Quick follow up to PSA Bounce

[Chasbearcat999]

RO called today and told me not to be concerned that my 1st PSA was 12 after original was 9 in March.

He said that there are likely a few reasons.

- remaing inflammation in prostate from treatment (I was tested 58 days after completing SBRT)

-possible mild prostatitis

-possible infection

He said he generally waits a solid 3-4 months for first PSA to let things “settle down”

He said he has complete confidence in PSMA scan as it lit up so strongly in same places MRI did. And that if by chance there was escape in the 90 days between scan and treatment, it would be small and not pushing that much PSA.

More importantly, he said while not common or ideal, he’s seen it often enough to not be concerned, unless he sees 3 tests trend up.

I mention yellowish tint in semen and he said that his first guess is “urine reflux”, which is not that uncommon after SBRT and is typically transient.

He kind of laughed and said “welcome to the world of radiation. There will be ups and downs and since I’m not on ADT the trend down it going to be slow.

Thanks for the info I have gotten here.

[cscmetsfacil]

I have not heard much about bumps in PSA following what sounds like SBRT mono therapy. I suppose that it's possible that material is in the blood after high-dose treatment without ADT due to a lot of cells being killed. I do wish that doctors would take the time to explain what to expect. I have never liked when a doctors says that "He.she is not concerned..." about something. It's a terrible choice of words. At a minimum, they should be concerned that their patient is experiencing anxiety because they failed to explain what the range of possible outcomes and side-effects might be. I would push for more information and get second opinions on whatever monitoring of results in planned. Don't be reluctant to ask questions and get second opinions. I am curious what your Gleason Score was, how often you are being checked, etc.

[Chasbearcat999 in reply to cscmetsfacil]

Gleason was 3+4. Second opinion from Johns Hopkins 4+3. Oncologist at University of Cincinnati had it reviewed there, they said 3+4.

It is frustrating. RO said, “it was too soon to test. And even if it was 90 days I have seen it often enough”

Had an appt today with GP for a shoulder injury and he said “your bloodwork shows high inflammatory markers, I wouldn't be concerned. They hit your prostate pretty hard.”