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Wondering about the rate in the drop of my PSA after HDR brachytherapy
I was diagnosed with prostate cancer approximately 18 months ago. My PSA was 4.7. Gleason scores were 3+4. 16 of cores were positive. PET scan showed that cancer was contained to the prostate. Elected for two factions of HDR brachytherapy. Four months after treatment my PSA dropped to 1.68. Four months later, it dropped to 1.33. Is this rate acceptable or should it have dropped lower?
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If this is only therapy you did with no additional radiation or ADT I would think it's acceptable. depending on your age normal PSA for older men is 4. I'm not an expert just my opinion. There are much more experienced members here who i'm sure will reply.
After High-Dose Rate (HDR) brachytherapy, PSA levels typically decline gradually over 1–2 years, often reaching a nadir (lowest point) of < 0.5 ng/mL or lower within 18–30 months. A "PSA bounce"—a temporary, benign rise of >0.2 ng/mL—is common within the first 1–2 years, frequently mistaken for recurrence..
as long as your PSA is dropping, gradual is ok...you have a somewhat moderate risk PC anyway, but seemed to be present throughout prostate. SO that might be what is slowing PSA drop..but good news it is dropping...test every 3-4 months and move on with life if you are not having any other problems/symptoms !
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3 Reactions@copyman thank you!
I know people who had their PSA continued to drop for three years before it hit the minimum. There’s no way to tell when yours is going to hit the minimum. It may go up a little bit one test and then go back down again in the next. That is not unusual so don’t get panicked.
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1 ReactionI do not exactly know what is mean HDR brachytherapy...and what PSA number should be after pro done.. but mine is after 5 weeks after surgery is 0.05 ...which is no so bad...best is 0.01 to 0.02 mean "undetectable" 0.2 it recurrence.
High-Dose Rate (HDR) brachytherapy is a targeted internal radiation therapy where a high-activity, temporary radioactive source (usually Iridium-192) is inserted directly into or near a tumor via catheters....
That is important because if you undergo Radiation and the cancer returns, salvage surgery regardless of your age is not done by most surgeons due to the risk, although it is done by a few highly skilled surgeons but not many, the age and health factor regardless comes into play even for the surgeon that can do salvage surgery. You have probably heard that you can still have Radiation after surgery if the cancer returns but not surgery after Radiation.
I hope your rate will drop lower
@xahnegrey40 thank you
There's an excellent Youtube video put out by the Prostate Cancer Research Institute that looks at how PSA responds after various Prostate Cancer treatments: https://www.youtube.com/watch
The video mentions a study that was conducted on HDR brachytherapy treatment and found that the median length of time before PSA reached its nadir was 3 years. Also a PSA "bounce" is very common with all radiation treatments (a rise in PSA level before a return). I found the video very helpful.
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2 Reactions@drewlevine thank you very much
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1 Reaction@drewlevine I had LDR using Palladium 103 seeds after 6 years PSA has gone up what salvage treatment is available?
I don't have the knowledge or expertise to answer your question but I am sure that there are other people on this site that do. The PCRI has been an excellent resource for me. There are lots of other Youtube videos posted by clinicians that may also be helpful. The field seems to be changing all the time. Wishing you all the best @celtic