PSA (0.32) after salvage radiation unchanged from PSA before radiation

Posted by nonnojoe @nonnojoe, Jan 28 8:03am

I was told by rad. uncologist and urologist to be patient.
I was gleason 8.
Anyone have similar situation?

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@nonnojoe

PSMA PET was clear. Both urologist and RO said it will take months for PSA to go down.
No ADT will not disguise the true effectiveness of IMRT

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Can you further explain what you mean when you say “No ADT Will not disguise effectiveness of IMRT”? I recently completed 39 rounds of IMRT and six months of Orgovyx. My PSA scores are down from when I started these treatments. I’m trying to figure out if my lower PSA scores are driven by the Orgovyx (off for 3 weeks before the PSA test) Or the IMRT treatments (completed 12 weeks prior to the latest psa test). PSA was most recently 0.014. While disappointed that it wasn’t undetectable at the first test, I’m hopeful that the radiation treatment will, overtime, drive PSA down further.

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@jaacm1

Can you further explain what you mean when you say “No ADT Will not disguise effectiveness of IMRT”? I recently completed 39 rounds of IMRT and six months of Orgovyx. My PSA scores are down from when I started these treatments. I’m trying to figure out if my lower PSA scores are driven by the Orgovyx (off for 3 weeks before the PSA test) Or the IMRT treatments (completed 12 weeks prior to the latest psa test). PSA was most recently 0.014. While disappointed that it wasn’t undetectable at the first test, I’m hopeful that the radiation treatment will, overtime, drive PSA down further.

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My RO waited 6 mos post salvage radiation for my 1st PSA test.
37 IMRT treatments Mar - May 2023
Also 4 mos Orgovyx Feb - June 2023
1st post tx PSA Nov 2023 was undetectable < .02 (limit of uPSA testing at Quest)
So if mine was .014, it would have reported as undetectable.
Personally I think that your PSA is excellent and may continue lower.
That is the issue with the Ultrasensative PSA test: it drives us crazy at very low numbers
A Salvage Treatment friend is only being tested with regular PSA post tx and is " happily" < .1 "undetectable ".
Best wishes and try to smile. I do understand your concerns.

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@heavyphil

Good for you! NO ONE ( not even your spouse) can understand the anxiety associated with this disease and the consequences of whatever treatment you choose. Sure, none of us wants to lose what makes us men, gain weight, grow boobs, ugh!!! But the alternative is far worse so you gotta do what you gotta do, cover all the mirrors, wear Members Only velour tracksuits….I’m Kidding!!!!
Get at least 2 more opinions before you decide and provide these Drs with as much info as you can Re: biopsy results, Decipher or other genetic tests, PET scans. You will then be able to make a decision that you are comfortable with - keep us posted as the more we all learn, the better!
AL

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I came across your blog note here and you are so right . I am post RP by 3 years and 2 years Post EBRT, ...after 22 sessions of EBRT ( External Beam Radiation Therapy) and no other drugs like ADT and so on . RO said I did not need it . I asked him 3 times ! Gleason was 3+4 originally . Im 61 now. Hike everyday for at least 8-10 km's...swim and sauna as well. My PSa since EBRT went from 0.14 , then to 0.072 , last time was 0.056 . Im due for PSA in 2 weeks . Lord , I am full of anxiety ! Cant sleep right . Wife is very supportive , BUT .... Yes, I know my PSA is relatively low , and the trend is my friend here . My father died of Protate Cancer . I was his caregiver . I was there for his horrible death . Man , this PC has consumed my life ! Any ideas ? James on Vancouver Island .

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@michaelcharles

My RO waited 6 mos post salvage radiation for my 1st PSA test.
37 IMRT treatments Mar - May 2023
Also 4 mos Orgovyx Feb - June 2023
1st post tx PSA Nov 2023 was undetectable < .02 (limit of uPSA testing at Quest)
So if mine was .014, it would have reported as undetectable.
Personally I think that your PSA is excellent and may continue lower.
That is the issue with the Ultrasensative PSA test: it drives us crazy at very low numbers
A Salvage Treatment friend is only being tested with regular PSA post tx and is " happily" < .1 "undetectable ".
Best wishes and try to smile. I do understand your concerns.

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My RO said the same thing . EBRT ( External Bean Radiation) , which I had 22 sessions of at 0.14 , went from 0.072 then to 0.056 4 months ago , then I have a PSA check in two weeks. I feel good and Bladder feels fine now , not jumpy . I guess my PSA trend is my friend so far , but this is two years after ! It can take that long for radiation to finally start working well ! James on Vancouver Island .

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@russ777

I'm curious why you weren't started on ADT after failure of your primary treatment and a Gleason score of 8. My understanding is that RT does not cause an immediate drop in PSA.

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I was at Gleason 3+4 . surgery 3 years ago , External Salvage radiation ( 22 sessions, no ADT ) about two years ago. I have gone from 0.14 , to 0.072 , now at 0.056 , and PSA is in 2 weeks . My RO said this would provide less side effect and equal effect for my case , he deems it 'light' . Whatever that means ! HA!! 🙂

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@vancouverislandhiker

I came across your blog note here and you are so right . I am post RP by 3 years and 2 years Post EBRT, ...after 22 sessions of EBRT ( External Beam Radiation Therapy) and no other drugs like ADT and so on . RO said I did not need it . I asked him 3 times ! Gleason was 3+4 originally . Im 61 now. Hike everyday for at least 8-10 km's...swim and sauna as well. My PSa since EBRT went from 0.14 , then to 0.072 , last time was 0.056 . Im due for PSA in 2 weeks . Lord , I am full of anxiety ! Cant sleep right . Wife is very supportive , BUT .... Yes, I know my PSA is relatively low , and the trend is my friend here . My father died of Protate Cancer . I was his caregiver . I was there for his horrible death . Man , this PC has consumed my life ! Any ideas ? James on Vancouver Island .

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James, I certainly understand your feelings as I am going through a similar journey. I had my first PSA (ultra sensitive) after my radiation and ADT. My score was .014. I saw my RO today and he stated there was nothing to do at this point but wait for another test in 3 months and watch for a trend - and live my best life in the interim. Brutal! My father died of PC as well. Your trend looks great - but I know that doesn't make the wait for the next test any easier. Good luck and I will be watching for your future posts. jim

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Jim, Your PSA is quite low now , it may be a bit of the ADT talking yet though . Lets hope falls even further . I would love a 0.014 - it's almost off scale here at the labs on Vancouver Island , I started my radiation at 0.14 actually. This was 2 years ago my wife tells me ( I kind of block it from my mind ), My Surgery was march 31, 2021 - 3 years ago . My trend looks good I think but not a huge number of data points yet , bladder is way better ( no issues) ... I just need a 0.022 or something like that next PSA yes . I will post a new blog when I get my test in 2 weeks , and see what the Gang has to say . Som every valuable encouragement and input here . Watch for my post in two weeks . Yes , having a father pass away from PC at 67 ( discovered at 60) is another issue for me ...trying my best Jim . God Bless to you and yours Sir . James on Vancouver Island.

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