PSA numbers after radiation with no ADT

Was your MRI guided SBRT or CT SBRT.

Did you get the space OAR gel? Any urination issues or ED?

I know ED may come on after 1-2 years?

Not sure on MRI, Did have the OAR Gel, first couple of weeks when I had to urinate I had to go right away but that went away, no leakage etc.
ED was a little problem in the beginning but that has improved without pills. Had mostly dry orgasms for the first 3 months, has improved a little but not much.

My SBRT has been a roller coaster. 3 opinions on biopsy. 2 said 3+4 W/cribiform. 1 said 4+3. W cribriform

Pre-treatment PSA was 9

Post-treatment:
2 months, 11.96
3 months 9.25
7 months 4.83
10 months 6.38
12 months 6.02
14 months 5.41
17 months 3.9

Test again in June.
I was the guy who had the post-radiation inflammation spike.
Then the radiation “bounce”
All doctors involved think its going well though.
PSA kinetics without ADT are unpredictable. But the thing I keep being told is that as long as it is dropping it is working.
The reason for no ADT was that I had limited positive cores 4/15. All in one area. And MRI showed a smaller than usual lesion. 3x3x7.
I'm treated at a major cancer center and my Dr said he expects it to nadir at about 1 in 2-3 years. Hopefully get to the .5 level but I have BPH and a history of prostatitis.

There seems to be a lot of individual variability in PSA numbers. Your trend is a positive one and bounces are usually associated with better outcomes. Any reason why you are having tests so frequently? They are usually stressful events for most folks. I have decided to go to a longer interval between tests.

My testing schedule was out of whack because of an initial error where the medical assistant scheduled my first at 2 months instead of 3 months. Since it was so soon I still had residual inflammation and I was one of the 10%-20% that rose immediately after treatment.
The the bounce which everyone was confident was a bounce, however the jump of 1.5 points was close to the 2-point threshold of bcr, so the went with every other month until that resolved. After last test showed a decent drop, next test will be 4 months. If that shows and drop it will be 6 months.
You are right about them being stressful. They are very stressful when psa drops are going as you want.

Update for those interested in the topic of radiation with no ADT and PSA numbers post treatment.

Last PSA before treatment: 17.53

[2-1/2 months post Tx: 4.33} updated today Sep 4]

3 months post Tx: 4.11

6 months post Tx: 2.47

9 months post Tx: 1.83

12 months post Tx: 1.22

15 months post Tx: 0,94
skipped the next one

21 months post Tx: 0.60
Skipped the 24 month test as I was in Australia at the time.

26 months post Tx: 0.40

Your case is very interesting. I agree that given all your data points prior to treatment, your path was a good one.
I would have almost certainly made the same decisions you did.

Would you mind giving an update to your situation? PSA wise?

ozelli,
Seems your numbers are good going down.

I did not have hormone treatment either. My PSA started at 3.75 (Yes normal but was rising steadily for several years). I at the post treatment mark now at 2.6 years. My last PSA was .10

My Mayo PCP said the Mayo Jacksonville lab does not give PSA numbers below .10 as with their lab considered undetectable. I know many other labs are different so just passing on what my PCP stated.

My UFHPTI R/O stated to me their goal was a below 1.0 PSA maintained. I was told I would have bumps and completely common and do not mean anything unless continue to bump up.

I would have had hormone treatments if my risk level of intermediate had been kept. But I had Decipher and came back as low risk so my risk level was reduced to low which did not come with hormone recommendation from my Mayo R/O nor UFHPTI R/O.

I was tested in June 2925?and I was at 3.0. Both doctors on team were happy and said the hope for nadir at about 36 months.

I will also update my PSA:
4/11/24 .94
5/24/24 .73
9/24/24 1.05
11/7/24 .8
3/4/25 .66
5/15/25 .71
8/15/25 .61