PSA Bounce

[StrongFives]

I'm 3 yrs post SBRT for 3 + 4 gleason. After treatment PSA decreased gradually with a small bump to 0.5 and stayed at that level for two readings six months apart. Then 3 months ago I got a PSA at 1.96 which RO said was likely return of cancer so I had PSMA-PET and MRI, both showing no cancer. Doc says either I have cancer which will show up later, or I am having a weird bump because so late. Today I had a PSA test at 1.89 so if it's a bump it's staying for a long time. Do I have cancer or a bump? Can you have a benign bump three years after treatment? How long do they last? Suggestions for further action?

[Tall_Allen]

Yeah you can, especially if you have a history of prostatitis.

[StrongFives in reply to Tall_Allen]

Thanks. Is there information out there about post radiation bumps so I can get a feel for how normal my circumstances are? I haven’t been able to find anything very definitive on line. My doc seems to think i am very out of the ordinary.

[Tall_Allen in reply to StrongFives]

Here ya go:

prostatecancer.news/2018/03...

[David82150]

Sorry for your continued worry.I was a 3 4 /7 gleeson in 2008 and decided on the opp.

Got it all over in one go.

I could not do with living with it.

All the best.

[1Ubspaine in reply to David82150]

poor response dude

[timotur]

Keep testing periodically and look for a trend. Hopefully it flattens out or goes in reverse.

[treedown]

I am almost 3 years past the start of radiation and in a similar situation but not exact. I stopped ADT over a year ago. My PSA stayed low but went up gradually and then quickly. I expected it to be over 2 on my most recent test but it appears to have slowed slightly and is currently 1.61. So Dr appt next week, I expect scans soon, but not quite a clinical BCR. With every test there's 3 options so we live test to test.

[NotDFL]

A bounce after radiation therapy is pretty common. Unless your PSA goes above nadir + 2, I wouldn't worry, but do follow up at a frequency that is acceptable to you. BTW, it looks like your nadir is 0.5 ng/mL.

[Jeff85705]

I understand that a PSA =/< 2.0 is chemical recurrence. According to that, you might not have a recurrence (especially since there are no other indications of such). I'm not sure how accurate these PSA results going into the hundredths of a percent can be. My labs just show "under 2.0." Maybe get another opinion. Good luck.

[conbio in reply to Jeff85705]

Good advice - get 2nd opinion