Hi everyone, I’m hoping to get some insights or hear from others with similar experiences. I’m currently 8 months into treatment for prostate cancer. My regimen has included:
Firmagon (ADT) since diagnosis (8 months so far)
23 fractions of external beam radiation (EBRT)
1 HDR brachytherapy insertion
Initial PSA was 26.7
Current PSA is 0.47
Testosterone is at castrate levels
Pathology showed cribriform pattern, which I understand can indicate a more aggressive form of cancer
I’ve heard (including from Dr. Mark Scholz) that PSA should ideally be ≤0.1, and preferably closer to 0.01, by this point in therapy. While my drop from 26.7 to 0.47 is substantial, I’m concerned it may not be as low as it should be, especially after combined ADT, EBRT, and HDR. Has anyone experienced a similar slower or plateauing PSA response? Should I be concerned about the possibility of hormone-resistant disease or undertreated cancer?

I would really appreciate any thoughts or experiences you’re willing to share.