Is an ADT Treatment PSA Drop From 25 to 0.63 in 2.5 months Fast?

Rapid drop in psa is good news as research I have read says the time to castrate resistance is longer and other forms of treatment work better if the psa drop on initial adt is rapid. Be well or as well as we can be in this club.

Is it fast....?

Yes...

What does it mean?

Well, data from clinical trials indicates that "rapid responders," those whose PSA drops to undetectable in roughly the first six months have better "outcomes."

What are outcomes?

If one is on treatment for a specific period, then an outcome is coming off treatment and longer PFS and RPFS period off treatment.

That begs the question, what is undetectable? In part I guess, depends on your medical team's philosophy, the equipment and assay.

Mayo generally does not measure below one decimal point. So, under their approach, you are "undetectable.

My medical team measures to two decimal places. Others measure to three decimal places. If my medical team measured to three decimal places I would be "detectable" at .03. Instead, at my oncology consult on Wednesday we'll talk about our vacations and the only decision needed, how far out to schedule the next labs, three, four, six months!?

To me undetectable simply means that at the level we can measure to, our systems do not detect any PSA. It does not mean there is no PSA.

So, based on what you describe, take the win, a rapid drop in PSA, continue with your treatment plan and discuss with your medical team what the clinical data from labs means in terms of measuring success of the treatment and the way ahead.

Kevin

My PSA dropped to 0.7 after 3 months in ADT. After 5 months it was undetectable. I think it varies case-by-case.

Just curious, What is your Gleason score? Mine is 9 and I have been undetectable since late Nov 2025. Mine didn’t have as far to go. Was about 2.5 after prostatectomy, but before ADT and radiation.

I was pretty much the same. PSA 30, October started ADT. By December PSA dropped to 0.7. Starting Radiation gone for about 2 week, first 3 sessions high Grey treatments and now lower gray treatments. Feeling good. Oh, had 2 Lupron shots also.