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PSA before EBRT/Brachy can start

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User
Posted 20 Jan 2024 at 16:31

For those here that have had EBRT and/or Brachytherapy, do you remember what your PSA was before commencing these treatments?

I've read several scientific papers and the concensus is that the lower it is the better, for long-term positive outcomes. But one paper recommends PSA <0.2 before EBRT/Brachy commences ! 

 

User
Posted 20 Jan 2024 at 19:05

Mine was 0.9 at the start of RT(from 36 at diagnosis) and the Onco was happy with that, he likes it to be below 1.
I ended up on HT for 9 months before RT though because of various issues.

6 months after finishing RT it’s 0.1, which the CNS said is a very good result.

Derek

User
Posted 20 Jan 2024 at 16:31

For those here that have had EBRT and/or Brachytherapy, do you remember what your PSA was before commencing these treatments?

I've read several scientific papers and the concensus is that the lower it is the better, for long-term positive outcomes. But one paper recommends PSA <0.2 before EBRT/Brachy commences ! 

 

User
Posted 20 Jan 2024 at 19:36
Before my EBRT my PSA was less than 0.1, this was after 12 months ADT (Zoladex [with abiraterone/enzalutimide on trial]). The delay was due to TURP in May 2016 then marriage later in year, all via oncologist 's suggestion, treatment going fine etc.

All still good, PSA 0.4 or so.

Peter

User
Posted 21 Jan 2024 at 05:54

Hi,

I started with PSA at 19, they put me on Zoladex for about 3 months before the Bracchy and the PSA went down to about 0.1. 

Otto

User
Posted 21 Jan 2024 at 21:24

Hi! Best of luck tomorrow.

Just one more storyline: 

 I started at a PSA of 17.8. After 9 months on Prostap it was down to 4.9 but then shot back up to 10 and then 13.9. Zoladex then took over the job and it came down slowly ( another 9 months) to 3.5.  Not quite good enough for RT to start. At that point the oncologist prescribed another blast of Bicalutimide, and that brought it down to 0.33, though onco guy would have been happy anywhere around 1. 

First test 2 months after RT was 0.03.

12 months after that it was 0.08

Due my next test next month....

User
Posted 06 Mar 2024 at 14:12

My consultant was originally going to book me when my PSA had dropped from 58 to 5.29 in 2 months and would be lower at 3 months when RT actually started. However, having read various papers which suggest getting pre-RT PSA down to 1 or 0.1, I wanted to wait longer, which my oncologist was fine with, with the proviso I only wait while PSA is falling quickly, and in no case longer than 6 months from starting HT. He'd had a couple of people do that before but they never got as low as they wanted before PSA starting to raise again, at which point you're reducing the chance of a good outcome. Mine reached 0.1 5 months after starting HT, when I started RT.

I subsequently posted links to some of the research papers I used.

User
Posted 06 Mar 2024 at 22:12

Another PSA test isn't clinically significant from his point of view, i.e. it won't change any treatment.

Of course, you might be interested. I had one done about 2 hours before my first RT session, again not clinically significant, but interesting for me. (I was aiming for 0.1 or less, and it was 0.12, but I was fine with that, and much better than the 5.29 I had when they were originally going to book the RT.)

User
Posted 06 Mar 2024 at 22:35

Hi, 

Interesting reading these comments. My last PSA test was done before my last chemo session at start of Nov 2023. The reading was 0.34. I had HDR brachy in Jan followed by 20 sessions of EBRT without any prior PSA test. The Radiographer did ask me to arrange a PSA test for 6 weeks after the last EBRT which I have done at the local docs. After all the chemo, radiation and HT I am hoping that the next PSA score will be zilch.😬

Spongebob

User
Posted 07 Mar 2024 at 08:52

My PSA was 19 at first, they put me on 3-months zoladex before my Brachytherapy, which brought it down to 0.1.  After the Brachy it dropped down to nearly zero. 

Otto

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User
Posted 20 Jan 2024 at 19:05

Mine was 0.9 at the start of RT(from 36 at diagnosis) and the Onco was happy with that, he likes it to be below 1.
I ended up on HT for 9 months before RT though because of various issues.

6 months after finishing RT it’s 0.1, which the CNS said is a very good result.

Derek

User
Posted 20 Jan 2024 at 19:36
Before my EBRT my PSA was less than 0.1, this was after 12 months ADT (Zoladex [with abiraterone/enzalutimide on trial]). The delay was due to TURP in May 2016 then marriage later in year, all via oncologist 's suggestion, treatment going fine etc.

All still good, PSA 0.4 or so.

Peter

User
Posted 21 Jan 2024 at 05:54

Hi,

I started with PSA at 19, they put me on Zoladex for about 3 months before the Bracchy and the PSA went down to about 0.1. 

Otto

User
Posted 21 Jan 2024 at 08:28
Thanks guys.

Been on Zoladex for almost 3 months now and just want get on with it. PSA test tomorrow should help determine when that might be.

User
Posted 21 Jan 2024 at 21:24

Hi! Best of luck tomorrow.

Just one more storyline: 

 I started at a PSA of 17.8. After 9 months on Prostap it was down to 4.9 but then shot back up to 10 and then 13.9. Zoladex then took over the job and it came down slowly ( another 9 months) to 3.5.  Not quite good enough for RT to start. At that point the oncologist prescribed another blast of Bicalutimide, and that brought it down to 0.33, though onco guy would have been happy anywhere around 1. 

First test 2 months after RT was 0.03.

12 months after that it was 0.08

Due my next test next month....

User
Posted 24 Jan 2024 at 19:36

Not a good day. 

Prior to HT PSA 71

24/10/2023 started 4 weeks of Bicalutamide 

07/11/2023 Zoladex 1st injection (continuously ongoing to date)

04/12/2023 PSA 8.0 great result

22/01/2024 PSA 8.5 !

Despite HT initially having a fantastic effect, PSA is now going up. I was hoping to start EBRT imminently. Now not going to happen. 

Onco wants another test in 6 weeks. 
Anyone have any experience or opinions on this ?

 

Very worried. 

User
Posted 06 Mar 2024 at 12:01
Me again !

I'm scheduled for RT in 6 weeks time. My PSA (done 2 days ago) seems to be stationary at around 8.5 having been on Zoladex for 4 months now. Is this the nadir ? Can or will Radiotherapy still go ahead with this PSA ?

Grateful for any opinions and views.

User
Posted 06 Mar 2024 at 14:12

My consultant was originally going to book me when my PSA had dropped from 58 to 5.29 in 2 months and would be lower at 3 months when RT actually started. However, having read various papers which suggest getting pre-RT PSA down to 1 or 0.1, I wanted to wait longer, which my oncologist was fine with, with the proviso I only wait while PSA is falling quickly, and in no case longer than 6 months from starting HT. He'd had a couple of people do that before but they never got as low as they wanted before PSA starting to raise again, at which point you're reducing the chance of a good outcome. Mine reached 0.1 5 months after starting HT, when I started RT.

I subsequently posted links to some of the research papers I used.

User
Posted 06 Mar 2024 at 20:43


Thanks Andy.

It does make sense that lower PSA levels (a general marker for prostate cancer) would be preferable for the long-term prognosis. However, as you alluded to, there comes a point where further reduction in PSA might not be possible. I fear I may have reached that point now. I received a call from the oncologist this afternoon (a nice chap) advising that after 4 months on hormone therapy, I really need to proceed with the RT as scheduled in 6 weeks time regardless, and that I really just need to get on with it. I’m in no position to argue, and neither would I want to. 

On his direction I'll begin taking Bicalutamide tomorrow, in addition to the Zoladex I'm already on. Interestingly, he doesn't plan another PSA test until after radiotherapy and brachytherapy, which I find slightly odd. However, I’ll get one done privately a week before RT, just for my own baseline reference point.

Thanks for your input Andy. 

User
Posted 06 Mar 2024 at 22:12

Another PSA test isn't clinically significant from his point of view, i.e. it won't change any treatment.

Of course, you might be interested. I had one done about 2 hours before my first RT session, again not clinically significant, but interesting for me. (I was aiming for 0.1 or less, and it was 0.12, but I was fine with that, and much better than the 5.29 I had when they were originally going to book the RT.)

User
Posted 06 Mar 2024 at 22:35

Hi, 

Interesting reading these comments. My last PSA test was done before my last chemo session at start of Nov 2023. The reading was 0.34. I had HDR brachy in Jan followed by 20 sessions of EBRT without any prior PSA test. The Radiographer did ask me to arrange a PSA test for 6 weeks after the last EBRT which I have done at the local docs. After all the chemo, radiation and HT I am hoping that the next PSA score will be zilch.😬

Spongebob

User
Posted 07 Mar 2024 at 08:52

My PSA was 19 at first, they put me on 3-months zoladex before my Brachytherapy, which brought it down to 0.1.  After the Brachy it dropped down to nearly zero. 

Otto

 
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