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PSA rise after LDR brachytherapy

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User
Posted 24 Jul 2024 at 14:33

Hi,

I'd like to know if anyone else has experienced a very steep rise in PSA 6 months after LDR brachytherapy. Mine has gone from a nadir of 4.1, 6 weeks after brachytherapy to 91.5 after just 6 months.

My consultant sent me for a PET/CT scan and am now awaiting a follow-up appointment.

I can't find any similar cases when searching the internet.

Thanks in advance

Dave   

User
Posted 24 Jul 2024 at 14:44

You can get PSA bounces after radiotherapy, particularly if no hormone therapy is being used. However, I never heard of a PSA bounce that large.

What was your diagnosis (PSA, Gleason, staging)?

It would be difficult to second guess the scan results, so I think you need to wait and see what they show.

User
Posted 24 Jul 2024 at 16:55

No direct experience of brachytherapy but I understand that a PSA rise is common after targeted radiotherapy, I've seen it described as the 'death throes' of the tumour.  But best to ask your consultant as that is quite a large increase.

User
Posted 24 Jul 2024 at 20:05

That rise in that timeframe is outside of anything we normally see on this forum. If you had LDR 6 months ago, the radiation is still active now at about 10% of the initial dose. I don't know if that could be causing a high PSA. 

Dave

User
Posted 24 Jul 2024 at 22:46

Originally Posted by: Online Community Member

That rise in that timeframe is outside of anything we normally see on this forum. If you had LDR 6 months ago, the radiation is still active now at about 10% of the initial dose. I don't know if that could be causing a high PSA. 

Oh, that's a very good point. LDR brachytherapy using Iodine125 (which is what's usually used in the UK) takes about 200 days to finish treatment (when radiation dose drops too low to be treating any more). I'm not sure what to expect from a PSA test done during treatment, quite likely when your prostate is still inflamed by the radiation. I don't know when a first PSA test is typically done after LDR brachy, but for external beam and HDR brachy, it's usually 12 weeks after treatment.

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User
Posted 24 Jul 2024 at 14:44

You can get PSA bounces after radiotherapy, particularly if no hormone therapy is being used. However, I never heard of a PSA bounce that large.

What was your diagnosis (PSA, Gleason, staging)?

It would be difficult to second guess the scan results, so I think you need to wait and see what they show.

User
Posted 24 Jul 2024 at 16:55

No direct experience of brachytherapy but I understand that a PSA rise is common after targeted radiotherapy, I've seen it described as the 'death throes' of the tumour.  But best to ask your consultant as that is quite a large increase.

User
Posted 24 Jul 2024 at 20:05

That rise in that timeframe is outside of anything we normally see on this forum. If you had LDR 6 months ago, the radiation is still active now at about 10% of the initial dose. I don't know if that could be causing a high PSA. 

Dave

User
Posted 24 Jul 2024 at 22:46

Originally Posted by: Online Community Member

That rise in that timeframe is outside of anything we normally see on this forum. If you had LDR 6 months ago, the radiation is still active now at about 10% of the initial dose. I don't know if that could be causing a high PSA. 

Oh, that's a very good point. LDR brachytherapy using Iodine125 (which is what's usually used in the UK) takes about 200 days to finish treatment (when radiation dose drops too low to be treating any more). I'm not sure what to expect from a PSA test done during treatment, quite likely when your prostate is still inflamed by the radiation. I don't know when a first PSA test is typically done after LDR brachy, but for external beam and HDR brachy, it's usually 12 weeks after treatment.

 
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