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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Profile picture for vircet @vircet

From last year:
ava11 | @ava11 | May 8, 2024

I started Orgovyx on April 1st and my last SBRT treatment(fifth) was on April 18th [2024].
xxx
My total PSA: 2.1 ng/mL
xxx
My PSA was 13.0 before the treatment. Orgovyx website says, PSA drops by 83% in 29 days for most people. That is exactly what happened in my case!

Now 2025: From PSAs 13.0 before treatment, 2.1 at 29 days after treatment, may I ask what were your
quarterly or trimestral PSAs until one year after SBRT treatment? I know PSA was 0.03 on 2/27/2025.

The reason I asked is: My PSA dropped from 10.5 February 2025 to 0.36 on July 9 2025, about 2.5 months after completion of SBRT, 3.5 months since starting on Orgovyx. I did not have my first PSA test 29 days after SBRT, so I want to compare with your tests after 3 or 4 months, and thereafter. I read in this forum that someone had undetectable PSA after one month only, so I'm not sure if 0.36 after 3 months is good enough.

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I am not sure how meaningful to compare with my results as long as your psa becomes undetectable at any rate:
Started Orgovyx on April 1,2024
SBRT started on April 8 finished April 18,2024
PSA Numbers:
May 15,2024 0.4
July 15 0.1
Oct 7 0.06
Dec 3 0.05
Feb 7,2025 0.03
Stopped Orgovyx March 27,2025
May15,2025 0.02
July17,2025 0.05
Hope this is what you were asking?
Best

REPLY
Profile picture for ava11 @ava11

I am not sure how meaningful to compare with my results as long as your psa becomes undetectable at any rate:
Started Orgovyx on April 1,2024
SBRT started on April 8 finished April 18,2024
PSA Numbers:
May 15,2024 0.4
July 15 0.1
Oct 7 0.06
Dec 3 0.05
Feb 7,2025 0.03
Stopped Orgovyx March 27,2025
May15,2025 0.02
July17,2025 0.05
Hope this is what you were asking?
Best

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Thanks @ava11 Yes, this is exactly what I was looking for.
For me, the comparison is meaningful:
Your PSA was 13, mine was 10.5
~3 months post-SBRT, your PSA was 0.1, mine was 0.36
Your PSA was almost undetectable (< 0.1) from Oct2024 until now.
My RO told me in April2025 that I will probably on Orgovyx 8 mos. to a year. In July, when she saw my PSA 0.36, she said I need just three more months.Because my PSA was 0.26 higher than yours at 3 mos. post-SBRT, I will tell my RO that I prefer to continue ADT until end of March2026. (I started Orgovyx on March 26, 2025.)
Thanks again for the information you provided.
Vir

REPLY
Profile picture for vircet @vircet

Thanks @ava11 Yes, this is exactly what I was looking for.
For me, the comparison is meaningful:
Your PSA was 13, mine was 10.5
~3 months post-SBRT, your PSA was 0.1, mine was 0.36
Your PSA was almost undetectable (< 0.1) from Oct2024 until now.
My RO told me in April2025 that I will probably on Orgovyx 8 mos. to a year. In July, when she saw my PSA 0.36, she said I need just three more months.Because my PSA was 0.26 higher than yours at 3 mos. post-SBRT, I will tell my RO that I prefer to continue ADT until end of March2026. (I started Orgovyx on March 26, 2025.)
Thanks again for the information you provided.
Vir

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What is your Testosterone level. Mine dropped to 8. It was 65 on July 17, 2025. Fatigue is the main problem for me. "Fight through the Fatigue" is the mantra for us! "Be fierce with exercise" is another mantra for us!

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Profile picture for ava11 @ava11

What is your Testosterone level. Mine dropped to 8. It was 65 on July 17, 2025. Fatigue is the main problem for me. "Fight through the Fatigue" is the mantra for us! "Be fierce with exercise" is another mantra for us!

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My T was 0.4 in July. My T was not tested pre-SBRT. I will be 69 on Nov 27. With such low T, I am hoping that my PSA will be undetectable by October.

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The drug is working well for you to bring down your Testosterone. What kind of exercises you do daily and how do you feel? I lift weights 3 times a week and do some aerobic activities including walking daily.
Fatigue is a big problem for me. But we have to exercise!

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Profile picture for ava11 @ava11

The drug is working well for you to bring down your Testosterone. What kind of exercises you do daily and how do you feel? I lift weights 3 times a week and do some aerobic activities including walking daily.
Fatigue is a big problem for me. But we have to exercise!

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Absolutely! Hormone Therapy will try and zap you of all energy. Fight through it. Like you, I walk nearly every day(about 3 miles) at a decent pace. I also do resistant band workouts for the muscles. I'm not giving into this!! Keep it rolling!!!

Doug

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Profile picture for dpayton @dpayton

Absolutely! Hormone Therapy will try and zap you of all energy. Fight through it. Like you, I walk nearly every day(about 3 miles) at a decent pace. I also do resistant band workouts for the muscles. I'm not giving into this!! Keep it rolling!!!

Doug

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Actually, fatigue from hormone therapy varies. I’ve been on ADT for almost 9 years and I’ve never really had a fatigue problem. I’ve had a lot of other problems from it, but not that.

People must Exercise and do weight training when on ADT. Like you, I walk twice a day on the track every day and go to the gym three times a week.

One of the first things people notice when they start ADT is that their stomach muscles weaken and they get a belly. I do a lot of situps when I go to the gym, I think it helps.

Just some ideas.

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Profile picture for jeff Marchi @jeffmarc

Actually, fatigue from hormone therapy varies. I’ve been on ADT for almost 9 years and I’ve never really had a fatigue problem. I’ve had a lot of other problems from it, but not that.

People must Exercise and do weight training when on ADT. Like you, I walk twice a day on the track every day and go to the gym three times a week.

One of the first things people notice when they start ADT is that their stomach muscles weaken and they get a belly. I do a lot of situps when I go to the gym, I think it helps.

Just some ideas.

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Jeff,
What is your Testosterone level for not getting fatigue?

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Profile picture for ava11 @ava11

Jeff,
What is your Testosterone level for not getting fatigue?

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My testosterone level is less than five And has been for almost 9 years. Not everybody gets fatigue, I am one of the people that doesn’t.

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Thank you jeff for that information.

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