I'm in the middle of my course of 6 doses of Radium223, to try to do something positive about my bone mets.
I had a consultation yesterday with the Nuclear Medicine (NM) Consultant (I call him "Oppenheimer"), and he explained that my PSA going from 98 pre-infusion one all the way up to 300 before the second infusion was a good thing. It was back "down" to 271 this week ahead of the third infusion.
Apparently, and I didn't know this, over time PSA gets stored in the bone structure. Radium causes pain flares as it works to repair the bones, and part of that repair process includes removing the PSA from the bones. Hence it shows up in the bloods. Because I had particularly unpleasant and long-lasting pain flares with the first infusion, he thinks that was why the PSA went up so much.
Also, in NM they don't tend to worry so much about PSA as the more important marker of bone health is ALP (alkaline phosphatase). Happily my ALP reading has gone down quite markedly, so things look better than they had for a while!
Yes, I've written it up in my blog: Just Cancer – 36 – 223Radium – Part Two | Stewart's Blog (wordpress.com)