Reno.

[Don_1213]

Are you on adjunct ADT? (Lupron or the like..)

[RenoPatient in reply to Don_1213]

No, just had 45 sessions of radiation. Thanks!

[LeeLiam]

Some have a smooth downward trend with radiation. Others, like me, have a rollercoaster ride with numerous PSA bounces. Radiation kills cancer cells by damaging the DNA but the cell doesn't die until it attempts mitosis (splits). With a more aggresive cancer, the cancer is splitting rapidly and dying quickly and the PSA drops suddenly. With less aggressive, it takes longer to reach nadir. Along the way, a large number of cells may split and die simultaneously releasing PSA and causing a bounce on your blood test. My PSA history is as follows:

Biopsy PSA dx 13.8

seeds 10/23/06

external beam 11/06 - 01/07

3.2 (1/23/07)

2.2 (4/23/07)

2.5 (10/23/07)

3.2 (1/23/08)

3.5 (4/23/08)

5.6 (6/26/08)

7.5 (10/23/08) bounce peak

6.0 (11/23/08)

3.7 (3/15/09)

3.4 (7/23/09)

2.3 (11/6/09)

2.7 (3/23/10)

3.7 (7/25/10) bounce peak

2.4 (10/16/10)

0.8 (2/22/11)

0.5 (10/17/11)

0.2 (5/3/12)

0.2 (10/24/12)

<0.1 (5/3/13)

nadir

0.1 (9/15/14)

0.1 (11/27/15)

0.19 (11/17/16)

0.4 (06/09/17)

0.4 (10/23/17)

0.71 (07/20/18)

1.1 (02/18/19)

1.4 (08/19/19) still bouncing

[RenoPatient in reply to LeeLiam]

Thanks for your input.

[curtisbirch in reply to LeeLiam]

Really appreciate this info as I haven’t seen anyone’s bounces laid out like this. Everyone says PSA bounce is a good thing after radiation as studies show that those who bounce more and take longer to reach their nadir have very good long run results. But still there can be unease and discomfort as you see your PSA go up, even if your doctor says don’t worry. So thank you very much for this —and if anyone else has PSA numbers to share that show us what a bounce looks like, please post those as well. .

[45RPM in reply to LeeLiam]

wow quite a wild ride to be sure LeeLiam

[RonnyBaby]

Nadirs via radiation treatment tend to be a bit higher than those who also have an ADT component in the treatment plan.

I recall reading of examples where a radiation nadir was around or below 1.0, which was considered to be a great result.

When you compare that to numbers others get using ADT (. > < 0.002) and you'll see a different set targets and expectations.

I point to trends or typical results that I've seen published, often enough. Of course, it's not a black and white thing ....

[RenoPatient]

Thanks for your help!

[fldrifters1]

I am starting my 4th year after my 45 fractions of radiation ....I also had a 6 month Lupron shot. My first PSA after treatment in early 2017 was a .7 , it has steadily dropped to the new low of .2 So happy with my treatment decision....15% ed now....testosterone in the 500`s.....slow stream , but was always somewhat slow...take generic flomax once a day.....good luck...and happy holidays to you !!....~David