Does thus look like a “bounce”?

[Chasbearcat999]

I see MO today.

History. Sbrt in 10-23.

PSA at 1st checkup had risen to 11.8 12/23 Put down to post radiation inflammation.

PSA 1/24 -8.6

PSA 5/24 - 4.6

PSA today 6.4.

No ADT

[Tall_Allen]

No,, it looks like persistant PCa. Did you ever have a PSMA PET scan?

[Chasbearcat999 in reply to Tall_Allen]

I did before treatment. It was negative.

[Xavier10 in reply to Chasbearcat999]

So I guess you had a MRI also and then a biopsy and there was cancer? Even though the PSMA said negative?

[Chasbearcat999 in reply to Xavier10]

Yes. Mri and biopsy. The PSMA lit up in the primary lesion, but nowhere else.

[Xavier10 in reply to Chasbearcat999]

oh, so the PSMA was not negative. I was confused how you could know you had cancer when the PSMA said otherwise. Because they are very accurate. You just mean it is not outside the prostate so probably curable.

[Chasbearcat999 in reply to Xavier10]

I wasn't real clear. I has a PSMA in July 2023, prior to treatment. It showed only cancer in prostate. SBRT in Oct 2023. Since then PSA went down but slower than hoped. It took 6 months to drop from 11.9 to 4.8. Then last month was at 6.2. 2 radiation oncologists are “optimistic” that it is a bounce. But also said that there is a chance it had spread before treatment but volume wasn't high enough to show in scan.

One also think it may be complicated by prostatitis.

The plan for now is to test next month. If it is lower, it was a bounce. If higher 30 days of treatment for prostatitis then, rescan if no lowering of PSA.

[Xavier10 in reply to Chasbearcat999]

Would be nice if they had a test for prostatitis. I wonder if this that TA mentioned the other day would work? Seems a little early for another PSMA. Seems like there would have been some type of uptake that was observable by the very exact PSMA scan it would have showed up. That's only a year ago. But I haven't done the research.

comment from Tall Allen

[Mgtd]

Not a doctor but from what I have read on this issue I remember the “bounce” comes much latter if at all. I also read that SBRT appears to cause more of a bounce than say IMRT. No real evidence presented to say why this is true.

Just a SWAG but perhaps PSA on 2/24 is a nadir. By the way SWAG is a highly recognized term that really means the validity of my statement is useless.

[curtisbirch]

I believe this is bounce based on the way my numbers behaved after HDR brachy. Your number hasn't risen that much (1.8) from its lowest point and it's only been 3-4 months. I will share my 4+ year history with the group soon--it took me several years to reach my nadir and some of my bounces were alarming to me at a similar stage. I will also say that, as Dr. King (Tall Allen's doctor) mentioned to me, your PSA should be taken at 6 month intervals, or longer, to paint a clearer picture of what's going on. Based on my personal experience, and I had brachytherapy not beam, you have nothing to worry about currently. But of course, I'm looking forward to what your doctor has to say. Keep us posted.