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

My post is a positive one. I just had my 1 year and 9 months after final radiation treatment PSA test. It came back at 0.17

My PSA at time of diagnosis was 3.75. I did not have a PSA test for 3 months after ending my treatments. Why? My R/O said need to let prostate settle down from being radiated which damages the cells of both the cancer cells and the normal cells.

I was told it would usually take 2 years (per UFHPTI) for my PSA to get to the lowest. I was told the goal of UFHPTI was to have my PSA below 1 and stay there. I was also told to expect bumps up and down during those two years and also there after which are completely normal. Just like prior to diagnosis it is the ongoing rise in PSA levels that are the concern not a bump here and there.

I had only proton radiation no hormone thanks to having a Decipher test that lowered my risk level from intermediate with hormone treatments rcommended to low risk and no hormone treatments recommended. It is why when I post and do not see a poster mentioning Decipher test or being told about it by their urologist or R/Os to consider asking for one.

A PET scan uses less radiation than a CT scan, So it does make sense to use it more frequently.

One of the guys over in last week’s Advance prostate cancer Ancan.com meeting, said that he was having PSMA Pet scans every three months. Advanced case, close monitoring.

Hi. I just want to know how long you have been taking Orgovyx, and what is your PSA level now? If you had topped taking it, how long now since you stopped and what was your PSA level after you stopped? I am asking this since I want to stop taking Orgovyx now because my PSA level is now down to .1 from 5.5 after 6 months. (Started 10/24 and last lab work is 3/25). My OD told me to keep taking it.

thanks, Jeff. I'd worried about exposure to the contrast agent with PSMA, Is there any concern there?

The lifetime radiation exposure from repeated scans could slightly increase cancer risk. According to documentation I’ve read.

There was no bell to ring. The staff were congratulatory and laughed when I said I might return in a few days with a cowbell.

@stew80
These are good questions to asked your R/Os and urologist.

I can pass on to your my experience. When you say 5 rounds it means high dose radiation and thus lessor rounds of radiation. When you say 28 it would indicate low dose extended treatment radiation.

Now what are difference in success? My R/Os said they are about equal. Then why not all just do the 5? My R/Os, and my PCP answered my question when I asked the same one you did. All stated that their research was showing more side affects and degree of side affects from the high dose radiation.

Some posters will have minimual side affects and others will have substantial. I had the low dose 30 rounds and had miminal side affects. I had my radiation done at UFHPTI which does proton radiation. The difference between proton and photo is that proton enters body at a lower dose, releases it full dose at the determined spot, and stops. It does not exit the body like photon does.

Now both have the same success rates. The theory behind proton would be less damage to surrounding tissues and organs. It is why I chose UFHPTI versus only have photon if done a Mayo Jacksonville (building new cancer center that will have proton radiation and opens in 2026).

This is helpful info. Thanks. I'm not sure if Proton radiation is offered in my neck of the woods. I'm in the 51st state.

Stew, 5 rounds is SBRT - Cyberknife, MRIdian….high doses directly to the prostate.
25-39 rounds is usually EBRT - lower doses delivered over a longer period of time to a wider area, usually the prostate and the pelvic nodes.
There are very specific uses for each depending on the nature of your cancer.

I had that same question - I didn’t want to have the anxiety of waiting months for the first bloodwork.
So my medical oncologist and I agreed to do bloodwork (PSA, testosterone, CBC, and CMP) right at the start of treatment and again right at the end of treatment.
With my PSA at 7.976 right before treatment started to 0.224 when my proton radiation treatments ended. (PSA then remained at 0.008 for 8 months when the full effects of the ADT kicked in.)
That’s how I knew early-on that treatments were working as expected.