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PSA Trends after Salvage RT and 6 Months of Orgovyx

Posted by jaacm1 @jaacm1, Nov 20 10:42am

I completed 6 months of Orgovyx 4 months ago and finished 39 IMRT Salvage radiation treatments 6 months ago. Just had a ultrasensitive PSA test result of .04. I'm told this is a very good result. I am curious as to what PSA trends others have experienced in the first year after completing salvage radiation and 6 months of Orgovyx. Thank you.

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jeffmarc | @jeffmarc | 4 days ago
In reply to @jaacm1 "Kevin, My results were in fact < .04 for this second test, not .04. As compared..." + (show)
@jaacm1

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

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Since .014 is less than < .04 you are in even better shape, another PSA test really isn’t needed with this low a PSA. You are undetectable with either number.

It could be the first lab doesn’t test below .04 while the second one did.

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heavyphil | @heavyphil | 4 days ago
In reply to @firespooks "I had salvage radiation 7 years after my prostatectomy. It worked for 2 years. Undetectable. Them..." + (show)
@firespooks

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.

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Sorry to hear of your recurrence…but what are your DRS waiting for? Your PSA going from undetectable to .99 and that is an indication that something’s on the move.
I would want to be put on some form of ADT, but first have a PSMA to see if anything lights up. At .99 something must be there, right?
You may only have a small single metastasis which can be successfully treated with SBRT. There have been cases of distant metastases showing up as far away as the clavicle but not present anywhere else. That one particular patient lived for another 14 yrs before he succumbed to something else. Guess we all gotta go from something😁

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retireddoc | @retireddoc | 4 days ago
In reply to @gkm "I finished 33 Salvage Radiation Treatments in July/22 and my PSA continues to be undetectable at..." + (show)
@gkm

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.

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I had RP in 10/21 and had the usual initial incontinence which gradually improved over the next year. I had gotten to where I didn't need a pad sleeping or at home and could play a round of golf walking and not have any significant leakage in a very light Tena pad.

As part of my treatment for rising PSA in last Q of 2022, I had triple therapy followed by 37 pelvic radiation treatments in April/May 2023. My incontinence has gradually increased since and I have been forced to wear a pad 24/7 and completely soak a light absorbency pad playing golf.

The good news is my PSA has remained undetectable (even with ultra sensitive assay) since my second chemo treatment in Nov 2022. My MO stopped my Darolutamide at the end of my 3 months of chemo and took me off Lupron after one year (last injection was 7/23). My T has failed to return to anywhere near normal levels (52 earlier this month). My MO has referred me to an endocrinologist to begin TRT. He said I am a 90 year old man living in a 70 year old body without T. From his extensive experience (>500 publications on prostate cancer and related topics, 30 years treating this disease, Director of prostate cancer research at Hopkins etc) he believes my aggressive cancer clones have been killed and if my PSA rises on the TRT it can be controlled.

I realize this is a controversial approach. It is not for everyone. It depends on extent of disease, response to treatment, type of treatment, etc etc. I begin my TRT next week and am looking forward to feeling like myself again. The fatigue, muscle loss (despite exercise), diminished libido, depression-all side effects from the very low T, have been difficult to endure. I will be interested to see if my incontinence improves as I continue to do core/kegel exercises and the T helps strengthen these muscles.

Good luck to everyone fighting this beast.

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