PSA at 3 months after radiation: Should it be lower?

@giordi
If that was your first PSA test at 3 month mark you are doing great. That is a very significant drop.

My R/O stated it will take 1-2 years for your PSA test to get to lowest mark. He stated as long as going down that is what they are looking for. So in my opinion and from what my R/O and PCP have stated about PSA testing you are doing great at 3 month mark.

Did they tell you that your prostrate is going to be really irritated for some time because of all the radiation. So it takes time for that irritation to go down. I was gold below 1 is goal and again was told that could take 1-2 years to get there.

Did you take ADT? I did not and had 30 rounds of proton radiation at UFHPTI and have my 1 year mark coming up. My last PSA test was .60.

Did you have ADT with your radiation treatments? If not, they say it may take 18+ months to reach target levels.

I had ADT with my 28 proton radiation treatments. 3 months after the first 3-month injection, my PSA was at 0.008; it stayed there for 6 months after the 2nd 3-month injection. Now 3 years later, it varies between 0.3-0.5.

I received 5 high dose proton radiation and 3 shots of adt, will be a year next month. My psa was around 6, Gleason 4+3/7 intermediate. So to date I’ve had 3 psa tests and my results were; .17, .19 and .23. My doctors are happy where I’m at. As to what it would be without adt, I don’t know. But so far, other than them not being clear on what should happen, I’m progressing well. The adt was a real bitch and I’m still having side effects from them, much diminished but they are there. Do your research and ask your team members about it. Good luck, my brother.

Thanks for your information. It is greatly appreciated. Good luck!

Thanks for the information, it’s greatly appreciated. Good luck!

Thanks for your reply, it is much appreciated. Good luck!

Thanks for your help, I appreciate that a lot. Best of luck to you!

giordi: Here are my psa results from 5 radiation treatment with the Mridian linac photon radiation machine completed 2/15/23 with no ADT. You seem to be on track.

10/5/2022 3/31/2023 5/25/2023 9/12/2023 1/9/2024 4/11/2024
10.29 4.61 2.99 1.4 1.5 0.94

Very different numbers depending on whether you also had ADT. I am presuming you had no hormone treatment. You may find this thread of use:
https://connect.mayoclinic.org/discussion/psa-numbers-after-radiation-with-no-adt/
Also, and this is just a possibility (I offer no evidence to support this), but it may be that the fewer number of treatments. the quicker you get to the nadir. What I mean by this is that it may be that 5 treatments takes you to the nadir in 12 months, 21 treatments takes 18 months, 44 treatment: 2 years. Total speculation on my part!

Your trend is a positive one. What was your Gleason score?

@ozelli
Was never told this by R/Os but have noticed that PSA numbers go down quicker and further with patients who have ADT. Just an observation on my part with all the posts who give that information having ADT with those who don't.

The high dose radiation versus the longer periods (30 round like I had) but have no idea it would go faster. Seems to be possible as the dose is much higher and the damae to prosrate cells much quicker.

My PSA was 3.75 and at 3 months was down to 1.9 then, .90, then .60. I was very happy with this as I did not have ADT. I was told would take 1-2 years to get to the goal of my R/O of below one. I am already there now at 6 months.

Just have to keep it below one. My next PSA test will be in July.