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Psa raise 5 years after brachytherapy

Posted 30 Nov 2022 at 15:05

I thought I’d add latest psa readings on here incase anyone is following, I know there were a few others who had brachytherapy at a similar time to dh. 7 years ago. Almost every psa test he has it has raised (was fine the first few years) It was 0.99 6 months ago, that was slightly lower than the time before. But his results this time are 1.8 so a big jump. He was told when it reaches 2 he will need to return to the consultant. I guess we just wait until the next test in 6 months, but dh has put a call through for the consultant incase he will speak to him now. 

Posted 30 Nov 2022 at 16:53
The threshold value for "recurrence" is nadir+2, so if the nadir was, say, 0.5, recurrence would occur when his PSA reached 2.5. A PSA of 1.8 is not abnormal for a man who still has a prostate.

Best wishes,


Posted 30 Nov 2022 at 17:02

Thanks. The lowest psa reading was about  0.07 (I think, can’t remember the exact reading, but definitely definitely zero point zero something) So the consultant said when it gets to 2 dh would need to return. As it has almost doubled in 6 months I’m assuming that’s definitely not good news. 

Edited by member 01 Dec 2022 at 16:43  | Reason: Wrong word

Posted 01 Dec 2022 at 18:05

The consultant phoned this evening. He said dh’s psa shouldn’t be 1.7 so he’s asked for another psa test at the end feb. When it reaches 2.1 he’s to return to discuss what to do next. Dh found out this year that he carries the BRCA2 gene. If we had known this when he was first diagnosed perhaps prostate removal would have been recommended. 

Posted 03 Mar 2023 at 14:01

Hello. I thought I’d post an update incase anyone is following. Dh spoke to the consultant about his psa slowly rising. He suggested another psa test in 3 months. So 1.7 last time, 3 months later it is 2.1 so that is 2 above the nadir. The consultant said he’d see him again once it goes over 2. Dh is reluctant to phone the consultant with the latest result though. We knew it was going up but the jump from 0.9 to 1.7 in 6 months was a much bigger jump than it had been doing. Dh will phone him next week. It’s 8 years since the brachytherapy. 

Posted 04 Mar 2023 at 10:12
Hiya Sam, Yes I have been following you and all other LDR cases that I could possible help with by offering my own experience and

PSA meanderings. You can click on my profile for a bit of information but I think to run you through my treatment path will be helpful.

I am rapidly approaching my 79th birthday and have complete faith in my very talented Urology Professor

My LDR procedure took place in Bart's at the Royal London on 20th April 2010 ,13 years ago next month. My lowest PSA reading

ever was 1.0(Nadir) back in November 2012. During the post procedure years my PSA has slowly, very slowly, meandered up and down and currently sits at 3.3, down from 3.8 in October 2022. For the past 3 maybe 4 years my Professor of Urology, a lovely man,

and I have agreed that no further scan or biopsy will be considered until PSA has breached 5.0. I have regular PSA blood tests and

never take my eye off the ball(Needle). The doubling of my PSA from 1.6 in March 2012 to now has taken 11 years.

I continue to play Golf 3 times every week and ride a mountain bike 2 times each week for an hour or so. This is not an admiration seeking exercise but an encouragement to all LDR patients and to those considering LDR as a treatment.

I would be very happy to offer any further details of my experiences. I continue to keep in touch with other men who over the years

have been interested in my opinions via this website. I drift in and out of prostatecancer.uk most days.

Best wishes


Posted 04 Mar 2023 at 11:09

Wiosal, I think the next step is a scan. They might want to do a bone scan first, but unless it shows it's incurable, what you really want is a PSMA PET scan to identify exactly where the cancer is. Hopefully, that will show one or two spots outside the prostate which can be zapped with SABR. If it's inside the prostate, options might be focal therapy (if the cancer is focal, i.e. one or two spots) or salvage prostatectomy.

Posted 04 Mar 2023 at 17:03

Thanks for reply Chigwell. It looks like your psa moves about a bit. Dh’s went as low as 0.02 where it stayed for several years. Then started to creep up, slowly at first. But it did a jump from 0.7 to 1.7 in 6 months. Then 1.7 to 2.1 in the last 3 months. So is going up faster now. All we can do is wait and see what the consultant says. We know a few people who have had brachytherapy. Their psa has either stayed more or less on the nadir. Or it has slowly crept back up and the cancer returned. One of them is no longer with us as he left returning to the consultant too late. Another has had his prostate removed and reconstructive surgery. Another is about to try hi-fu or other type of treatment. They are all a fair bit older than dh. But as those we know whose psa had risen again all had a return of cancer, it made us assume that would be the case for dh as soon as the psa started to rise. I can’t see why else it would rise as much as it has. 

Posted 04 Mar 2023 at 18:07

Originally Posted by: Online Community Member
But it did a jump from 0.7 to 1.7 in 6 months. Then 1.7 to 2.1 in the last 3 months. So is going up faster now.


Just to make you feel a little better about this, the PSA rise has slowed down in the last 3 months, not speeded up. It is the doubling time that is measured, not the numbers so your OH's doubling time in the second half of 2022 was 4.7 months and for the last 3 months is 9.6 months


Hope you get some reassurance or certainty soon

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Posted 05 Mar 2023 at 11:01

Thanks. Will keep you posted. I just need to persuade dh to phone the results through to the consultant. He’s reluctant. He is already saying he doesn’t want treatment because he’s worried about side effects. But we don’t know for definite that it has returned. 

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