After Radiation, what should PSA be?

[Photographerhere]

intermediate pc, with 3+4, 3+4, and 4+3. PSMA clean. Went through SBRT, am on Lupron. Seven months in. usual side effects, especially exhaustion. I went for a PSA and testosterone test today. Should my PSA be undetectable?

[Tall_Allen]

Close to, while on Lupron.

[Photographerhere in reply to Tall_Allen]

Yes. Just got results. Psa < .01. ; T< 6

Good news. And only one more lupron shot, assuming doc doesn’t change the plan.

[Hidden in reply to Photographerhere]

is that .01 or .1? Usually they just say <.1. But if it's .01 that's even better I guess.

[Photographerhere in reply to Hidden]

Just checked the lab report again. Results says <0.01. I’ll take that any day

[ToolBeltZia in reply to Photographerhere]

Excellent, congratulations!!

[Hidden]

Probably will be. Also significant is where it goes after your testosterone comes back. If it comes back.

[Hidden in reply to Hidden]

The articles that I have looked at say there is a better prognosis if the PSA is <.1, whether with radiation alone or radiation plus ADT.

dailynews.ascopubs.org/do/p...

So you have that on your side. But one thing I have noticed since doing a lot of reading, on here, other sites, studies, etc. is everybody's PCa is a little different. So it's difficult to draw firm conclusions. And of course when testosterone comes back or if you add testosterone, PSA may rise for awhile. But the way I understand it, if it stays below .5 for a couple years that is consistent with remission. Some call it cure. But I also had an MO tell me that .7 would be ok too as long as it was stable. So I think stability is the main thing

[Hidden in reply to Hidden]

BTW, my personal MO yesterday said 2 years was too soon to judge anything and when 5 years rolled around under .5 that we could talk about whether it is a permanent remission. Still Dr. Scholz does say that in his video. He has a lot of interesting videos. youtube.com/watch?v=zQktPZ6...(Not working as expected?)

[ToolBeltZia]

I have been on Orgovyx for two weeks, have my second SBRT tomorrow. RO said we will check the PSA (along with cholesterol, triglycerides) in 3 months and he expects the PSA to be undetectable. If that is my nadir he said even once I am off Orgovyx a PSA of 2 would indicate biological failure.

[Hidden]

I was given a 4 month shot of Lupron just prior to my 27 sessions of IMRT. Th effects of the Lupron wore off after about 6 months after the injection. That was in 2019. My testosterone came back to 500+ within a year of the radiation and my PSA has been .25 or under each of the past 4 years.

[cscmetsfacil]

My understanding is that the lower the PSA and T under ADT, the better. Different labs and health systems have different thresholds. I use LabCorp's ultra-sensitive tests. Labcorp detects T down to 3 and PSA down to 0.006 - the most sensitive I can find. So, the best scores would be <3 for T and <0.006 for PSA as the measure of undetectability. For those of us with very aggressive PCa, I test monthly and want to stay at undetectable - and be alerted if things begin to change. As to the ADT, you should be able to take a break as soon as your doctors let you. As others have mentioned, you then want regular (for me monthly) T and PSA tests. Hopefully you have some record of what your T level was prior to treatment so you can benchmark how much it returns. That will take a while with Lupron, but happens faster with Orgovyx. Normally, PSA comes back a bit post RT (a "bump" from the returning T) and then goes back down to a new low point which should be your new "normal" and stays pretty steady. That would indicate a "cure". Good luck.

[cedaral]

I've been on Lupron since 2018 and have adjusted to the side effects pretty well. I exercise everyday not giving a thought whether on not I felt like it. In my case, my PSA number never went to zero when starting Lupton after radiation. The number did spike when I took a short vacation from Lupron, so for me I will stay the coarse with no breaks.