Side effects and PSA after photon radiation.

Hi Ed, I ordered broad spectrum CBD oil in small bottles with an eye dropper. Each bottle holds 6000 mg and each eye dropper/dose holds 200 mg. I do it in the morning and around dinner time. The CBD oil I get has no THC and I don't feel any effects at all, so it doesn't make me happy or stupid. I put a full dropper under my tongue and keep it there for a few minutes then swish it around my mouth before swallowing.
There have been some limited studies that say "Cannabidiol Inhibits the Proliferation and Invasiveness of Prostate Cancer Cells", that is from the NIH website. I figure if it slows the cancer down at all I'm ahead of the game. That along with White Button Mushroom powder, I think I'm giving myself the best chance I can do.
Other things like Taurine and Turmeric have been reported to have an effect too and they are typically good for you and have been taking them off and on for years prior to cancer diagnosis.
Hope this helps. Dave

Hi Ed

What does your radiologist say about your PSA?

I think your PSA is doing fine. I also had a urologist question the PSA result 3 months after SBRT w/o ADT. Even said "perhaps they did not do it right". I suspect now he was still cranky as I did not choose him for surgery, and was not familiar with RT w/o ADT. My radiologist was fine with my PSA decline from 4.77 to 2.98 after 3 months. Its been a slow 4 year decline to now 0.8. Hang in there.

Check it every 3 months for year, then every 6 months thru year 5. Then perhaps once a year? not sure on that.

Duckster

Hello Ed, I can answer this based on my recent first Psa test which has been 3 months since treatment. Below is my brief outline"
"Assessment/Plan
IMPRESSION/PLAN:
is a 68 YO male with recently diagnosed UIR prostate cancer. At least T2c. S/p biopsy with 4/7 cores positive. 3+4=7 GG2 disease. PSA = 9.3. DECIPHER: 0.34 LOW RISK
He is presenting today for consultation and second opinion.
NCCN guidelines for intermediate risk prostate cancer includes active surveillance, radical prostatectomy wwo pelvic lymph node dissection, external beam radiation wwo ADT, brachytherapy (HDR & LDR) wwo EBRT/ADT, and trial enrollment. The role and utility of radiation therapy in the patient's disease setting was extensively discussed. While no head to head comparisons between surgery and radiation therapy have been done, the breadth of data seem to indicate that similar rates of control are achieved with each therapy approach.

He is a candidate for MRgSBRT. The MIRAGE trial interim analysis indicated that MRI-guided SBRT significantly reduced acute grade ≥2 GU and GI toxicities compared to CT-guided SBRT, highlighting the potential benefits of MRI guidance in reducing treatment-related side effects.

The logistics of receiving radiation therapy was also explained. Prior to starting treatment, placement of fiducial markers and barrigel spacer for rectal sparing would be done first.

The benefit of spacer hydrogel placement was also discussed with patient for reduction of rectal toxicity.

Plan:
- we recommend MRgSBRT in 5 fractions
- Hydrogel spacer placement prior to RT
- he has low risk decipher and GG2 disease, and may omit ADT.

I had 5 treatment sessions on the MRIdian which MR_guided SBRT. My total radiation given was 42.5 gy over 5 treatments with NO ADT.
I had to use just two Flowmax 0.4 mg after the 3rd radiation treatment due to some diminished flow characteristics, that problem self resolved after the 4th radiation treatment and no further Flowmax has been needed. GU function has actually improved slightly to what it was prior to any treatment. GI some changes that include at times no time wait when the need to go is present. Before I could wait, but now go means go, if you know what I mean. GI can drip just a little now if I also wait when I know my bladder is full or getting near full, so I have just learned do not wait on these signals like I was able in the past.
My initial Psa prior was 9.3 and now 1st test after 2.4 which is more than I expected. I think yours is ok as well, because I was told after treatment by my RO, it's not the amount of decrease, but more of wanting to see a decreasing trend over time.

It’s good to hear your doctor telling you about the fact that it will Decrease over time. I’ve actually heard about people that took three years to get their PSA down to the lowest level after radiation. Be aware that it could bounce up a little bit and then down again, that is not unusual after radiation.

Sounds like you’re going in the right direction.

Hi Duckster,

Thanks for sharing your experience with PSA after radiation. I have an apt with my radiologist this Friday. I want to understand his expectations compared to my urologist, who felt my decline in PSA was insufficient. What you are describing and what I have been reading both on this site and the internet, slow declines seem to be the norm. I am feeling more confident in my results and hopefully my radiologist agrees as well.

Similar results with my Urologist before I made a decision to go with radiation rather than surgery. While I had only one sample of 3+4 from my (2) biopsies, reported < 5%, I asked my urologist if he would recommend surgery for any amount of Gleason 4 score, he replied yes. Not the answer I expected, so I take his recommendations with a grain of salt.

Just got back from the docs and PSA is 0.40 so quite pleased with that result all things considered.

@ozelli
I am really very interested in following your progress.
I see your numbers as follows:

Radiation Type: Proton Beam
Number of Sessions: 21
Last PSA before treatment: 17.53

With no ADT post-treatment:
[2.5 months post Tx: 4.33]
3 months post Tx: 4.11
6 months post Tx: 2.47
9 months post Tx: 1.83
12 months post Tx: 1.22
15 months post Tx: 0,94
[18 months post Tx: skipped]
21 months post Tx: 0.60
[24 months post Tx: skipped]
26 months post Tx: 0.40

I had 6 months of ADT-Orgovyx, starting from two weeks before SBRT. I am 1 week off ADT now, and my second PSA test post-radiation is this coming week, My radiation oncologist originally told me that I will be on Orgovyx 8 months to a year, but when see saw my PSA:

3 months post Tx: 0.36 , she indicated that 6 months was enough.
6 months post Tx: To be determined week of Oct 6.

I will be happy if it is already undetectable by this month, but I won't mind if it is still >0.1 ; I think I have balanced my treatment (between no ADT and some ADT post-radiation) and need not extend hormone therapy beyond t6 months.

Thanks for the update on your month 26.

I am encouraged with your record of consistent PSA drops with no ADT at all.

Hello - my journey is as follows - gleason 8 psa 47 n also in seminal vesicles. Started orgavux in April 2025 - psa end of April < 3 - finished 28radition treatments mid August. 1st psa test 2weeks after radiation- < .01. My question is your decision to stop adt - my oncologist wants 3yrs. I'm thinking 9months. What influenced your decision to stop after 6months. Everything I read says stopping adt if psa is undetectable is not being reckless. This Gary

@garyhu
With a Gleason 8 NCCN Recommends 18 months ADT. The Seminal vesicle issue is something that makes PC much more aggressive.

Your doctor is just trying to be protective, To prevent the cancer from coming back sooner. If you do decide to stop Orgovyx You should get monthly PSA test to make sure your PSA is not rising.

I’ve been on ADT for almost nine years. I do have to exercise a significant amount compared to before I had PC. I run on a track a mile twice a day, every day. I try to get to the gym three times a week and usually do. Weight training is critical to prevent a muscle deterioration, You may quickly notice a beer belly. Doing a lot of situps can offset that. Just some things to consider.

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