Thanks Jeff, and my radiation oncologist at UCLA said it can take up to 5 years for NADIR to be reached, and what they are looking for is .5 ng/ml or less as the lowest PSA level reached after treatment.

The important thing as you said is that the trend is going down. However, up to 30% of people experience a temporary PSA bounce on the way that does NOT indicate a reoccurrence, and what makes it more nerve racking is there can actually be several bounces along the way.

That is why it is so important to work with your radiation oncologist when you have questions or concerns.

A lot has been learned in the last 20 years, and when there is a reoccurrence they used to say if you had radiation treatment first, you could not have further radiation or surgery, but would automatically go to ADT. That is not necessarily the case any more. A lot depends on whether it is localized, regional, or distant.