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What should the PSA be after RT

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User
Posted 13 Mar 2021 at 19:53

I'm 6 weeks on following Proton Beam therapy and had my first PSA test which has come out as 1.5.  I was 9.8 before treatment.   My appointment with the oncologist on Tuesday has been cancelled and I'm wondering is 1.5 good?

I was expecting less than 1 but maybe its too soon or 1.5 is fine for a 63 year old?

 

Anyone any advice

 

thanks

 

User
Posted 14 Mar 2021 at 09:14
Sounds reasonable enough to me. My PSA fell to a minimum of 1.4 a year after RT. My oncologist said he'd be happy with a nadir of 2 or below.

Chris

User
Posted 14 Mar 2021 at 13:16
Hi audiman,

You can't directly compare results from Proton Beam, which is a Hadron or Particle Therapy, with various forms of Radiation Treatment as they cause damage to cells in a different way. Proton Beam unloads very little dose on the way to the target and almost nothing after it (Bragg Peak). EBRT damages good and bad cells on the way to the tumour target and after it. Brachy seeds cause most damage to the area in which they are placed with reducing radiation further away from them. So Proton Beam should damage fewer good cells than Photons, however administered. This will affect PSA and how you are doing is something your consultant can best advise on.

Barry
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User
Posted 13 Mar 2021 at 22:57

Usually, PSA is pulled low by hormone therapy for the 3-6 months before radical treatment, but you haven't said if you're on hormone therapy. The PSA profile around radiotherapy is very different if you aren't on hormone therapy - in that case it will usually continue dropping to a minimum 2-3 years after treatment, and you might get some PSA bounces too, which are unnerving, but actually tend to suggest good outcomes.

User
Posted 13 Mar 2021 at 23:11

I think that is probably a good number. You still have a prostate. When you hear people on here talking about 0.1 etc. these are people who have had a prostatectomy and they are really hoping for near zero. The RT only kills the cancer cells not the healthy cells (well not too many of them) 

So if you were a healthy 63 year old and had a psa test which came back at 1.5 you would be very happy.

The fact it has came down from 9.8 means the RT has clearly knocked out a lot of bad cells, hopefully all of them.

I've just noticed Andy's post, I'm assuming you are not on HT because that would indeed change the expected psa. 

The annoying thing about not having surgery is that you can never know whether the cancer has all been removed. The figure of nadir + 2.0 is taken as the fairly arbitrary "oh well it might be back" threshold. 

Dave

User
Posted 14 Mar 2021 at 00:45

Hi Audiman,

A little early to gauge anything meaningful, as you say.  When do you have next one then ?

My brother values were  2017   -  post RT  = 0.69 

(He lives in Australia and decided on RT in  Feb 2017,  Gold seeds & Space OAR May 2017 with RT simulation &  a practice 'run' followed by 9wks, 5 per wk = 45 sessions).    

2018  0.47   Feb 2019  0.55 Nov 2019 0.38 June 2020  0.42 Nov 2020  0.37

 Regards Gordon

 

Edited by member 14 Mar 2021 at 00:56  | Reason: Not specified

User
Posted 14 Mar 2021 at 08:06

I was on Bicalutamide for about 6 weeks before the treatment then told to stop as soon as the treat finished so therefore only 8 weeks of that.   Your right Dave when I have  reading about PSA's less than one that is what has made me a little disapointed that my result was 1.5.     All in all the treatment I had was fantastic with hardly any discomfort.  ED is a problem in that I have the desire now the HT has stopped and the sensation but I'm not getting hard enough for penetration.  My orgasms are not dry but not the amount of ejaculate before treatment which is hardly an issue.   It is very early days and its only another bridge that I need to cross I feel very well in myself which I did before and all of the way when each time I had a DRE they all kept saying how fine everything felt but the mri and biopsy gave a different picture.

I consider I'm one of the very lucky ones on here that this was caught early and purely by chance and I have had treatment which fingers crossed seems to have worked.  My son did the prostate cancer run in Janaury and raised over 4K which I'm very proud of and from his contacts it transpired that many also had fathers and grandfathers with this illness which only highlighted how many of us men should be checked and its about time screening was introduced to stop so many dieing of this.

Thanks for the replies it puts my mind at ease before I get to speak to the oncologist and I will be retested in 3 months.   Take care everyone

User
Posted 14 Mar 2021 at 09:14
Sounds reasonable enough to me. My PSA fell to a minimum of 1.4 a year after RT. My oncologist said he'd be happy with a nadir of 2 or below.

Chris

User
Posted 14 Mar 2021 at 12:24
6 months after Brachytherapy (LDR) I had a PSA of 1.2. Two years on and it is now 0.1 I had no hormone medication just 72 seeds through 25 holes and 70 Greys Units of radiation.

I think it may be a bit early to expect more of a drop. Give it time. We are all different but all in the same boat! John

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 14 Mar 2021 at 13:16
Hi audiman,

You can't directly compare results from Proton Beam, which is a Hadron or Particle Therapy, with various forms of Radiation Treatment as they cause damage to cells in a different way. Proton Beam unloads very little dose on the way to the target and almost nothing after it (Bragg Peak). EBRT damages good and bad cells on the way to the tumour target and after it. Brachy seeds cause most damage to the area in which they are placed with reducing radiation further away from them. So Proton Beam should damage fewer good cells than Photons, however administered. This will affect PSA and how you are doing is something your consultant can best advise on.

Barry
 
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