PSA levels after salvage radiotherapy

Hello to all out there

I finished salvage radiotherapy to the pelvic bed on November 18th (35 session over 7 weeks of 70 Gray)

My original operation (radical prostatectomy) had been in February 2020 and original post op PSA was 0.09 which unfortunately went up to 0.20 by August .

I had not done adjuvant therapy as it seemed to me better to heal the wounds of the OP.

As I have Gleason 9 ,RT was rapidly initiated in September at PSA level of 0.21.

PSMA scans were clear but they show little at such PSA levels.

I just did blood tests yesterday and PSA is 0.07 .

This is two months after finishing RT.

Does anybody on this forum now when the lowest PSA would be measured after salvage RT?

Also is this considered an acceptable result ?

I will consult the urologist and oncologist next week but am not totally pleased had hoped we would go to zero PSA.

I do hear that sometimes the nadir is reached slightly later than two months after RT,does anybody here have experience of that?

I had some side effects for continence but they are largely ok now digestion was slightly disturbed for a while but not too bad.

I am worried as my white cell count is low (3700) and my ferritin level is low (27) and also have low lymphocytes (800) so immune system is not at best level.

Hematologist says though my blood levels are acceptable.

I realise that the prostate cancer is really very difficult to figure out at any given time as there are so many different types of recurrence.

This is still a BCR  measured by ultra sensitive tests but one wonders where it ends.

But main question is does anybody know when nadir is normally reached.

All the best to fellow sufferers and family of the patients.

Keep as safe as possible.

  • Hi Troc

    Thanks for contacting us. It is encouraging to hear your PSA has reduced since treatment. I can understand it is difficult to find information on reaching the nadir following radiotherapy.

    The time it takes to reach nadir can vary from person to person.  There has been little research exploring this, following salvage radiotherapy (SRT).  However, you may find this study interesting.  Which concludes that:

    the median interval from starting SRT to the nadir PSA was 6.3 months”.

    Your team will be monitoring your PSA levels over the coming months, which will give an idea of when nadir is reached. 

    Contacting your consultant to talk this through in more detail is a great idea, and their expectations regarding PSA.

    In terms of your other blood tests, these are all within the normal range, although, as you indicated, they are on the lower end of the scale.  You mentioned you have a haematologist, so hopefully there is a plan for these to be monitored.  If in doubt please do contact your specialist for further information. 

    I hope this is helpful, and remember you can also call us on the helpline if you want to talk things over with one of the nurses.  We are open 8am to 8pm every day.

    Take care 

    Lisa G-Macmillan