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Xtreme PSA bounces after radiation cancer or inflammation?
Prostate Cancer | Last Active: 5 hours ago | Replies (15)Comment receiving replies
Thanks @jeffmarc .
Comments from my ONC after 9.6 spike, subsequent to 9.6 it dropped to 3.8. "I think your judgment is sound; it's reasonable to be worried. Your PSA is not where I expected it to be. The reason for waiting is not that I'm convinced you're in the clear, but that I think it's the best next step to gather more information/data to help us figure out what's going on.
PSA "bounces" are defined as a post-radiation increase, and yes those are usually of smaller magnitude. PSA "spikes" on the other hand are exactly this magnitude and usually related to prostatitis, UTI, sexual activity, or someone else similar. I'm hoping that is all this is". Now we are at 6.4 nearly doubling the 3.8 so I think the spike theory might be wrong. In my mind this will be quite aggressive cancer or the spike of the century. Urologist gave me similar feedback. If they are off base with their judgements its a real disappointment as I am at a center of excellence. With Dechiper, .30 Color Genetic, low Gleason score this should have been killing an ant with a hammer as they say and my team suggested. Sigh
Replies to "Thanks @jeffmarc . Comments from my ONC after 9.6 spike, subsequent to 9.6 it dropped to..."
@neilmartin This is where we have to be careful with one specialist’s opinion (even at Centers of Excellence) unless they can show data to back it up. (I always asked my Uro, RO, and MO to “show me” or “where can I find that?” so that I could look it up for myself. Not that I didn’t believe them, but if something is going to happen to me - possibly something bad - I want to have buy-in first.)
What one doctor might call “the spike of the century,” this doctor at a PCRI conference a few years ago said that “…the typical bounce is in the 1, to 2, 3 range.” Then he goes on to say that “I have had patients at 10; I had one guy at 16 and didn’t treat them. They didn’t want to go with treatment and waited, and their PSA went away.”
See that PCRI Conference interview at: https://youtu.be/ogDhQv-1Axo (starting at about the 6:00 minute mark). The full interview is less than 8 minutes so, you might want to watch the whole thing just to have context.
I bookmarked that interview a couple of years ago because when I heard him say PSA bounces to “10….16” that seemed so far beyond everything that I had heard/read elsewhere.
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My personal view is that doctors aren’t gods - they’re just people like you and me. They’re working in an occupation for which they have an aptitude and great passion for (and I respect them for that); but, they’re not perfect; they’re human, with human frailties; they sometimes make errors. (No different than you and I who were very good in our individual careers and the teams we worked with, but we weren’t perfect.)
So, they’re not always right; no one doctor knows everything; they only know as much as they’ve learned and experienced. Whatever they tell me, I accept it with some cautious and informed skepticism (and optimism).
(Ok..,,off my soapbox.)
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@neilmartin Very frustrating indeed…all your parameters portend smooth sailing so something is definitely up.
Couldn’t hurt to have another PET but if it is negative what then?
Perhaps a month on Orgovyx would be the best diagnostic thing you can do.
If your PSA plunges to almost zero, then you know for sure you still have active PCa…if not, then perhaps it is one of the easier fixes like UTI, etc..,
I would, however, try to avoid a Lupron shot since it might just make you more miserable; if the Orgovyx affects you adversely you can always stop it. Best,
Phil