prostate MRI results one year after SBRT

Posted by ava11 @ava11, Apr 16 12:05am

I finished SBRT treatment on April 18th, 2024. I had an MRI performed on April 8th, 2025.
I had 2 lesions prior to SBRT(1/25/2024):
Left lesion o.9cm PI-RADS 4
Right Lesion 2.2cm PI-RADS 5
Prostate volume 37cc
PSA Density 0.26
One year after SBRT + 12 months on Orgovyx(4/8/2025):
I still have 2 lesions:
Left lesion 0.4cm PI-RADS 3
Right Lesion 0.6cm PI-RADS 5
Prostate Volume 24.3 cc
PSA Density 0.001
I just got these results today from a PA. I didn't talk to my team yet.
I will reach out to them tomorrow to find out if I have cancer recurrence and next steps. Hope I can sleep ok tonight!

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bens1 | @bens1 | Apr 16 6:23am

@ava11
Do you know which SBRT machine was used?

toolbelt | @toolbelt | Apr 16 8:40am

What caused your provider to determine you needed the MRI?

ava11 | @ava11 | Apr 16 9:32am

In reply to @bens1 "@ava11 Do you know which SBRT machine was used?" + (show)

My MRI guided SBRT was done at UCLA. Don't remember the machine now, may be view Ray?

ava11 | @ava11 | Apr 16 9:35am

In reply to @toolbelt "What caused your provider to determine you needed the MRI?" + (show)

I assume they routinely do an MRI one year after SBRT treatment. My PSA was 0.03

toolbelt | @toolbelt | Apr 16 10:01am

Your PSA is fabulous, as expected considering you are just off Orgovyx. As far as I know an MRI post SBRT is not routine nor the standard of care. I would put the question to your doc asking for his/her basis for doing it.

At this point your PSA nadir is 0.03. Biochemical recurrence is defined as nadir +2.0. I think you are doing great.
Stay Strong Brother.

jeffMar | @jeffmarc | Apr 16 10:41am

When you have radiation, your PSA will frequently not go down to undetectable Because it takes a while for the radiation damage to actually kill the cancer. Actually, seeing people that it’s taken more than three Years before the PSA hit rock bottom, And that’s not necessarily undetectable unless you’re on ADT or another drug. Your results are showing your PSA at .01 Sounds like a success to me.

The MRI results show that the Lesions have reduced in size, which is what you want. I’m a little puzzled, though, about the fact that your prostate does not appear to have been completely irradiated. When they did the SBRT, did they do five sessions to the prostate, I would expect that the radiation would have destroyed those two Lesions. Could be it just takes more time, As other people that have had radiation have found, It doesn’t kill everything all at once, It dies over time.

ava11 | @ava11 | Apr 16 2:30pm

In reply to @jeffmarc "When you have radiation, your PSA will frequently not go down to undetectable Because it takes..." + (show)

Yes, they did 5 SBRT sessions Most recent PSA 0.03 on 2/27/2025

jeffMar | @jeffmarc | Apr 16 4:07pm

In reply to @ava11 "Yes, they did 5 SBRT sessions Most recent PSA 0.03 on 2/27/2025" + (show)

That’s definitely good enough, there is no reason to change what you’re doing now since it seems to be working..

A good question is why there are still lesions there and are they just dying since they are so much smaller.

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