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PSA after Salvage RT, can anyone shed any light?

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User
Posted 03 Jun 2021 at 12:15

Just wondering if anyone has any understanding why 2 months after SRT my husbands PSA is still at it’s pre-treatment level of 0.2. 
I was expecting it to drop back to <O.1 if the treatment had been successful, or is it just too soon to read anything into it. He has his oncology appointment next week so can ask the question, but I am impatiently trying to find out what this PSA result could mean. 
He worries that the achy groiny sensation has come back, the same one that he had just before his PSA showed an increase a few months ago, but stopped during the RT, so he’s very concerned.

 

User
Posted 03 Jun 2021 at 14:11

I had SRT but was also on hormone therapy.  I can't remember how long it took for my PSA to fall.  To get a quick answer why not try the specialist nurses?  

User
Posted 04 Jun 2021 at 17:56
I had SRT and no HT and 6 years on have PSA <0.02
User
Posted 06 Jun 2021 at 15:36
It took about 3.5 years for my PSA to reach its nadir following ART

Bri

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User
Posted 03 Jun 2021 at 14:11

I had SRT but was also on hormone therapy.  I can't remember how long it took for my PSA to fall.  To get a quick answer why not try the specialist nurses?  

User
Posted 03 Jun 2021 at 15:38
It doesn't mean anything at this stage - your onco will be looking for the PSA to fall to its lowest point about 18 months after the RT finished.

Did they not put him on hormone therapy with the SRT?

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

User
Posted 03 Jun 2021 at 16:00

Agree with Lyn. RT does not kill cancer cells straight away. It kills them when they next try and divide, and with PCa being a slow cancer that will be many months or even years. So expect a gradual decrease over the next 18 months or so. 

Dave

User
Posted 03 Jun 2021 at 16:26

Thank you, my understanding is much clearer now.
He has already had 6 months of HT last year before and after the RP. Maybe they didn’t want to overuse HT, I’m still not sure of the rationale behind the timing and duration of HT use. I guess it’s just what the onco feels is most suitable for each individual.

 

 

User
Posted 04 Jun 2021 at 11:27
I would ask about the HT, you are normally on it for at least 18 months for Salvage RT
User
Posted 04 Jun 2021 at 12:00

They aren't going to start him on HT 2 months after he finished ART / SRT; it would prevent them from being able to monitor over time whether the RT has been successful. Presumably, he is under one of those oncos that thinks HT is unnecessary with SRT. 

 

If the PSA rises over the next few months rather than falling, the HT will be long term. 

Edited by member 04 Jun 2021 at 12:02  | Reason: Not specified

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

User
Posted 04 Jun 2021 at 12:55

They did talk about chemo as a possibility alongside SRT if the CAT scan showed any tumour outside of the RT treatable area, but nothing was seen, so chemo was not needed. Only the prostrate bed was treated. No mention of HT.
I had assumed that long term HT would be  the next line of treatment if this wasn’t successful. That would mean coming to terms with being incurable and just holding it back for as long as possible I guess. 

User
Posted 04 Jun 2021 at 17:56
I had SRT and no HT and 6 years on have PSA <0.02
User
Posted 06 Jun 2021 at 15:36
It took about 3.5 years for my PSA to reach its nadir following ART

Bri

 
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