Post IMRT PSA Check

[EJC61]

Hello,

I went for my 6 month PSA check today. This is my 3rd check since IMRT was completed in May 2023.

Prior to IMRT, I was at 4.31. The next 3 results were 2.12; 1.12 and today's 1.15. So I know its gone up 0.03 this time. I'm aware there are bumps along the way as explained by my medical team and it takes awhile to reach the nadir. It's only been 15 months. My NP-C knows I am a bit anxious. 7 years on AS should have prepped me for this as my PSA has always bounced up and down. If I were still on AS, I wouldn't even give a 0.03 increase a thought. Missing her call, she left a message stating that it's stable. She's ok with it. She's happy it didn't significantly jump. It's stable and this happens. We will recheck in 6 months. I knew all of this but I guess you always want it to drop some more in the post treatment world.

[Tall_Allen]

This may ease your anxiety:

prostatecancer.news/2018/03...

[EJC61 in reply to Tall_Allen]

Thanks this was very helpful. Bounces will be something new to try to understand.

I did have a question on a point I read, not relating to my initial thought. Does a bounce need to have a decrease to the previous nadir immediately or gradually following the bump up?

“They defined a bounce as a PSA rise ≥ 0.2 ng/ml but less than 2.0 ng/ml above the lowest level (nadir) it had reached thus far, followed by a decrease to as low or lower than the previous nadir”.

[Tall_Allen in reply to EJC61]

If it keeps increasing, it's not a bounce, if that's what you're asking. But you can only know with hindsight.

[EJC61 in reply to Tall_Allen]

Right I agree. But the decrease after a bounce can be gradual is I guess I’m asking?

[Tall_Allen in reply to EJC61]

Your anxiety is understandable, although counter-productive to your health. I learned to practice mindfulaness. Over time, I found there was less racing of the mind in circles around imagined future scenarios. It took me 3 months of daily practice. I found I was better able to stick with it signing up for a group.

[BettyandBob in reply to Tall_Allen]

hey there T_A — I like your approach. I’ve been practicing mindfulness ever since getting my diagnosis. You’re right - it helps. I’m also into yoga and I’m in a spin class that is kicking my butt. I love it.

[Justfor_]

The published intralab accuracy of the PSA test is <20%. You are concerned regarding a 3% increment. I can't stress you enough how wrong that is.

[NanoMRI]

I manage and watch my PSA with more frequent testing and having a PSA plan based on projected post treatment lowest potential value, potential/projected bounces, anticipated (hoped for) fall rate. For those of us with RP this is easier as we can look for potential lowest value of <0.010; and this also applies post RP and after salvage RT and additional salvage ePLND as in my case.

[tucker_man]

Mine was around 7.5 before RT and has bounced up and down for 5 years not getting below 2 but not above 3. I found that having sex within a few days before testing gave me a higher score so now I abstain for a week before and it has stayed close to 2. I’ve heard that this type of prostatitis can happen. When I first got RT, I was under the erroneous assumption that I would reach some sub 1 nadir but the fact is, I still have a healthy prostate, hopefully cancer free for life but I assume could get cancer again since my prostate cells are obviously susceptible. I just live a healthier lifestyle now. You seriously have nothing to worry about with your results so far.

[Mgtd]

Put your mind at ease. I am just a little older and we had our IMRT about the same time. I was 4+3 with a PSA of 4.8 at diagnosis. After radiation my PSA tested values were as follows:

<0.01, 0.04 and 0.05 and has held there for about 6 months.

My MO explained to me as my T rises I should expect a change/increase in PSA.