How long after VMAT-RT 3Gy X 20Fx (June 2020) and Lupron Depot/6 months (End Nov 16th 2020) does it take to reach my PSA nadir?
My PSA went from 13.6 pre-Rx to 0.03 post-Rx.
I am not sure if that 0.03 is my nadir or simply the result of my ADT. It cannot be the result of my RT, too early for a result.
ADT. And it is your nadir. Nadir just means lowest value.
Yes but when the ADT stop working in lets say 6 months from now, my PSA should start to climb to the post-VMAT-RT level, no?
Revisit it when and if that happens. For now, that's a great result. Take the win.
I know everybody react differently but some peoples with only EBRT get their nadir around 2.5
I had 81 Gys and 6 months lupron ......been 4 years now...started at .7 and now at .4 PSA...yes for me about 3 years now at .4 ......hoping it stays there or goes lower ......good luck ...Peace
Thanks.But PSA 0.03 is usualy for Post-RP no EBRT.
With your Lupron you did not go lower than 0.4?
My PSA went from 0.03 to 0.01,So 0.01 should be my new nadir.
Yes.
What happen if my PSA goes down to 0.00?
Her in Quebec, they test you for PSA every 3 months, then every 6 months.We can not be tested every 2 weeks.
It is the same approach after treatments.
* APS μg/L =
Pré-Hormonothérapie = 4.23 (2001/07/18), 2.2 (2002/07/23), 1.8 (2006/07/04), 2.2 (2008/09/22), 2.4 (2009/05/20), 2.05 (2011/08/26), 2.25 (2012/08/13), 2.05 (2013/08/06), 2.77 (2014/07/28), 3.84 (2015/07/06), 1.97 (2016/06/30), 3.89 (2017/06/13), 6.8 (2019/09/10), 11.7 (2019/10/28), 13.7 (2020/01/08), 16.7 (2020/03/02), 20.4 (2020/04/06),
Per-Hormonothérapie = 1.76 (2020/05/04), 8.58(2020/05/27), 0.18(2020/07/29), 0.03(2020/09/15),
Post-Hormonothérapie = 0.01(2020/12/15)
If it goes down to <0.01, then that will be your nadir. Nadir simply means the lowest point reached.
Thanks
It's not necessarily your nadir-- you could go lower, e.g. <0.01, but even if 0.03 is nadir, it's a good result. I was 0.03 three months after HDR-BT/IMRT on Lupron, then it fell to <0.01 and stayed there since. Been off ADT now for three months. You'll know more when your T recovers after ADT wears off.
**********Correction**********
Got my latest results (2021/03/12)
.PSA 0.01 and
Testosterone = 6.6nmol/L or 1.9036µg/L or 1903.572ng/L or 190.3572ng/dL
So PSA new nadir is <0.01µg/L from 0.03 and
Testosterone increase from:
<0.2nmol/L or <0.0577µg/L or <57.684ng/L or <5.7684 ng/dL to
6.6nmol/L or 1.9036µg/L or 1903.572ng/L or 190.3572ng/dL
I am very happy because my 2 cancers are dormant so now I can use my energy to fight my Severed Depression and cope with my Severe Pulmonary Emphesyma.
Congrats, A reading of .01 is magnitude of three times less than .03. Very good result. Cheers!
Thanks.My 2 cancers and my other chonic diseases like Pulmonary Emphysema were keeping me exhausted.
Now I should have a break.
And I also have to deal with a severed depression which we are trying to control with Sertraline that went from 100 to 200mg.
Hope to finaly get good results.
My next PSA & Testosterone test will be on March 1 st 2021.
I have few medical issues other than an aneurysm in the ascending aorta that I am thinking was caused by a period of high blood pressure that also caused temporary heart enlargement and also have paroxysmal supraventricular tachycardia (PSVT). Diltiazem and losartan pretty much make them a non issue.
I was diagnosed with prostate cancer just before my 74th birthday (happy birthday) and am now 75 and almost six months post treatment.
Right now the PSA is 0.34 ng/dl and testosterone 359 ng/dl.
Other than survival, retaining sexual function was my main goal. As I understand it, the radiation plus 6 months of lupron are probably giving me a good chance to move on. Now it is about waiting to see whether there are any permanent side effects. I am fully functional sexually and, as I understand it, if that continues through about 2 years I will probably not run into ED.
Something I did not expect were continuing emotions and maybe depression like we typically experience with hormone therapy, continuing fatigue and sensitive nipples. My urologist mentioned that the hormones are still readjusting and it dawned on me that moving back to male hormones may be a form of puberty! Crazy, but this IS what I experienced during adolescence.
So after an adventure with the symptoms of menopause, it is back to the symptoms of puberty. The doctors didn't mention this so I wonder whether they are even aware.
As I understand it, ADT causes a very low PSA number as it removes the testosterone feeding the cancer and the cancer based PSA drops. After my fifth month of lupron treatment my PSA was .13 ng/dl compared to pretreatment 3.1 ng/dl. The prostate is still there, so the PSA will probably not drop to the post surgery undetectable levels.
Six months after my last 1 month lupron injection the PSA was .34 ng/dl.
The radiation does not kill the cancer, but hopefully prevents it from reproducing. With radiation and ADT treatment we still have a prostate and it will be producing PSA. As the cancer dies off over a period of time the PSA should go down to a nadir. I can't find a specific time frame, but appears to be one or more years before the cancer is no longer producing the excess PSA and a nadir is reached.
Since my newset PSA result was PSA = <0.01µg/L, I will just know my Nadir PSA when the PSA start to climb.Not holding my breath(could not with my Pulmonary Emphesyma) but when it will come, we will deal with it.
So I call my PSA Nadir = <0.01µg/L.
It would be nice to have your info(PSA & Gleason Score.
BTW if you prefer a more private, you just click on my icone then click "Message".
This video may help answer your questions.
youtube.com/watch?v=zQktPZ6...
So after ADT the testosterone hopefully rises which can cause increase in PSA and the cancer is dying and as it dies the PSA goes down.
Have you had surgery as well?
No. With all my heath problems plus in Quebec, the do not do any form of RP to peoples of 70 and more but with exception.
I missed that we are using different units, ng/dl vs μg/L. If I calculate correctly, my pre-treatment PSA was .031 μg/L, at five months lupron would be .0013 μg/L and is now .0034 μg/L. I expect that as the cancer dies off the PSA will go down.
We do not have that acurate results.
0.01 μg/L This is the most acurate than we can get as results.
That's the same accuracy, I think, just different units.
They are not the same unit but if I transform 0.01μg/L then I get 1.0ng/dL.
What was your PSA before they discover the cancer,And what was your Gleason Score,
My PSA had been 2.7 ng/dl going up to 3.2 ng/dl over a six month period. Gleason was (3+4) 7. Intermediate favorable.
There are 2 web sites for conversion between different units.
This one is for Testosterone:
In Quebec, Canada they are using the nmol/L.
And this one is for PSA:
In Quebec, Canada they are using the µg/L.
And you, did you had RP or just RT alone or RT + ADT?
I had VMAT-RT 3Gy X 20Fx = 60Gy but equivalent to 118Gy in 48 Fx.
I was supposed to have my ADT 8 weeks prior to my RT but due to a BIG F*CKING screwup, I finally got the ADT 8 days before RT. My swing in my PSA in May 2020 was due to Casodex 50mg/30days started on April 4th 2020.
I had IMRT and ADT; 28 sessions for a total, I believe, of 70 gy with the Varian TrueBeam which appears to be the same as VMAT and six months lupron.
I'm not familiar with the Fx notation you are using. The purpose of the ADT is to make the cancer more susceptible to the radiation and I had my first lupron shot 2 months before beginning IMRT session.
Fx = Fractions or number of treatments.
So you got VMAT-RT 2.5Gy X 28 Fx = 70 Gy.
This RT we got is also called Hypofractionnated RT but mine was a little bit stronger so they could cut down the number of treatments.
So from your answer I presume that you still have your prostate.
I have my prostate and am sexually fully functional. No diapers, no catheters, no knives. At 75 I didn't want to spend up to 5 years in recovery from surgery.
IMRT rather than VMAT, but I believe they are basically the same thing.
This video shows a sterilized version (no dropping of the pants) of the IMRT in use.
youtube.com/watch?v=CxJguWh...
I am not sure, the way I understood, the VMAT-RT is supposed to be more acurate, the treatment is shorter (2.5 minutes including positionning) and they deliver a higher dose (3Gy(my RT) vs 2.5Gy(your RT) vs 1.5 to 2.0Gy(traditionnal RT)).
With a total of 60Gy(me), 70Gy(You) and 118Gy(Regular RT), our lower dosage is equivalent and better than the 118+Gy.
LESS RT toxicity.
Compared to older technology. There is a lot of marketing in the industry, particularly with proton treatment.
I think they are both the same technology. Fractional doses delivered as the head revolves around the patient, lens shutter constantly adjusting to the shape of the target from the angle of delivery.
Dosages are whatever the oncologist feels is needed.
This video looks exactly like the VMAT-RT that I have received, 20 times.Blood tests of this morning are stable = anemia & Lyphoma results.
More Bkood Tests tomorrow with a REAL R/V.
I come her to be enlightend.....sometimes i feel wayyyyyyy...undereducated...and i passed a bar..... of course i turned around an went in........thats all i got j.o.h.n........no fear
Do not feel like that.I worked 40 years as an Anaaesthesia-Assistant so my medical knowledge is above the average bear (said Yogi Bear)
Think it went like this...."why do people smoke yogi......i dont know boo boo"...
Psa still showing post surgery. 
About PSA keep decrease
Advice on when to start salvage RT
Sustained bounce + blues (SBRT)
