How long after EBRT does the PSA bounce around?

vancouverIslandHihker, If I read correctly you had your prostrate removed is that correct? If so your PSA should have eventually gone to the undetectable level (I don't know that number so won't post it). If you still had your prostrate you are going to have PSA. And that PSA can rise without any connection to cancer baseid on irritation, infections, etc.

I am not sure why you did NOT get a PSMA prior to your surgery. A PSMA would have determined whether the cancer had spread outside the prostrate. I had both as PSMA and bone scan as well as Decipher test. A rising PSA after having your prostrate removed is something I would asked questions on.

A PSA above undetectable level and NOT having your prostrate would be a concern that some of the cancer cells were still in body and creating PSA levels. All this is information I have learned but IN NO WAY am I a physician so all this needs to be discussed with your doctors. Bottom line if you PSA is above undetectable level and it has been a year (If I read correctly) would be in my opinion a need for a PSMA.
Good luck and welcome to MCC

JC , thanks for your thoughts here . Yes, I had a prostatectomy about three years ago. Your right , My PSA should be at Zero ( here 'unreadable' is 0.008 ) , but it is hanging around 0.11 right now , down from 0.14 . I think the reason no PSMA PET scan was done is that I was well under the 0.4 that is needed to get a clear view of any progress ( so I was told) . the oncologist indicated I would get a PSMA Pet scan IF the PSA ever got to and passed 0.4 . When I got my 22 sessions of the EBRT , I had no ADT or anything else . I asked about that about 6-7 times too , as I thought it was weird . But I hear now that if your PSA is under 0.2 , you down really need ADT . Anyway , off to the lab tomorrow for a PSA test ....God I hope it's less than my last one at 0.11 ! . Take care JC and thanks for your time . I sure appreciate it ! James .

James, here’s some information to chew on. I had my prostate out in August 2015. My PSA stayed < .01 for just about 7 years before heading north to .1, then .5, then 1.0, then 1.31 and then 1.6. My PCP initially thought the rise in PSA was an anomaly. Well it wasn’t. Further tests came back and I have been diagnosed with an aggressive cancer. I was subjected to ADT(Lupron) and 39 radiation treatments. What I have learned over my so called journey is this, according to the Prostate Cancer Foundation any PSA over .2 you should see a Urologist immediately. What they don’t want to see is a doubling of your PSA IN A SHORT PERIOD OF TIME. If you have been .1 or .14, back to .11 I would listen to your PCP and/or see a Urologist. But right now it seems like you are ok, but again I’m not a doctor only a guy who just completed the radiation treatments and now waiting to see if the cancer was eradicated which will be another 12-18 months. Good luck with your journey. God Bless you and your family

VancoverIslandHiker, You will see here on MCC very reluctant to give medical advise. I do see you are in Canada with what looks like different medical practices.

In U.S. what I see is the PSMA is usually done based on the risk level of your cancer and the decision of your urologist, and/or oncologist and not PSA number. But even though I had a low risk may oncologist/radiologist at UFHPTI did a PSMA.

When I went for my initial consultation with Mayo oncologist/radiologist my Gleason worst was 3+4=7 and was given a intermediate risk. My Mayo oncologist/radiologist stated they do the hormone treatment (or recommend it) for everyone except those with cardiovascular issues. I think he was referring to those with intermediate risk and higher.

When I had the Decipher test it came back low risk and they changed their recommendation to no hormone treatments. What was your risk level? This is usually given at the biopsy time based on the biopsy results NOT PSA.

Is Canada is using something different as you say 0.4 is normal level of PSA. USA is using 4. My PSA was 3.75 still normal but rising every 3 months. As you can see my PSA was under normal but because of rising numbers biopsies ordered along with suspicious areas seen on MRI. The PSMA and bone scans were done to determine if had spread beyond prostrate so could be treated initially.

I wish you good luck James. Hope your numbers come back good!

Dear V I H (your island looks soooo beautiful !),
I'll agree with the above good comments and reinforce the suggestion to get a PSMA and Bone Scan. You may want to be assertive in your request OR get a second opinion from another Urologist/Oncologist you consider outstanding.

Dear V I H (your island looks soooo beautiful !),
I'll agree with the above good comments and reinforce the suggestion to get a PSMA and Bone Scan. You may want to be assertive in your request OR get a second opinion from another Urologist/Oncologist you consider outstanding.
Praying with you that it turns out to be no concern.

OK Thanks Scotty ! I sure appreciate your input . Im going for a PSA test today . I hope its less than 0.11 like last time . How did they test for the 'aggressive form' . My urologist thinks im going to be fine ....BUT he just drew blood for a DNA analysis to see if their was any mutations in the Genes with regard to cancers or other stuff like diabetes and sorts . My father passed away with prostate cancer ...so it runs in the family . Father passed away young at 67. He caught it late . Even though he was an engineer , he rarely went to doctors and was hesitant to go near them . It was discovered when his PSA was up near 20.5 , they did treatments for 6 years or more . It was a late diagnosis . Me on the other hand was going to a urologist 4 years prior to my diagnosis just for a urology check - as I was so afraid of it . In the 5th year the urologist said "lets get a biopsy , yoru PSA has been slowly rising and is now 3.2 at age 56( at the time) its on the high side , you may have the very start of Prostate Cancer , maybe" .Well, it came back as Gleason 3+4 on the biopsy and so this started my PC journey . God Bless to you and yours Scotty, and thanks for your help . James

Thanks for the wishes JC . In Canada , at least in my province of BC , I dont think we do a "Decipher test' BUT the Oncologist ordered up a DNA test for me just recently looking for mutations and other stuff . It takes a while to get test results back , so I expect them in 3-5 weeks . Both doctors seem positive about my case ( Urologist and Rad Oncologist ) they even said " James, you will die one day , but it wont be from Protate Cancer" . Shocking but reassuring at the same time. BUT how do they know? I asked my Urologist if he knew that I would have background PSA from 0.03 to 0.14 , then after radiation it went down to ~0.03 , then when I got back from overseas it went back up to 0.14 , then the last one was 0.11 . He said 'NO' I thought you would have zero PSA as the operation went well. Your prostate was small, PSA at operation time was 4.0 , and Gleason 3+4 , reason was small . He also said it appeared to him the 3mm breach on the side of prostate looked like it just happened with Zero cancer cells near the breach , lymphs, bladder or any other 14 samples he took for biopsy . He did comment at the very small breach site all cells were type 3 , which he said was the best case give the small breach . Thanks for the help JC ! Merry Christmas to you and yours . James .

Thanks for your comments Grandpun. Yes , I am blessed to live here . Its a unique Island in the Pacific NW . Seattle and the San Juan Islands are just south of me . BUT we get half the rain as Vancouver and Seattle area , as we are in a unique climate zone . Sure we have skiing and stuff at the 4-5000' altitude , but the snow stays up there as the warm Japanese current by the ocean( where I live) keeps winter really mild . Love the place, great fishing, Hunting, Hiking with my dogs and raw-nature everywhere ! The culture of Vancouver Island is distinct from the mainland for sure too ! Very easy going people here. I spend 1/2 the year overseas in the Philipines m as I grew up there as a ex-pay kid 🙂 . I will take your suggestion and push for a PSMA-Pet scan . The doctor said he would do one , but , "they needed 0.4 to get a good reading, IF I every get there" . The doctor said my case looks positive ...BUt how ? , I dont have a zero PSA after surgery and a 22 rounds of EBRT radiation a year ago . Thank God is was at 0.11 ( down from 0.14) last time . I get my PSA done again today ! Yikes ! I hate needles ! With our Government system here , they do look after you well , but the doctors I find tend to supportive yet very rushed with you ! God Bless you my friend ! James , from Vanc. Is .

Scotty , I reread your notes here . 39 sessions ? Holy ! , thats a lot . Why did I only get 22 ? Zero ADT as well . The Dr said I didn't need it , as I was at 0.14 at the time of the EBRT radiation . I asked him 3-4 times about the 22 short sessions and no ADT and he was confident I didn't need more . BUT , it did rocket down to 0.03 right away ....then started to climb back to 0.14 and now 0.11 . It will be interest to see what todays PSA brings . Gosh I didnt sleep last night and had some cold sweats too ! My father died of PC at 67 and I was his care giver . I remember shutting his eyes for the last time , like it was yesterday but it was 24 years ago now .... I know , the Dr's say things have changed ten times since then ....BUT I still worry . I am a introspective guy, use to studying materials, and worry a lot . I trust my doctors but only to a point at times . I chummed around with a few Med students in my university days , and they are only human and do guess at things all the time . Thanks for your help Scotty ! James .