Normal PSA level post Radiotherapy

User

Posted 22 Sep 2025 at 14:20

I have just completed 20 sessions of radiotherapy treatment following a T3a prostate cancer diagnosis with PSA value of 81.

My PSA value post Radiotherapy has now reduced to 1.7 (8 weeks after radiotherapy finished).

My oncologist is happy with the post radiation PSA of 1.7, I am continuing with hormone therapy (Prostap injections) and my PSA level will be monitored again in 4 months time and thereafter every 6 months.

Does anyone know what the normal levels are for PSA values post radiotherapy, and NHS guidelines for detecting prostate cancer recurrence in Scotland or UK post treatment?

Currently my oncologist is not offering any MRI or CT scan which is a concern for me given my radiotherapy treatment was rolled out 9months after my original diagnosis.....

I should be grateful if you could share any experiences by replying to this post.

Kind Regards

Tom

User

Posted 22 Sep 2025 at 15:17

Hi Tom,

I'm not medically trained but as far as I'm aware your PSA drop from 80 to 1.7 is positive news and indicates that the treatment has been affective. I believe that following radiation treatment it can take up to two years to reach your lowest PSA level or nadir.

Here's a Dr Scholz video on monitoring PSA levels following radiotherapy.

https://youtu.be/aUXnlncOiBU?si=dtpJ832V-d84YKhG

Here's NHS Scotland guidelines on follow up procedures.

https://www.woscan.scot.nhs.uk/wp-content/uploads/WoSCAN-Prostate-Cancer-DFUP-Guidance_April-2025_V2.0.pdf

In the UK, I believe BCR is defined as your lowest PSA level + 2ng/ml.

Edited by member 22 Sep 2025 at 15:22 | Reason: Additional text

User

Posted 22 Sep 2025 at 15:58

Thanks Adrian for your reply and links to the useful information.

Regards

Tom

User

Posted 23 Sep 2025 at 02:09

It's really the HT that dramatically reduces PSA rather than RT which causes cancer cells to die over time and can't divide to continue. Some cancer cells can be relatively radio-resistant and the process can take longer in some men than others. An early scan after treatment would show little if any difference so this is monitored by PSA.

Barry

User

Posted 23 Sep 2025 at 10:01

Thanks Barry

User

Posted 24 Sep 2025 at 19:08

Thanks Barry

User

Posted 17 Oct 2026 at 18:07

Hi I am wondering what this all means, my husband had radiotherapy Gleason score 7, 3 plus 4, all went well, this was 2 years ago, stopped hormone tablets 2 months after radiotherapy. His PSA results every six months arena from the first one after radiotherapy, 0.28, 0.21, 0.25, 029, 0.49, due again in 6 months time, worried that it is increasing, Christies said it can be normal healthy prostrate tissue and not taking hormone tablets, wondering if any one has experienced this and their outcomes

User

Posted 17 Oct 2026 at 21:55

In the UK where RT is the radical treatment, it is usual for a man to start HT some 3 to 6 months before RT. This is because HT sort of puts the brake on PCa and reduces PSA.and makes RT more effective by working with it.. Men who discontinue HT soon after RT, are more likely to find their PSA has increased. There may be good reasons for or just that a man finds HT difficult to cope with in respect of side effects for example. I had no further HT after RT and ny PSA remained low for a couple of years or so. However, there was then a very slow but persistent increase in my PSA and it became apparent that I still had some cancer in my Prostate. I had 2 applications of Focal treatment which subsequently led to my being considered as being In Remission. I do sometimes wonder if I had had HT after RT whether I would have avoided the Focal Treatment but there is no way of knowing.

Barry

User

Posted 17 Oct 2026 at 23:40

Hi Barry thanks for sharing this, when you started to see your increase can you recall what it was? we were also wondering if he should have carried on with HT for longer, he stopped two months after radiotherapy.

User

Posted 18 Oct 2026 at 00:34

Hi again,

All I can say on that one is that if HT was discontinued after only 2 months and not at your husband's request, you need to ask the consultant concerned why as it is unusual in the UK.

My situation is not normal because I started HT at the Royal Marsden, in Surrey, then had RT in a trial in Heidelberg and Darmstadt in Germany and was subsequently monitored by the Royal Marsden, who incidentally referred me to UCLH in London to participate in a trial there for Focal Therapy for men who needed salvage treatment for failed RT. When I came under the Aegis of the Royal Marsden again they didn't suggest I continue with HT (maybe because my PSA was so low and I did not ask for it.

There is a record of my PSA test figures under my Profile/Bio which you can read by clicking my Avatar on the left of this post.

Barry

User

Posted 18 Oct 2026 at 08:59

Originally Posted by: Online Community Member

Hi I am wondering what this all means.........

Hi, Ally.

Welcome to the forum.

Your husband's sequence of 6-monthly results (0.28, 0.21, 0.25, 0.29, 0.49) shows a low baseline, but a mild rise.

The three most likely causes for this are:

Testosterone Recovery. You mentioned that hormone therapy was stopped. As the effects of HT wear off, over the next few months/years, your natural testosterone levels begin to recover. Testosterone stimulates both healthy prostate cells and any remaining benign tissue to start producing PSA again. A gradual rise often just shows normal hormone levels returning.

PSA "Bounce": Men who have radiation therapy can experience a temporary spike in PSA levels—often called a PSA bounce. This harmless fluctuation typically occurs within the first few years after radiation and does not mean the cancer has returned. The PSA rises and then safely drops back down on its own.

Early Signs of Recurrence: A continuous, steep upward trend can sometimes indicate that microscopic prostate cancer cells are active again.

If you see my earlier post are on here, it mentions Nadir, the lowest level his PSA has dropped to, in his case 0.21. Recurrence is deemed Nadir +2

Which in your husband's case is 2.21. His last rise to 0.49 is still well below that.

Best of luck to you both. 👍

Edited by member 19 Oct 2026 at 08:19 | Reason: Typo

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