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PSA Bounce or récurrence?

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User
Posted 10 Apr 2026 at 21:48

Hi all, It’s been a long time since I posted on here.

I had a prostatectomy in Sept 2022 then waited as the cancer grew back and in 2024 had 9 months of HT, in the middle of which I had 20 fractions of RT. My last injection of decapeptyl was Christmas 2024.

The first PSA result was undetectable (<0.01), the second was 0.01 and I’ve just had one of 0.19. 

My onco has asked for more bloods in 4 weeks and if it stays up, a test - probably PET-CT I expect.

So my question is: am I the perfect candidate for PSA Bounce or has anyone been in this situation and found the cancer is back (biomedical recurrence)? 

I think I am getting my worrying in early.

Thanks in advance.

User
Posted 11 Apr 2026 at 01:16
Sounds like a recurrence unfortunately. PSMA PET required now.

Did you have whole pelvis salvage radiotherapy or just the prostate bed?

User
Posted 11 Apr 2026 at 02:03

Well, a bounce after SRT after prostatectomy it seems is very unlikely. It seems that there is only one known case.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7450009/

Let us hope you are the second case. 

It is probably worth printing that article and taking it to your next appointment with the oncologist. When your oncologist realises he might get a paper published, he will start monitoring you closely, so if it isn't a bounce, you'll get treated quicker.

Edited by member 11 Apr 2026 at 12:21  | Reason: Not specified

Dave

User
Posted 11 Apr 2026 at 08:02

Nick , my PSA fluctuated after salvage RT to the bed, I didn't have HT with the SRT. Have a look at the beginning of my profile it lists the PSA results and events. 

Thanks Chris 

User
Posted 11 Apr 2026 at 16:23
So good potential for further salvage treatment in the pelvis.
User
Posted 11 Apr 2026 at 18:01
Hopefully they will be somewhere they can be treated with radiotherapy.. you need the PSMA PET to decide where
User
Posted 11 Apr 2026 at 20:16

Nick, my understanding is the decapeptyl reduces the testosterone and the apalutamide stops testosterone getting into the cancer cells. I started the decapeptyl 3 months before the apalutamide, the decapeptyl alone brought the PSA down from 13 too below 1. My oncologist would not do a PSA test just before I started the apalutamide, so hard to know which has the most benefit, but stopping the apalutamide for a short period didn't result in a PSA rise. 

My cholesterol always hovered around 5, my increase may be linked to my crap diet and not wanting too take statins until I get the other side effects sorted. Something was causing joint pain and since stopping the statins last year the general joint pain has stopped, I still have knee pain but that has a known cause, same applies to the hip pain.

Thanks Chris 

User
Posted 11 Apr 2026 at 21:35

Thanks Chris. Interesting about the different drugs, it’s a shame the doctor didn’t run a PSA test.

I’m not on statins even though I’ve been offered them. I’ll stay off before any more treatment, just in case. I also have joint pain but I’ll put that down to running! 

cheers

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User
Posted 11 Apr 2026 at 01:16
Sounds like a recurrence unfortunately. PSMA PET required now.

Did you have whole pelvis salvage radiotherapy or just the prostate bed?

User
Posted 11 Apr 2026 at 02:03

Well, a bounce after SRT after prostatectomy it seems is very unlikely. It seems that there is only one known case.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7450009/

Let us hope you are the second case. 

It is probably worth printing that article and taking it to your next appointment with the oncologist. When your oncologist realises he might get a paper published, he will start monitoring you closely, so if it isn't a bounce, you'll get treated quicker.

Edited by member 11 Apr 2026 at 12:21  | Reason: Not specified

Dave

User
Posted 11 Apr 2026 at 08:02

Nick , my PSA fluctuated after salvage RT to the bed, I didn't have HT with the SRT. Have a look at the beginning of my profile it lists the PSA results and events. 

Thanks Chris 

User
Posted 11 Apr 2026 at 13:49

@francij1 It was just the prostate bed. 

Edited by member 11 Apr 2026 at 13:50  | Reason: Not specified

User
Posted 11 Apr 2026 at 16:23
So good potential for further salvage treatment in the pelvis.
User
Posted 11 Apr 2026 at 16:46

Thanks Dave, I’d say the chances are fairly slim but I guess I’ll find out soon enough. N

User
Posted 11 Apr 2026 at 16:47

Thanks Franci, Is the pelvis the most likely location of rogue cells?

User
Posted 11 Apr 2026 at 16:57

Thanks Chris.

So, do you think the decapeptyl was the thing that did the job and got your PSA so low?

Also, do you have a history of high cholesterol? Mine has always hovered between 5-7 (I’m skinny, it’s hereditary) so I’m interested to know if your cholesterol score is linked to the hormone therapy.

Cheers

Nick

User
Posted 11 Apr 2026 at 18:01
Hopefully they will be somewhere they can be treated with radiotherapy.. you need the PSMA PET to decide where
User
Posted 11 Apr 2026 at 18:29

Thanks Franci, I’m on old hand with PSMA PET scans. Yes, hoping it shows up if/when PSA gets to 0.2 and that it can be zapped (again).

User
Posted 11 Apr 2026 at 20:16

Nick, my understanding is the decapeptyl reduces the testosterone and the apalutamide stops testosterone getting into the cancer cells. I started the decapeptyl 3 months before the apalutamide, the decapeptyl alone brought the PSA down from 13 too below 1. My oncologist would not do a PSA test just before I started the apalutamide, so hard to know which has the most benefit, but stopping the apalutamide for a short period didn't result in a PSA rise. 

My cholesterol always hovered around 5, my increase may be linked to my crap diet and not wanting too take statins until I get the other side effects sorted. Something was causing joint pain and since stopping the statins last year the general joint pain has stopped, I still have knee pain but that has a known cause, same applies to the hip pain.

Thanks Chris 

User
Posted 11 Apr 2026 at 21:35

Thanks Chris. Interesting about the different drugs, it’s a shame the doctor didn’t run a PSA test.

I’m not on statins even though I’ve been offered them. I’ll stay off before any more treatment, just in case. I also have joint pain but I’ll put that down to running! 

cheers

 
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