PSA following SBRT treatment

User

Posted 06 Mar 2026 at 16:47

Would be nice to hear from anybody who has recently had stereotatic SBRT treatment with regards to their PSA results following treatment.

Was on AS for 10yrs with a G6 3+3 but towards the end of last year following bi-ops this was changed to a G7 3+4 with a PSA of 4.64.

As it was localised and contained I was offered SBRT as an option to RT and after research and looking at what the outcome would be for both options I decided on SBRT and it also meant no hormone treatment.

Have just had my 1st PSA test done 6 weeks after completion of treatment and whilst it has fallen it has only dropped from 4,64 to 4.09, which is disappointing as the general indication on the web would indicate a fairly rapid fall to something between around 2.5 to 2.0 over the same 6 week period?

So it would be nice to hear from anybody else who has recently had SBRT and what their PSA fall has been following treatment.

As indicated, I have not had any hormone treatment.

User

Posted 08 Mar 2026 at 08:50

Rudge, it has often been said on here that the result after 18 months is the one that really counts. You can also get a bounce in the following few results, until it all the cancer cells die.

I have had SABR and EBRT, but as salvage treatment not primary treatment. At subsequent scans it showed the three treatments to three separate areas had worked.

Thanks Chris

User

Posted 08 Mar 2026 at 13:24

It is usually patients who have HT with RT that experience a large fall in PSA early on. RT only works more slowly over a longer time as damaged cancer cells die and fail to reproduce. So as Chris says, consider over the long term, 18 months or even 24 months.

Barry

User

Posted 08 Mar 2026 at 13:56

My husband didn’t have HT, his went up after 6 weeks post RT, it then slowly dropped but had a big bounce before starting dropping again.

I find it worrying but I believe that without HT it doesn’t go to the very low figures and it’s a slower process.

User

Posted 10 Mar 2026 at 14:11

I doubt that HT makes any difference to the final PSA level, but it certainly impacts the figures very significantly during treatment.

There are differences in final PSA levels seen from different treatments. External beam (20 or 37 sessions) might typically end up with a PSA between 0.5 and 1 at the end of all treatment (after recovery of Testosterone when HT is used), whereas brachytherapy (particularly HDR) can see that 10x lower (but I'm not aware this difference has any long term significance regarding outcomes). I haven't yet seen enough people a few years after SABR to know where that fits on the scale.

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