1st PSA results after Proton Beam Therapy

Posted by saxman911 @saxman911, Dec 5, 2023

Prior to my biopsy and 28 proton (1 core was positive Gleason 7) therapies with a rising PSA to 4.8, quest diagnostic reports (6 weeks later) reports me having a 3.52 PSA

over the last six week sexual function is completely normal and I have lost nothing

urination is on the mild side - I drink more water during the day now

any thoughts

Alan

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saxman911, Good to hear your results. Where did you have your proton radiation done?

I had 30 rounds of proton at UFPTI in Jacksonville FL. What Mayo and UFPTI do is after your last treatment they wait 90 days (3 months) to do a PSA test. This is to allow the prostrate to recover from the irritation of radiation and give a more accurate PSA reading. I am not sure why yours had it done at 6 week follow up as the norm is every 3 months for the first year after treatments.

The norm for PSA is below 4. So yours has returned to under normal. To give you an example, mine was 3.75 (I know under the norm but rising PSA just like yours for several years) prior to treatments and went down to 1.2 after 90 days. I have another PSA test on December 8th the next 3 month mark.

I would asked your provider why they did 6 weeks not 3 months. Great to hear you are normal in the sexual function this tells me you probably did not have ADT hormone treatments (nor did I). Urination should improve with time. It took about 3 months for mine to return to normal. I was urinating a lot, high urge, etc. and slowly improved and back to normal now (soon at 6 months past last treatments).

Drink the water is good for you. Good Luck Alan!!!!

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One comment from my own personal bias:
I'm sure Quest is a good lab. But since Quest offices around my area are like store-front operations that send the samples out to a lab, I"m not sure our specific blood/PSA tests are done at the same facility each time or by the same equipment each time.
For that reason I only rely on the PSA tests done by my Cancer Center who have the lab on-site. That way I'm sure the tests are done the same way on the same equipment each time (and I get the results more quickly too)
FWIW
Good luck and keep wailin' that sax 🙂
Bob

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@grandpun

One comment from my own personal bias:
I'm sure Quest is a good lab. But since Quest offices around my area are like store-front operations that send the samples out to a lab, I"m not sure our specific blood/PSA tests are done at the same facility each time or by the same equipment each time.
For that reason I only rely on the PSA tests done by my Cancer Center who have the lab on-site. That way I'm sure the tests are done the same way on the same equipment each time (and I get the results more quickly too)
FWIW
Good luck and keep wailin' that sax 🙂
Bob

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I took the test at 7:00 AM December 4 and this morning December 5 I got the results so they must've done the test on the premises

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@jc76

saxman911, Good to hear your results. Where did you have your proton radiation done?

I had 30 rounds of proton at UFPTI in Jacksonville FL. What Mayo and UFPTI do is after your last treatment they wait 90 days (3 months) to do a PSA test. This is to allow the prostrate to recover from the irritation of radiation and give a more accurate PSA reading. I am not sure why yours had it done at 6 week follow up as the norm is every 3 months for the first year after treatments.

The norm for PSA is below 4. So yours has returned to under normal. To give you an example, mine was 3.75 (I know under the norm but rising PSA just like yours for several years) prior to treatments and went down to 1.2 after 90 days. I have another PSA test on December 8th the next 3 month mark.

I would asked your provider why they did 6 weeks not 3 months. Great to hear you are normal in the sexual function this tells me you probably did not have ADT hormone treatments (nor did I). Urination should improve with time. It took about 3 months for mine to return to normal. I was urinating a lot, high urge, etc. and slowly improved and back to normal now (soon at 6 months past last treatments).

Drink the water is good for you. Good Luck Alan!!!!

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my proton therapy center is in Delray Beach about 13 miles from my house so it was very convenient. my oncologist told me to come back six weeks later so I just did what he said. I did not have to take any hormones my previous sex life was always excellent (I am still a professional musician ) so the sperm and pre-ejaculation is still coming out which I'm thrilled about.
When I stop drinking water at 6:00 PM I would only go to urinate 2 times over an eight hour period. But if I get very thirsty at night I would end up going 4 to 5 times so I guess this is going to improve as I head to the three month marker. I'm going to have a phone call with my oncologist on December 14 I'm sure he already knows that the PSA did go down and since it is a little bit cooler in Florida I have started my daily 2 1/2 mile walk around evening.

Stay in touch and I thank you so much for reading my post

Alan Russell

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I went from 17.5 at treatment to 4.33 eleven weeks after treatment. 6 month test is happening next week. I am hoping that it will at least go down to 3 but you just never know. Could get a “PSA bounce” which is not unheard of but would naturally be a concern.

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@saxman911

my proton therapy center is in Delray Beach about 13 miles from my house so it was very convenient. my oncologist told me to come back six weeks later so I just did what he said. I did not have to take any hormones my previous sex life was always excellent (I am still a professional musician ) so the sperm and pre-ejaculation is still coming out which I'm thrilled about.
When I stop drinking water at 6:00 PM I would only go to urinate 2 times over an eight hour period. But if I get very thirsty at night I would end up going 4 to 5 times so I guess this is going to improve as I head to the three month marker. I'm going to have a phone call with my oncologist on December 14 I'm sure he already knows that the PSA did go down and since it is a little bit cooler in Florida I have started my daily 2 1/2 mile walk around evening.

Stay in touch and I thank you so much for reading my post

Alan Russell

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saxman911, Hello Alan. Wow you were lucky to have your proton center so close. I had to drive 45 minutes to UFPTI as I live in Ponte Vedra area.

I agree with you important to follow what your oncologist wants you to do. He/she may just be more proactive and have your PSA test done earlier and more often. I just wanted to mention that my PCP and oncologist/radiologist said the first one they wanted to wait until 3 months mark to let the prostrate calm down from the radiation treatment. An irritated prostrate will have a higher PSA level.

I found the same thing with water drinking. If I drink at lot before went to bed I get up more often during and after my treatments. But the norm is that the urinating usually does improve with time. Mine took longer than I would have liked but did improve back to what was normal for me before treatments.

I see you exercise and everyone connected with my treatments says exercise goes a long way to recovery. I wish exercise was promoted more. Delray Beach is pretty far south. Ponte Vedra is near Jacksonville. I grew up in Vero Beach.

Take care and good luck!

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thanks so much for your reply and we will keep in touch as we are in a state of remission

Alan

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@ozelli

I went from 17.5 at treatment to 4.33 eleven weeks after treatment. 6 month test is happening next week. I am hoping that it will at least go down to 3 but you just never know. Could get a “PSA bounce” which is not unheard of but would naturally be a concern.

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ozelli, I would be positive you had such as drastic reduction in your PSA 11 weeks after treatment. This is the 3 month mark most are done at. I am told that it takes sometimes a year or more to get to the lowest mark you are going to get. Everyone is different in their recovery.

My PCP told me the prostrate is still pretty irritated after being radiated and thus they are looking for reduction after the tests. My oncologist/radiologist said the same think they are looking for reduction in PSA and only get concern if significant raise in PSA. I see from several posts that those who had hormone treatments and ADT their 3 month marks are lower than most who don't have ADT. Just my observation and don't know if medically means something.

You are correct PSA bounces are normal. Many things can cause the PSA bounce and not cancer so it is the test results over time. I am having my second one this week on Friday. I am just hoping for a reduction.

Remember watch what you do prior to test. I was told to not bike ride or have vigorous sex a week prior to test. The bike I understand as can cause prostrate irritation. I don't know why the vigorous sex is on there and what that means but I did not ask either.

Good Luck and let us know how you did!

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Helpful Thread!

I comppleted 5 treatment Proton beam at Mayo Rochester January 19, 2023. PSA was originally between 8.9 and 10.5 in the Fall of 2022. Gleason 6, no hormones. Started having urination issues post biopsy locally in Oregon. Multiple runs to the bathroom at night and slower stream.

Proton beam treatment went smoothly, no issues. Explained the urination issues which were chalked up to inflamed prostate due to radiation and biopsy, as well as marker placement and hydrogel Spaceoar injection. All symptoms resolved in April 2023 and PSA had fallen to 2.59. No issues with erection, ejaculation or other potential sexual functionality symptoms. Have since had a recurrence of slow stream and multiple runs to the bathroom at night. Am going to try to change diet to avoid irritating or filling bladder after 6:PM. May add Flomax if absolutely necessary. PSA currently at 2.55 and may take 44 months to bottom out.

Best wishes to all!

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@saxman911

I took the test at 7:00 AM December 4 and this morning December 5 I got the results so they must've done the test on the premises

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Saxman911:
My experience (layperson) has been that regular PSA results report in about 24 hrs; Ultrasensative PSA (uPSA) can take a few days.
The reports include information on the equipment used and sensitivity levels of detection (fine print below).
Quest labs is fine. I was tx'd at Johns Hopkins in Baltimore and offered to return from Pennsylvania for PSA testing, and Rad Onc said that I could go to Quest locally (have 2 local hospital systems available also, but Quest had better connectivity to JH for ordering tests and reporting results).
What is important is to use the same lab for consistent reported results.
And I have 2 friends being treated who also had PSA measured shortly after tx; not sure why. My Rad Onc was uninterested in results prior to 6 mos post radiation. Just FYI.
PSA after radiation therapy should continue to fall until you reach a low point or nadir.
Best wishes.

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