PSA Trends after Salvage RT and 6 Months of Orgovyx

I never had the ultrasensitive test, but after salvage radiation, my result was < .1. .04 is a lot less than that and definitely within the realm of undetectable. This is about what you’d expect after Salvage radiation.

Because you asked specifically:
My uPSA test results have been < .02 undetectable following 37 IMRT radiation treatments to the whole pelvic floor and pelvic lymph nodes together with 4 mos of ADT Orgovyx.
My 1st post treatment test was in Nov 2023, 6 mos following completion of the radiation and has continued undetectable for 1 year with my most recent test this week.
I have a treatment friend who tested .02 after treatment and his PSA went lower to < .014 over the following 2 quarters.
Another Salvage Treatment friend is being tested with the standard PSA test and has been < .1 following treatment.
We each have different ROs at JohnsHopkins.
So I believe that anything less than .1 is very good. And that all 4 of us are in the same ballpark and have had a good Salvage Treatment result.
Best wishes.

I finished 33 Salvage Radiation Treatments in July/22 and my PSA continues to be undetectable at < .008 Unfortunately my testosterone level is also almost undetectable but I was still able to win my squash match this evening. I have had incontinence issues ever since my RP in 2018 and throughout 2023 I was leaking approximately 200 grams per day. Suddenly in January 2024 my average urine weight jumped to 300 grams per day and I have just been informed that increased incontinence issues can arise 6, 12, or 18 months after the salvage radiation.

Were you on ADT at any time?

Was it .04 or < .04?

The latter may indicate that the lab's measuring equipment and assay cannot measure below that.

Either way, a single data point is of marginal use in determining the "success" or "failure" of treatment from my perspective, three or more provides trends and may be more definitive in assessing what is going on.

Would be interesting to know if they tested your testosterone too as with Orgovyx, recovery of T may be faster than with say, Lupron. If T has recovered, mine did after three months to 300+, that may be a factor in PSA results.

For now, the data you present in your post is "good" news from my foxhole.

Kevin

I had two Zoladex injections; the first was 3 months before I started my SRT and the 2nd was when I started my salvage radiation.

it took about five years after salvage radiation before my incontinence problem started. It has gotten progressively worse since then. Getting a physical therapist that specializes in incontinence could help. There are a lot of treatments that a urologist that specializes in the incontinence can suggest you try Bulkamid, a sling, ProAct and more.

I had salvage radiation 7 years after my prostatectomy. It worked for 2 years. Undetectable. Them slowly rose . Now I’m at 0.99. Both my doctors want to watch and wait before the next treatment. I too, have frequent urinary issues and leakage. I also have 3 or more bowel movements a day. This all started after radiation.

Kevin, My results were in fact < .04 for this second test, not .04. As compared to my first test result which was taken one month after completing Orgovyx and 3 months after the radiation treatments. This first test was done at a different Lab (Labcorp) that used a different assay. That first test came in at .014 and it had no "less than" sign. I'm considering going to take another test at Labcorp now, but I may just take the win and let my anxiety take the next three months off. Thanks for all your help. jim

Aren’t you on ADT yet? If not, you need to see different doctors. What type of doctors are you saying now? Hopefully they’re not just urologist, they do not specialize in prostate cancer and do not all know how to treat it. Some medical oncologist also don’t study enough about what needs to be done with prostate cancer patients. The standard of care is to put you on ADT.

At this point, my doctor would’ve put me on Lupron as soon as my PSA started rising above .2. After being on Lupron and it started rising again, they would put me on a drug like. Zytiga or one of the lutamides.

What was your Gleason score? If it is above a seven, they might put you on the second drug right away if you were seeing a Genito urinary oncologist, the type of oncologist that specializes in prostate cancer and knows what the correct treatment is.

You are facing a potential metastasis problem if you let this continue the way it’s going. Have you had a PSMA pet scan? Once it has risen as far as you have had your PSA rise, you should’ve had that scan.

Your life’s future depends on you doing something proactive about this.