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PSA numbers after radiation with no ADT

Posted by ozelli @ozelli, Apr 5, 2024

I tried to get a thread started about people who had radiation without ADT but often the thread got jumbled with input from people who had radiation and ADT.

I would like to hear from those who had radiation and no ADT. Just for ease of reading, if you could use the same format below, that would be appreciated.

One study of a few thousand men who at the 6 month mark had an average PSA of 2.2 (so I was a little higher than average at that point).

My numbers were:

Radiation Type: Proton Beam

Number of Sessions: 21

Last PSA before treatment: 17.53

3 months post Tx: 4.11

6 months post Tx: 2.47

9 months post Tx: 1.83

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jaygk | @jaygk | 1 day ago
In reply to @bigtoe "Jessica Wilson, I had 5 treatments, Monday, Wednesday, Friday one week next week Tuesday and Thursday...." + (show)
@bigtoe

Jessica Wilson, I had 5 treatments, Monday, Wednesday, Friday one week next week Tuesday and Thursday. Stayed at the Rochester Hope house free which was really nice to meet people going though the something. Best of luck.

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Was your MRI guided SBRT or CT SBRT.

Did you get the space OAR gel? Any urination issues or ED?

I know ED may come on after 1-2 years?

REPLY
1 reply
bigtoe | @bigtoe | 1 day ago
In reply to @jaygk "Was your MRI guided SBRT or CT SBRT. Did you get the space OAR gel? Any..." + (show)
@jaygk

Was your MRI guided SBRT or CT SBRT.

Did you get the space OAR gel? Any urination issues or ED?

I know ED may come on after 1-2 years?

Jump to this post

Not sure on MRI, Did have the OAR Gel, first couple of weeks when I had to urinate I had to go right away but that went away, no leakage etc.
ED was a little problem in the beginning but that has improved without pills. Had mostly dry orgasms for the first 3 months, has improved a little but not much.

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bearcat998 | @bearcat998 | 1 day ago
In reply to @jb2buckwater "67 Years old, had 5 treatment proton beam radiation at Mayo Rochester. PSA pretreatment 10.5. Two..." + (show)
@jb2buckwater

67 Years old, had 5 treatment proton beam radiation at Mayo Rochester. PSA pretreatment 10.5.
Two years later it had dropped to 0.5. It does eems to take 2 years or longer to reach a new nadir after which we need to respond to an increase of 1 before hitting the fire alarm.

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My SBRT has been a roller coaster. 3 opinions on biopsy. 2 said 3+4 W/cribiform. 1 said 4+3. W cribriform

Pre-treatment PSA was 9

Post-treatment:
2 months, 11.96
3 months 9.25
7 months 4.83
10 months 6.38
12 months 6.02
14 months 5.41
17 months 3.9

Test again in June.
I was the guy who had the post-radiation inflammation spike.
Then the radiation “bounce”
All doctors involved think its going well though.
PSA kinetics without ADT are unpredictable. But the thing I keep being told is that as long as it is dropping it is working.
The reason for no ADT was that I had limited positive cores 4/15. All in one area. And MRI showed a smaller than usual lesion. 3x3x7.
I'm treated at a major cancer center and my Dr said he expects it to nadir at about 1 in 2-3 years. Hopefully get to the .5 level but I have BPH and a history of prostatitis.

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1 reply
ozelli | @ozelli | 1 day ago
In reply to @bearcat998 "My SBRT has been a roller coaster. 3 opinions on biopsy. 2 said 3+4 W/cribiform. 1..." + (show)
@bearcat998

My SBRT has been a roller coaster. 3 opinions on biopsy. 2 said 3+4 W/cribiform. 1 said 4+3. W cribriform

Pre-treatment PSA was 9

Post-treatment:
2 months, 11.96
3 months 9.25
7 months 4.83
10 months 6.38
12 months 6.02
14 months 5.41
17 months 3.9

Test again in June.
I was the guy who had the post-radiation inflammation spike.
Then the radiation “bounce”
All doctors involved think its going well though.
PSA kinetics without ADT are unpredictable. But the thing I keep being told is that as long as it is dropping it is working.
The reason for no ADT was that I had limited positive cores 4/15. All in one area. And MRI showed a smaller than usual lesion. 3x3x7.
I'm treated at a major cancer center and my Dr said he expects it to nadir at about 1 in 2-3 years. Hopefully get to the .5 level but I have BPH and a history of prostatitis.

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There seems to be a lot of individual variability in PSA numbers. Your trend is a positive one and bounces are usually associated with better outcomes. Any reason why you are having tests so frequently? They are usually stressful events for most folks. I have decided to go to a longer interval between tests.

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1 reply
bearcat998 | @bearcat998 | 1 day ago
In reply to @ozelli "There seems to be a lot of individual variability in PSA numbers. Your trend is a..." + (show)
@ozelli

There seems to be a lot of individual variability in PSA numbers. Your trend is a positive one and bounces are usually associated with better outcomes. Any reason why you are having tests so frequently? They are usually stressful events for most folks. I have decided to go to a longer interval between tests.

Jump to this post

My testing schedule was out of whack because of an initial error where the medical assistant scheduled my first at 2 months instead of 3 months. Since it was so soon I still had residual inflammation and I was one of the 10%-20% that rose immediately after treatment.
The the bounce which everyone was confident was a bounce, however the jump of 1.5 points was close to the 2-point threshold of bcr, so the went with every other month until that resolved. After last test showed a decent drop, next test will be 4 months. If that shows and drop it will be 6 months.
You are right about them being stressful. They are very stressful when psa drops are going as you want.

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