Post-Treatment Recovery and PSA Levels: Seeking Guidance After SBRT and ADT

[SierraSix]

68-Year-Old with Localized Gleason 9 (4+5)

Diagnosis: September 2022

Treatment Plan: 18 months of Lupron (started October 2022) and five sessions of SBRT, completed in December 2022.

Current Status: Took my last Lupron shot in January 2024. Just had a blood test yesterday (PSA and testosterone).

Latest Results:

• PSA: 0.02 (previously undetectable)

• Testosterone: 151 (up from 8 in the last 3 months)

It’s been about 6–7 months since my testosterone has started to recover after my last Lupron shot. I’m not scheduled to see my Radiation Oncologist until December, when I’ll also have another blood test and my 2nd-year MRI.

Additional Context:

• I’m getting a DEXA scan today to compare with the one I had when I first started ADT.

• I’ve lost over 10 pounds and continue to lift weights, run, and eat a healthy diet.

Questions:

• Do these numbers seem on track for a favorable outcome?

• Is there anything else I should be doing at this stage?

• Can anyone share studies or info on PSA levels post-radiation/ADT? I understand PSA can fluctuate. Is the typical post-treatment PSA range between 0.02 and 0.2?

Trying to educate myself on what to expect in the next phase of recovery and cancer treatment. Any advice or resources would be greatly appreciated!

Thanks,

Mark

[Tall_Allen]

So far, so good.

[Miko710]

Sounds good. Similar situation. Following.

[Mgtd in reply to Miko710]

As T goes up you can expect the PSA to rise. Looks good!

[conbio]

I'm similar. 66 when diagnosed G 4+5, localized to gland. Had 18 months Lupron, 24 sessions of EBRT and then Brachy. You are doing good.

I'd say it took about 5 months for my T to get into the normal range again as did my RBC. Like you, I kept active. I started weekly lifting program with a trainer and lifted a second session a week on my own. I kept climbing, biking, and backcountry skiing as I could - but really, it was at a lower level.

Even though my T and RBC was back up it to another several months for me to feel I was back at my basic fitness level. All very good now.

And while my T is up to normal my PSA has remained low, bouncing around between 0.1 - 0.3.

My advice: Keep exercising - weights are good, get in some aerobics, whatever you like. Sounds like you are on the right track.

[BubbaC]

Has anyone suggested a Pet Scan to check your current status? My research indicates that it is the current Gold Standard to determine whether the cancer has spread. My current situation is similar and I'm pushing for that test. Best of luck!

[Mgtd in reply to BubbaC]

With his low PSA I would suspect that a scan would have no value. The scan at that PSa has an extremely low probability of catching any cancer.