Slight increase in psa level, after finishing external beam radiotherapy

I'm only on the start of my journey but there are lots of people who I am sure will help. I wish you and your husband my very best wishes.

Thank you 

all the best to you x

Hello Dudebear 

I am so sorry you are worrying. There is something called "PSA Bounce" and many of us have this after external beam radiotherapy. (you can expect it for up to 2 years!!).

My understanding of PSA is that after Radiotherapy anything below 0.5 is fantastic and after RT the nadir or lowest reading will the one 18 months after you have completed the treatment.

During my radiotherapy I asked the radiologists how I was doing and one of them told me after about fraction 16 - "your prostate will look like a mushed walnut now and the radiotherapy will keep on  affecting your PSA readings for up to 6 months".

Moving forward at Macmillan we have an amazing set of resources (more accurate than Dr Google!!) and below is the link to our booklet - understanding metastatic prostate cancer -

https://www.macmillan.org.uk/cancer-information-and-support/stories-and-media/booklets/understanding-advanced-metastatic-prostate-cancer

Don't forget our support line is for all the family - not just your husband and if you feel you need  some extra support please do give them a ring on 0808 808 00 00 (8am to 8pm 7 days a week). They are a great set of people.

If you have a Maggie's centre near you - they are a cancer support centre - feel free to call in and see them - they can offer lots of support for both of you - link here - https://www.maggies.org/

I hope this helps, if I can do anything else for you please give me a shout through the forum or my message box.

Best wishes - Brian

Thank you x

Hi Millibob (Brian)

I have seen the term ''mushed walnut'' mentioned numerous times in various threads when the topic of what a prostate looks like after radiotherapy.  No one however mentions if it stays in that condition as time passes by, or does it start to recover at all?

Hi Brian (Buzzers) 

It all came about as I had my routine Macmillan meeting and I think it was after fraction 16.

She said all's well and the RT is working well - I asked how do they know - the reply was - we know it is. So I said - the RT has 3 rotations, the first is a CT scan to ensure the RT is targeted correctly so I assume you see it then, and rotations 2 and 3 is when you zap it. The answer was yes and no - it's not a proper CT scan it's a positioning scan but we do see the prostate.

In answer to your question - I don't know but I think it would. You could always ask your G P for a DRE (digital rectal examination - or up north finger up the bum test)..

Best wishes - Brian.

The prostate is completely jiggered (is that an allowed word) by the radiation.
However, it does not appear to be eradicated and may recover somewhat.

Sort of "mush minus".

I have to say that the only way I got to that was the fact that people often recover from the radiotherapy side effects over time.

I also found this:

https://www.youtube.com/watch?v=Qol0lRY4DeY

This is from a YouTube cahnnel operated by the US prostate Cancer Research Institute, and I found it after reading some of Alwayshope 's contributions.

If you work through some of the videos that are remarkably thought provoking and calmin.

Thanks for the reply mstev.  I will spend a few minutes later this evening watching the video.

Nothing wrong with jiggered as far as I know, but then maybe I'm not very PC (politically correct this time round).

Hello Buzzers . You knew that this would get me searching as I didn't know the answer. The attached article gives you the technical details but the summary is:-

Long-Term Recovery Following Irradiation Leads to Increased Levels of CSCs in PC Cell Lines

The greatest risk of PC recurrence is 1.5–3.5 years after radiotherapy, which may be the period of time required to establish the proper microenvironment for tumor regrowth and the regeneration of a tumor mass from a small initial number of radioresistant cells [5]. To study the effects of recovery and regrowth following irradiation, we irradiated DU-145 and LNCaP cells for 5 days at a dose of 2 Gy and then allowed cells to recover. Irradiated DU-145 and LNCaP cultures initially showed marked cell death, but a few repopulating colonies, termed recurrent, developed approximately 22 days post-irradiation, and cultures were fully repopulated after 33–35 days.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417080/

Apparently prostate tissue can regenerate with time e.g. a TURP may need to be repeated. I suppose it depends on how much of the prostate is zapped and how it feels will depend on how much scar tissue there is.

Ah Alwayshope 

That all makes sense now as when I was having my TURP the surgeon did explain the process and said we may well be back here in 8-10 years time.

Thanks - Brian.