Side effects and PSA after photon radiation.

I'm surprised they didn't put you on ADT prior to radiation. Active cancer or hormone treatment cutting the fuel off. Your choice. Frankly I found the radiation side effects much greater than hormone therapy.

They didn't put me on ADT because I only had one biopsy sample, from two different biopsies, that was 3+4 Gleason, and that one sample was < 5% Gleason 4. Other than the higher PSA, I was borderline active surveillance. The options were more biopsies until they found a significant sample, or radiation w/o ADT. I went with radiation and no ADT.

Ed, your scenario is definitely one where NO ADT is recommended. Gleason not bad, volume of tumor pretty low…SO why the heck isn’t your PSA a lot lower? Weird…
Before going on ADT, which will definitely lower your PSA but NOT pinpoint the problem, another PSMA is probably a good idea.
Although all your factors seem very, very favorable - something must have gotten out of the gland…has to be. Did you have complete pelvic radiation or just to the gland only? This could be the issue, but that’s a lot of PSA being made outside the prostate bed, don’t you think? Stay on top of it…
Phil

Thanks Phil.
I'll need to confirm with my Dr. if he did the complete pelvic. I doubt it as the focus was on the prostate and to reduce any unnecessary radiation to good tissues. But I know he radiated the seminal vesicle because I asked. He stated that the SV had a high probability for cancerous cells so he was being prudent. My PSMA prior to radiation was clear but it is confusing why the PSA is high.

Just wanted to share some information that I found on Chat AI which was somewhat positive regarding my PSA situation after radiation. I put in the question of having a 5.3 PSA after radiation, clean Pet Scan, no cancer detected in lymph nodes per MRI, if that would suggest cancer is still present. AI gave the following answer:

1. What’s expected after prostate radiation?
After radiation therapy, the prostate gland (and any cancer cells in it) are damaged gradually over time.
Unlike surgery (where the whole prostate is removed and PSA should drop close to zero quickly), radiation does not immediately eliminate PSA.
The PSA can decline slowly for 12–24 months after radiation. This slow decline is normal and is called the PSA nadir (the lowest level you eventually reach).
Sometimes the PSA even fluctuates or has a “PSA bounce” within the first year or two, which does not necessarily mean recurrence.

2. Why is your PSA still 5.3 after 3 months?

If your PSA before radiation was high, it often takes many months for it to come down significantly.
A level of 5.3 at 3 months is not automatically a sign of persistent or spreading cancer—it could just mean your prostate is still releasing PSA while the tissue (cancerous and normal) is being gradually destroyed.
Doctors usually don’t judge radiation success at the 3-month mark. They look for the long-term trend (6, 12, 18 months).

When I typed in my where my PSA was prior to radiation this was the reply:
Your PSA timeline so far

Before radiation: 8.4

3 months after radiation: 5.3
👉 That’s about a 37% drop already. This is reassuring, because the PSA is moving in the right direction.

📉 How this compares to expectations

At 3 months, many men still have PSA in the 4–8 range, especially if they started above 8.

A clear MRI and PET scan strongly suggest there isn’t detectable cancer outside the prostate.

The key is whether your PSA keeps trending downward at 6 months, 12 months, and beyond.

🔮 What’s likely ahead

6 months: You might see it in the 3–5 range (though there’s variation).

12 months: Often below 2–3, but it depends on how your prostate tissue responds.

18–24 months: Many men reach their nadir (lowest point), often < 1.0–2.0, though some land higher and still do well.

✅ Bottom line

Your PSA drop from 8.4 → 5.3 in just 3 months is actually a good sign.
It doesn’t mean there’s cancer outside the prostate — it means your radiation is doing what it’s supposed to, and we just need more time to see the long-term trend.

Just thought I would share this information from AI. Not advocating for AI, just found the information refreshing and interesting, and maybe you will too.

Ed, seminal vesicle involvement generally indicates a more aggressive - or further spreading - than your numbers would indicate. And now with the PSA not dropping as much as it usually does, your Decipher score is a very key piece of data.
If it comes back high you’ll have the answer. Probably ADT to stop it from growing, but where to radiate - if you can - is the question. Best,
Phil

I would retest in 3 months, not 6. If the number is lower it’s all good.

My PSA started at 14 prior to any treatments. I have metastatic PC with a Gleason of 4+3. Been taking hormones since around February with abiraterone and prednisone. My PSA prior to SBRT was around 0.2, Had SBRT radiation on my prostate and pelvic area during the last part of July. After contacting one of the members here in this forum, I investigated White Button Mushrooms (WBM) and the associated clinical trial results, and it was really good, so I began taking WBM at the termination of SBRT. I've also been taking CBD oil for 3 months or so as tests have proven that it has an effect on PC cells.

I just got my first test results back and my PSA is now undetectable. I don't know if that is just from the SBRT and hormones or the combination of that along with the WBM and CBD oil.
Wasn't expecting being undetectable from other reports I've read and seen after SBRT, but I'm not complaining.

As low as your PSA started having SBRT plus radiation would make it undetectable for almost everybody. The WBM and CBD May help but they are not really a factor Since you are on hormone therapy, what happened is what is expected.

Maybe those two things can help prevent reoccurrence.

Hi Bonazaman,

Curious, how are you taking/applying CBD oil? Thanks