Increased PSA from 0.268 to 0.344 after 6 months, pain passing urine

While you were on hormone therapy, what was the lowest your PSA reached?

What was your PSA nadir following radiation treatments?

Which medications have you had for the urinary issues?

What was the concern with your 4+3 that required a brachy boost to your RT+HT?

They say that sometimes with with brachytherapy (& SBRT) there can be a PSA bump (or bounce), due to the high radiation dose and the delay of death of prostate cancer cells (causing a PSA spike); that’s typically 12-18 months out from treatment. (If it were me, I’d get another PSA test just to see if was a bump, or if it’s still trending up.)

(For a 4+3, I had 28 sessions of proton radiation + 6 months of Eligard. I had no lingering adverse issues. PSA dropped to < 0.008 due to the HT; nadir was 0.13. Now 4-1/2 years later, PSA varies between 0.35-0.55; most recent PSA was 0.473.)

Following

It is not typical to have severe urination pain after RT and especially not for this length of time. However, radiation cystitis or inflammation of the bladder and/or urethra can occur.

So that others responding can provide you with the best input, some additional information will be helpful.

Have you noted any blood in your urine?

Is your radiation oncologist and any other medical team members aware of your urination pain?

What therapies have you already tried since June?

Other background information for those responding with similar experience may be helpful.

Timeframe of original treatment, Brachytherapy? No urination pain prior to most recent radiation therapy?

RT completed in June. What type of RT? (e.g. EBRT, IMRT, SBRT) Was RT for a recurrence, rising PSA after a Brachytherapy nadir low point?

Please clarify the date of the last PSA test. Was the date Sept 25 or earlier in October?

That is a 28% rise in PSA in six months. The real question is, does it continue to rise? In some cases, the PSA can bounce around a little after radiation. I would not want to wait six months before the next PSA test. Request that your doctor order a PSA test at three months, just to confirm that things are getting better.

@brianjarvis Thanks for your reply.
My first PSA reading after all treatments was 0.006 on the 8th October 2024, last R/T was the 25th June 24 and HT August 24.
The Brachytherapy with the HT+RT was the recommended treatment.
My consultant said there can be a bounce as stated. I have a meeting on the 28th of this month, I will request a cystoscopy and maybe a bladder scan.

@jsh327 Radiation cystitis and/or inflammation of the the bladder and/or the urethra probably the cause pf the pain. I had a CT urogram but nothing showed.
I have been on the following medications Diclofenac 75mg twice daily for 2 weeks, Ciprofloxacin 500 MG for 1 week, Tamsulosin twice daily 400mcg for 4 months and Vimovo 500mg but I still have the burning and stinging. I had EBRT and ADT for 6 months.
The date of my last PSA was 6th October 2025.
My EBRT finished on June 24th 2024.

@jeffmarc
Thanks Jeff, meeting my consultant next week.