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

Posted by Guerri2024 @guerri2024, Nov 26 12:04am

I had 23 sessions of IMRT and 2 sessions of SBRT boost while still being on ADT. I will have my PSA checked in a month. 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?
Does anybody have any thought?

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jc76 | @jc76 | Nov 29 5:53am

In reply to @beachguy "I was fortunate to have a low decipher score, so I was treated without the ADT." + (show)

@beachguy
I had same. My original diagnosis was intermediate risk per my Gleason Score. My treatment plan was radiation and hormone treatments.

R/O Mayo did Decipher and came back low risk. That changed my Mayo R/O treatment plan from radiation with ADT to radiation only.

It is one reason I really promote the Decipher test. I had that test and can share my personal experience with having had the test and how it changed my cancer treatment.

rlpostrp | @rlpostrp | Nov 30 6:53pm

Hello,
It is not quite clearly stated, but perhaps obviated: Did you have a radical prostatectomy and "then" your course of radiation, or...do you still have your prostate, and you only did a course of radiation? If you had a prostatectomy, and your course of radiation followed, I would ask how long it was post-prostatectomy before your PSA started to rise, setting in motion your course of radiation? How high did your PSA climb until you had radiation? But...if you did not have a prostatectomy, then I would ask "why" did you choose the course of radiation, knowing that in most cases, it prevents you from having a successful prostatectomy after the fact? I have heard there are some newer methods to make a post-radiation course prostatectomy have a better/best outcome, but when I asked my urologist about my options during the review of my biopsy, he said he never does radiation followed by prostatectomy, because "radiation turns your prostate into a walnut-sized piece of concrete" that is not amenable to prostatectomy thereafter. He said it is extremely difficult to successfully remove "all" of a post-radiation treated prostate. No matter your answers, good luck to you.

vircet | @vircet | Nov 30 8:33pm

In reply to @rlpostrp "Hello, It is not quite clearly stated, but perhaps obviated: Did you have a radical prostatectomy..." + (show)

@rlpostrp Somebody posted in this forum several months ago that he searched/looked for surgeons who would do prostatectomy on a radiated prostate; he found very few [like you can count on the fingers of one hand]. This year 2025, I have seen posts that favored having prostatectomy first, followed by radiation if necessary. I don't seem to have read a post about someone who had radiation followed by surgery. Did I miss any such post?

rlpostrp | @rlpostrp | Nov 30 9:55pm

In reply to @vircet "@rlpostrp Somebody posted in this forum several months ago that he searched/looked for surgeons who would..." + (show)

@vircet
Thanks for your message. Yes...after I posted what my experience had been discussing my options, with my urologist saying he would never do radiation only or first, because it turns your prostate to a walnut sized piece of concrete, a couple of gents replied that they are aware of some new techniques in both radiation delivery and surgery that makes it possible. So...I am waiting for them to chime in, allowing for the possibility that I may not have been offered the latest info on current treatment (which would be concerning!).