I had LDR BT in May 2023 as detailed in this thread and my bio.
I wasn't thrilled by my initial 4 month PSA result of 2.12 (down from 7.07 pre procedure) but consultant seemed perfectly happy with it.
My 8 month result in January ‘24 result was even less encouraging at 3.14 but again consultant said, ‘don’t panic’ it could be (probably be?) PSA ‘bounce’ which is quite common in younger men. (I was 48 at time of procedure, and 49 by then).
At this point, I decided for the sake of my sanity that I needed to take a step back from the forums and just constantly thinking about PCa in general because I suspected the rollercoaster had started.
Now though, the rollercoaster is on it's third inversion - I’ve just had my 12 month result and consultation today. PSA is up again - now to 4.64 which is a rise of 2.52 on my post procedure nadir.
What a shame because otherwise, life has been tickety-boo and any early adverse side effects to the BT have long since disappeared….
I had hoped my 2.12 nadir was an ‘initial’/pre bounce nadir and not my ‘final’ nadir – now I’m beginning to think it may have been my final nadir and I’m already +2.52 eight months later 😔
The consultant said today that it was still possibly a ‘bounce’ and we couldn’t be sure but he’s decided to bring my next PSA test forward to 3 months instead of 4. He also said that if that was also a rise, it would be 3 consecutive rises and that would trigger a PSMA PET scan and MRI.
He said the MRI never usually showed anything except the seeds, so regardless of the result, the scans would almost inevitably be followed by a biopsy which would hopefully show whether any remaining cancer cells had been radiation affected (and would eventually die) or not.
Having had a few hours to ponder, I’m wondering whether I should have asked whether it was possible to have the PET scan now to rule out spread and at least ‘settle’ me in that respect? Equally, I’m not sure if there’s a reason why having the PET scan now would be too soon?
I’m not that keen to rush into an MRI and subsequent biopsy mainly because (a) I hate the biopsies 😂 and (b) I’m clinging, probably beyond hope, that this is indeed a bounce and not a rise. 😬
I started properly reading around the ‘bounce’ phenomenon after January’s PSA results but as I said above, pretty quickly buried my head in the sand fearing the worst but willing myself to remain optimistic. I’ve revisited some of those bookmarked papers and studies this afternoon and it appears that bounce is not as common as I hoped but when it does occur, it can take quite some time to come back down (often more than 12 months post rise after initial nadir?) and I wonder whether moving to 3 monthly PSA tests has already predetermined the next result to be a rise whether it’s failure or bounce?
I have a ton of respect and confidence in my consultant but with time to think after the consultation, I’d still be grateful to hear your opinions on bounce and timing of PET scan, MRI and biopsy if you have any experience or knowledge.
Thanks!
Paul