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How long after EBRT does the PSA bounce around?
Hello from Vancouver Island. I had a prostatectomy about three years ago and the PSA went down from 4.0 to about 0.03 after surgery. Within a year or so (18months) the PSA climb to 0.14. At this time my Urologist referred me for discussion to a radiation oncologist. The radiation oncologist suggested 22 sessions with no chemicals or ADT of external beam radiation. It must've hit something as my PSA rocketed down to 0.035. I went overseas, and seven months later came back and my PSA was 0.14 roughly, again. Since then I had another PSA and it went down to 0.11. Both urologist and oncologist think that this may be indicative of a PSA bounce. My prostate was small at surgery and so was the lession. I had a 3 mm breach that looked like it just happened , so says the Urologist, and all the cells around the breach were type 3 . My question is , could I still be suffering from PSA bounces? What do you feel about my case? Some type three cells are generating a PSA in my prostate bed( Oncologist thinks this may be true ) ? I have a family history as my father died from prostate cancer at age 67. My Gleeson on the lab work of the prostate surgery indicated a 3+4 Gleeson. My radiation oncologist indicated that if my PSA ever gets up to .4, he would suggest a PSMA- Pet scan . Any input would be helpful. I do suffer from anxiety from this prostate cancer as I was my dad's caregiver when he was going through his prostate cancer. I live on Vancouver Island in the province of British Columbia . Any input is greatly appreciated. What would you do in my case? Thank you for your kindness and time.
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The aggressive prostate cancer these oncologist and urologist make reference to comes from the initial prostate cancer. So back in 2015 my cancer was called an aggressive cancer and that was perhaps why my urologist said I had 6 months to get it out!
So when this present journey started my radiation oncologist was referencing my biopsies and surgery reports! He referred to the reports of the initial surgery back in 2015. They both have told me there isn’t a lot of research and studies on this cancer, my luck, so at the end of my radiation I was talking to my oncology team and asked why the max number of radiation treatments and Dr. said because of aggressive nature of your report. I asked what was probability they got the cancer and response was 60-70%. That means there is a 30-40% chance it is still there.
You know guys I’m ok with it as I’m not afraid of dying. My faith is very strong and it will be a glorious homecoming. Don’t get me wrong, I don’t want to die snd leave my wife, daughters and grandchildren but like I said I’m not afraid! Live life guys one day at a time and keep your eyes up! Peace to you guys out there with PC. Hey I’m around to answer questions so fire away!
Merry Christmas
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1 ReactionThanks Scotty . Yes I agree with you live life to the fullest ! I dont want to die as I have so much to live for . Im only 60 as well. My mother is 94 and in great shape .... my father passed at with PC at age 67 about 25 years ago . Thats why I am so hypersensitive to prostate cancer. Being his caregiver when he was sick with prostate cancer 25 years ago has stuck with me like it was yesterday. Scotty, I think because of the initial report you had in the file that your PC was aggressive ( or could be) that your doctor just went "pedal to the metal" with the radiation. Maybe that was a good move at the time. My Urologist and Radiation oncology in Victoria, both think that my prostate cancer is not that severe but I point to the 3 mm breach another factors (3+4 Geason) and I don't understand why they take it so lightly?. I only got 22 sessions of external beam radiation and that is on the very light side of sessions, of all the people I know. Anyway, I just got back from the laboratory at the hospital, and I had my PSA blood test. It will show up tonight or tomorrow on line . Pray for me and wish me luck. I need to get below 0.11 as that was my last reading, down from 0.14. I want to continue the slide downwards to unreadable, god willing. Take Good Care / Merry Christmas to all ! James
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1 ReactionVancoverIslandHiker, Boy sounds like you live in a great area and beautiful. Live in Florida so if you don't (I do though) like the ocean not much else here.
Forgive my lack of knowledge but the undetectable PSA level is something like .02 (again I am not sure but there is a bottom number) what that number means is undetectable not that PSA was found.
If you had your prostrate removed it should be at that undetectable level as told to me by my PCP and urologist. If the PSA starts going up it is not something generated by your prostate which again could be normal and not be caused by cancer. If you numbers go up an indicator that the prostrate cancer had spread to another area and is generating PSA again.
I read one post that said something about other causes of having some PSA but I am not familiar with that information. I heard the same thing from my Urologist that I was not going to die from prostrate cancer but it was based on the type I had, within my prostrate only, and my tests scores. His father died of prostrate cancer.
Merry Christmas to also James and hope you new year is a good one.
I am going to forget 2023 as was diagnosed back in January/February and almost the entire year has been dealing with the anxiety over prostrate diagnosis, testing, treatments, and now my first two follow testing after treatments.
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1 Reactionvancouverislandhiker,
the contrast agent pylarify approved in 2021 has special affinity for PSA. Tell your oncologist to requisition a PSMA PET scan for you. You shouldn't endure this anxiety.
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1 ReactionComment on number of radiation sessions: The total dose of radiation is being delivered in fractions, and to different areas.
My salvage radiation after prostatectomy was 66.6 gy to the whole prostate bed (WPRT) and 45 gy to the pelvic lymph nodes; 37 sessions; 1.8 gy per session.
Also PSMA Pet scans are less diagnostic when PSA is less than .2. And more definitive at higher levels, such as .4
Layman understanding.
Best wishes for a low, or stable, PSA reading.
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1 ReactionGently , thanks for your help. I never knew this about this contrast agent. . I wonder if we use that in Canada ? I am goign to ask about this. Will the PSMA PET work if we are under 0.4 ? I was at 0.11 last time down from 0.14 . I did a blood test yesterday for PSA but too much anxiety to open the darn Lab web site , I dont know what I will do if it over 0.14 . Its only 830 am here on the West yet - so I will . I will have another coffee and open it . IF The PSMA works at 0.14 I should get in line for one, as I hear there is a month or more wait if its not an "immediate" need . Thanks Gently , for caring , James
JC , thanks for the note Bud ! I sure appreciate any input . I had my Prostate removed almost 4 years ago now (3.8 years) . So it went down immediately to 0.03 , then started to rise slowly . Then last year I got 22 sessions Of EBRT , with no drugs . Again , they MUST have hit something as my PSA immediately went down to 0.04 and even lower . Then after coming back from my house in the Philippines for 6 months it rocketed up to 0.14 again and last one was at 0.11 . SO they hit something with the Radiation. The trip to the Philippines worked out ok. I raised about 30K ( which is a lot there) through a fundraiser for free PSA tests . Who knows a may save a guy out of it , I leaned on some of my fish Pinoy buddies . I lived there as a ex-pat kid , as dad worked there as an engineer . we still have a family home there . They Never talk of PSA there . I had posters written up too and placed in numerous cities through my motorcycle buddies . Lets hope we save a guy . Man !!! I want to live . With my father having prostate cancer I have been living this PC stuff for over 25 years now. I still remember dad going for "cobalt" therapy . I remember asking the Dr's at the time " was this good for his body ? " . God Bless him .. Thanks JC James
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1 ReactionMichael , thanks for your note . You have 37 sessions , I only got 22 sessions ... I dont know how many gy's though . Maybe my sessions were stronger ? Yes I heard that the PSMA was MUCH more accurate at 0.4 or higher ! I guess there is a risk at letting it go that high. too (?) . I will get one IF my PSA ever gets to 0.4 or higher the Dr's say . They were happy how I was progressing , BUT I still have a PSA after surgery and 22 sessions of EBRT , albeit quite low last time at 0.11 . Thanks Sir for your help ! James
May I say my hat is off to those like you that try to help others. I hope your help does save some guys!!!
Good luck to you and hope that PSA goes undetectable.
well I figure JC , I grew up their , so , I have to give back . So many poor people there and a very rich class and a fragile middle class . The money I raised will go to routine testing for PSA. I figure we will catch many with 3+ PSA that need further investigation . They have "Phil-Health" there a form of government insurance that pays 50-80% of the bills for hospital and even dental at times. They also pay for 100% of any pneumonia type illness, including tuberculosis. Because of the region and straight across the water from Vietnam, TB is quite common. These days drugs take care of the resistant bacteria, but even when it's free, Filipinos/Pinoys have an aversion to go to the hospital or even the dentist. So, Pinoys dont think they will ever get sick or die ....plus with the poor, every dollar have 6 places to go - that is a need. So, immediate food for the kids is more of a priority than 'Phil-Health' insurance for yourself and family . I think it's only about 14 CAD/month , so about 11 USD/month. That the sad part , most cant even afford this. I have a few plans to generate income, health checks, and jobs around my area of Luzon . Just need to live long enough for the plans to see themselves through ! At 60 I should have 20 more good years to make it happen. Thanks JC . James
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