Finished radiation therapy today, how will I know if it worked?

If you live another 20-30 years, it worked.

Seriously, as long as PSA stays low, you're good to go.

You will know when the first PSA test comes back. It will probably be undetectable because of the Orgovyx. It can take a while for the actual PSA to drop after radiation, but your results are different from everyone else like everything else with PC.

johnny8924,
I laughed when I read your question (the answers too) because I never thought to ask. Your PSA and Testosterone will be low as long as the Orgovxy is working, so that isn't a good clue. While the oncologist is planning a PSMA/PET a year after stopping Orgovyx, I think the extra PET is unusual.
I guess we just trust the radiation until PSA rises, but is that a measure while on ADT.
Did they do a CT scan weekly with the EBRT. Those would show the tumor.
I know you are going to ask when you see the oncologist. Let us know what he says.

@johnny8924
Congratulations on finishing your treatments.
Taking hormone treatments is going to keep your PSA numbers will probably keep your PSA numbers low. I did not take hormone treatments so that comment comes from my R/Os consultations.

Your prostate underwent a lot of damage with your treatments. That is why they don't do a PSA upon completion of treatments. Takes time for PSA to come down. I did not have a PSA test after 30 rounds of radiation treatments until 3 months later. This gave my prostate time to calm down after being radiated 30 times over 7 weeks.

The PSA going down and keep going down from your original number before treatments will be a key. So you are asking if know it worked. The hormone treatments will definitely slow your cancer down and the treatments will define if prosate cancer cells have been damaged enough to not reproduce.

It will take some time. Doctor said checking PSA in about a month to me from my experience is too soon. But I am not a R/O or urologist so just passing on what was told to me and why they waitng 3 months to do my first PSA after treatments.

Posters will tell you that your PSA will not reach it bottom number for quite a while as the prostate calms down and you get a good test results of not having a prostate still upset over the treatments. With hormone treatments the PSA and what happens with hormone treatments is not something I can comment on and how that affects your PSAs if you are still on hormone treatments after your treatement and ongoing during your first PSA after treatments.

You won't really know anything until at least three months after you stop taking Orgovyx. While on Orgovyx my PSA was 0.01. My first PSA test, two months after Orgovyx was .08. My second one this month was .04. According to Harvard medical, for radiation treatment: "Recent studies have shown that for optimal results, PSA levels should be lower than 1 ng/ml, and even lower than 0.5 ng/ml. Levels that are above 1 or 2 ng/ml 12 to 18 months following completion of radiation treatments are very worrisome, because they indicate that the cancer may not have been eradicated." The gist of the article is that 0.5 or lower after a year is very good sign, but < 1 ng/ml is still OK.

My oncologist told me that as long as I stay below 2 ng/ml I'm good and that PSA will bounce around a bit, i.e. don't freak out if one reading is suddenly higher as long as it's below 2 ng/ml. Other oncologists use something called a "nadir" (the lowest PSA you reach) as the starting point and if you go more than 2 ng/ml above that it's a sign the cancer has returned.

Johnny, did you get to ring the bell in the waiting room. Did everybody clap? They did for me 28 months ago. This month I should be off ADT as the Psa has been < .01 for over 24 months. Best of Luck to ya.

@johnny8924
I was not on adt and finished my radiation treatment in 2023. My psa started at 11.2 before treatment and declined consistently to .55, as of a few weeks ago, which I think may be my nadir.

Unfortunately, you'll never know for sure if it "worked"; you'll just know that it's working (this day/month/year). If it ever stops working, there may be much better treatments available by then.

Neither radiation nor a prostatectomy is a do it and forget it proposition, but the outlook is very good if they caught the cancer at an early stage.

After completion of radiation it has been reported (per Mark Scholz @PCRI) that the median time to reach nadir is around 30 months. That's quite a long wait isn't it?

In my case, I completed radiation treatment in early December and finished six months of Orgovyx in early February. Labs a couple of days after stopping the Orgovyx were: PSA 0.06, testosterone virtually undetectable. A month later PSA was 0.42, testosterone 392. What does that mean? Probably not a heck of a lot. Of course I would have liked to have seen a lower PSA but an increase is likely due to testosterone recovery. The radiation is still doing its thing in knocking out the cancer, and it will continue for quite some time. At least that's the hope.

Question? - is 28 rounds of radiation better than the 5 rounds I read about? To me, 5 is better than 28 if the result is the same.