psa and testosterone gone up a little instead of dropping

Hope it’s all good news for you both!

Morning Ah

Good luck!

Lots of love

Dafna

Hi Dafna. 

My partners PSA has also gone up a tiny bit in each of the last two monthly blood tests, we have an eye on it. I’m hoping it’s just a settling phase now it’s reaching its nadir? 

L

* add on . Initially his PSA did plateau at 9 and wobbled around for a while and then he had a change of drugs to push it down for RT. It then stopped at .29 but it was like a slow grind to a halt . After RT it then went to its lowest point of 0.04. Now wobbling again . It’s very low like your husbands so hopefully we can just watch it casually . 

Hi BarryW

This is a learning progress for me and the more I learn the more I understand how little I know. Yesterday it was the first time I heard about the nadir point. If you have the time can you explain a bit more about it. Who decide when is the nadir? how do you know it is the nadir? The ecologist team shy off any explanation.

All my good wishes to you and your partner.

Thank you and lots of love

Dafna

Hello jacobanddafna . The general rule for anyone having Radiotherapy is that it carries on working after your visits to the hospital are over.

It's accepted that your "nadir or lowest" PSA reading is going to be the one 18 months after your Radiotherapy is over. Once your team have this reading they don't tend to take any further action or treatment unless the PSA rises by at least 2 whole points.

Best wishes - Brian.

Hi Dafna,

I'm not that knowledgeable about it really, all I know (in my partners case and RT ) is that he should reach his "Nadir" =settling point, I thought roughly about 18 months after RT. So this is a different treatment to your husbands? but I'm guessing with all treatments there will be a point where it settles. Definitely a conversation to have at your next appointment. I also remember that I read that if you can get down to .5 it's a good indicator of reaching a 10 year + survival point . NOW - this is coming out of my memory of something I read so please take this as unconfirmed information . Definitely need to have a proper conversation with consultant .

L x

Hello BW  It's a question I have asked and there is no definitive answer - my team agree with my post above but they also say 3 consecutive rises in your PSA over a 9 month period would also trigger a review.

Kind Regards - Brian.

Hi Dafna.

A simple explanation is that the nadir is the lowest reading of PSA following treatment. It is individual for each person and dependent on the type of treatment. Someone who has had a prostatectomy would expect to have a negligible PSA soon after surgery. Someone who has just hormone therapy will reach a bottom plateau after a few weeks. For someone who has radiotherapy it can take up to 18 months to reach the lowest point as the radiotherapy can continue to work for this long. For someone on chemotherapy then it can be several months. To confuse things there can be a PSA bounce in the middle as cancer cells die and 'release' protein. Once each persons individual nadir has been established then this is used as the baseline for which biochemical recurrence is measured. Please come back with any questions.

Thank you Brian. It is clearer now

Lots of love

Dafna

Hi Brian, 

Great info.  So not worrying at this point  ( only a little bit ) and it's a minuscule rise for us. I was saying to OH half the problem is that he has blood tests every month , whereas if he had every three months at this point we wouldn't even know he had a rise and it may go down by the next one, so it could better to just have 3 monthly ones if possible. If it goes back down I think we need to change the 3 monthly. 

I think because partner is in 50's it tends to be a bit more aggressive? with that fight to keep testosterone down, so maybe they just being cautious for this last year with the blood tests. 

L