What PSA to expect 2-3 months after ending Radiation.

How long will you have been off of ADT at that 3-month point after ending radiation treatments? If the hormone therapy is still in your system at that point, your PSA will still be artificially suppressed due to the lack of testosterone.

In my case (see my attached PSA tracking chart), I had 28 sessions of proton radiation during April-May 2021, and had Eligard injections in April & July. My PSA remained suppressed by the ADT for 8 months after the radiation treatments ended, and then began to rise slightly, until it leveled out to where it is now.

(My official nadir in April 2022 was 0.198; though I did have a self-ordered PSA test done in February 2022 which was 0.13.)

Here is my PSA chart from before treatment to a few days ago. I had 5 mridian radiation treatments with no ADT.

@guerri2024
I did not have ADT. For those who did your PSA test will be much lower that those who did not.

Every lab (and it is important to know the facts of your lab not statistics of others) has different types of equipment and will different levels of PSA determined to be undetectable. At Mayo Jacksonville the lab there does not give PSA numbers below .10 At our lab numbers below .10 are considered undetectable.

So what ever lab you are having your PSA test done is real important to know what the undetectable number they use not statistics or other labs who might be different.

If you did not have ADT your PSA would slowly go down with radiation. Remember your prostate just went through WWIII and is not going to be happy for awhile and PSA will slowly go down. My PSA dropped on full point at 3 month after mark. Then went down to .12 at my 2.5 year mark.

You had ADT. My doctors told me ADT does not kill the PC. What it does is starve the PC from testosterones which it feeds on. So a person on ADT will have usually a higher rate of PSA going down that a person who did not get it along with PSA numbers being lower as long as on ADT. If you have a prostate you are going to have PSA numbers. My R/O said my goal was to keep PSA under 1 Mine right now is .12 so way under that goal.

These are questions your urologist and R/O should be answering for you. Have you asked them these? Most doctors don't automatically start giving information without questions. So important to asked your doctors every question you have then you can research or asked others for their personal experience who can share that with you.

The ADT will be a large factor in your PSA. You should be off it for at least 3 months before they retest, and in some men the effects can last much longer depending on the type of ADT used.
Also, remember that ‘everyone is different’ - can we EVER say that enough?
Your drop is going to be yours, not someone else’s; so please don’t stress if your first PSA is not drastically lower than the original reading, or if it’s not ‘undetectable’.
It can take many months to reach its nadir and as long as the trend is downward you’re doing fine.
Phil

Your question: "I have been reading that a PSA of < 0.2 (Nadir point) within 6-12 months means a good long term outcome. So my question is: what PSA to expect in 3 months after ending Radiation in order to predict a better outcome?"
1. This was my experience 3 months and 6 months after ending radiation: 0.36 and 0.22 PSA levels, respectively.
2. I asked my radiation oncologist if PSA 0.22 was my nadir already? She said no, the nadir will be the lowest reading before PSA starts to rise.

I was already two weeks off Orgovyx when I had my PSA test 6 months after radiation (SBRT), so it could have been artificially low, with Orgovyx not yet fully flushed out of my system. On my next PSA test, which will be 9 months already after radiation, if the reading is below 0.22 then the lower value can be my nadir. If gthe January 2026 value will be higher, then my nadir will be 0.22 the last value before PSA rise.

My oncologist said it will not be a surprise if my PSA will rise because I would have been four months off Orgovyx by then, and my testosterone would also have been higher. However, if testosterone had not risen high enough to match the increase in PSA, then it is something to be looked into. I am prepared for the possibility that my PSA will be going up in the next little while then start going down again.

I was comparing notes with another in our brotherhood here

@vircet I was comparing notes with bens1. His PSA was 0.8 two yearsbe over after radiation, 0.61 two years and 10 months after radiation, then it rose to 0.7 in his 3-year mark. Based on what my oncologist told me, bens1 nadir with be 0.61 and even if it kept rising after that in small increments (as is expected in my case after nadir), it will not raise an alarm so long as the rise is explainable with a corresponding increase in testosterone.
From other readings of posts in this forum, the PSA should not be over 2.0 at any point after nadir. Others who have been in this journey longer than the two of us can correct me.

@vircet Excellent posts, bud…your analysis of the PSA vs T equation shows just how different it is for men who’ve had radiation as primary tx vs surgery.
You STILL have a prostate so you will still make PSA; and even with ADT, the ‘healthy’ cells will still survive and do their thing depending on your level of T…
With no prostate, the math of rising PSA is somewhat easier to understand since the amount of T doesn’t matter.
I tell you, no matter which entree you choose from the menu, anxiety and stress will be a constant side dish for a long time…Best
Phil

Me experience is....I completed 5 treatments of SBRT in June of this year. My starting PSA was 9.3 and three months later in Sept it was 2.4, currently wait for my next 3 month at the end of this year. I was not nor have been on any ADT.

@beachguy Were you favorable intermediate risk? I was unfavorable intermediate, that's why my radiation oncologist started me on Orgovyx (ADT) two weeks before SBRT, for a total of six months on Orgovyx. If I was favorable intermediate, I would have preferred no ADT.

I was fortunate to have a low decipher score, so I was treated without the ADT.