IMRT sessions finished now waiting

Thanks for the feedback. As I was reading the notes I began thinking about what a lower PSA means. I realize that a high PSA is a strong indicator of cancer so does this mean that a low PSA is an indicator that there is no longer any cancer? This seems logical but is it?

@mkostera, welcome. Can you tell me a bit more? What is your prostate cancer diagnosis? What treatments have you had or will be getting? How are you doing?

Diagnosed with Gleason 9 localized cancer affecting 5 cores PSA of 11. Started with ADT in March on Firmagon, (did a PSA in June, it had dropped to a value of 2), switched to Eligard in July receiving a 6 month injection. In September started IMRT this lasted for 30 sessions last session was on October 23rd.

Come November 6th I have an appoinment with my Urologist. My Oncologist has ordered blood work on November 17 testing testosterone and PSA, being told not to pay too much attention to the PSA because there still may be side effects from the radiation. Will be meeting with Oncolgist on December 5th

I am doing OK just kinda worried about the effectivenes of the IMRT with me having a high Gleason score. I have read that with the type of treatment I am having that my PSA should continue to drop and I am wondering if this means there is no more cancer.

Thanks for your enquiry

I had a gleason score 10, 8 out of 12 cores positive. Was put on Orgovyx September 1, 2022, began 45 sessions of radiation end of October 2022. My first PSA at 6 weeks following radiation was o.o4. I will be on orgovyx until September of 2024. Two year plan. My psa is staying at o.o4, which the Dr says in the same as zero. I have side effects, but not awful. Have added the gym 3-4 times weekly and stay very active. So far, so good.

erkbiz, if you have a prostrate you probably will show PSA.

When I started radiation treatment I was within the normal range for PSA. So having a lower PSA does not mean you do not have cancer nor does a higher PSA indicate you do.

When you have surgery to remove prostrate the PSA should eventually go to undetectable range and stay there. If it starts to rise it indicates cancer is still within body. If you did not have prostrate removal surgery many things can cause a PSA to rise and not be cancer.

What my radiologist/oncologist and primary care doctor stated is that once it goes down to a stable level (they want it to be below 1) they monitor a rise in PSA levels. If it rises it can be two reasons (non cancer prostrate issues) or cancer. PSA is only made in prostrate and prostrate cancer cells.

There are some good research sites you can investigate that get into PSA levels after surgery and radiation treatments. It is the rising PSA that is concern that needs to be check to determine in prostrate issues or cancer causing it to rise.

I did not need hormone treatments so my experience with radiation treatments and PSA will not be the same as yours. The hormone treatments you get are designed to stop the prostrate cancer cells from growing. They feed of testosterone so it eventually starves it from that hormone needed to grow and makes radiation treatments more effective.

I see prior to radiation your PSA was 12 which was quite high. Mine was 3.75 and after 3 months went to 1.2. I was told by radiologist/oncologist that it can take 1-2 years for it to get to it's baseline because there can be left over irritation to prostrate which will cause PSA to be higher.

So good luck on your PSA test but don't beat yourself down worrying. As long as it keeps going down your treatments are working and may make some time to get to it's lowest level baseline.

Sorry, 6 months after, .002

bettwils16, Was your PSA .24 or 24 before radiation? A .24 is very very low. A .24 means it was not even at the 1 level. Normal PSA levels end at 4.0.

Looks like your is holding and that is great news. I don't think they have a marker below a certain level and just list undetectable.

The waiting for the 3 month follow up is challenging.
However my oncologist/radiologist stated that it may take 1-2 years for the base line (lowest level) number to occur. As long as going down is what my doctors have said is good. If it starts to rise again (significantly) it means need to check to see why (radiologist/oncologist).

I am seeing from posts that if you have had hormone treatments the PSA follow ups are lower that if radiation only.

This would be a good question for moderator to comment on.

Mine PSA was 3.75 (normal range is to 4.0) and after radiation at 3 months went down to 1.2. Have my next test in December 2023. Radiologist/oncologist said getting it below 1 is the goal and to keep it around there.

If you have your prostrate you are going to have PSA and many things can cause it to rise and not be cancer so it is the continuous rise that my oncologist/radiologist say is important.

PSA .24 x 2 which indicates biochemical recurrence. Prostatectomy 2014.