PSA up in.8 weeks

Good Morning Vickie (Willow67) 

PSA "bounce" is normal after Radiotherapy and the rule of thumb I always follow is:

* You reach your nadir (lowest) PSA 18 months after Radiotherapy has been completed.

* After Radiotherapy you can expect PSA "bounce" of up to 1 whole point.

* Further investigation would be required if he has 3 PSA tests in a row showing a rise on the last one or there is a rise of 2 whole points or more from the lowest test.

You could have an issue here where the GP and the Hospital use different laboratories to conduct the PSA tests which can give slightly different results. My oncology team issue strict instructions to have PSA testing by them and NOT the GP practice - even if it's a routine blood test.

I hope this helps.

Best wishes - Brian

Good morning VickieWillow67 . From reading your bio I see that your husband has also come off hormone therapy so he could be seeing a rise as a result of the testosterone levels coming up again. If he was on a 3 monthly/ 12 week dose of HT injection it will still be in his system until mid November and then will gradually reduce. If he was just on tablets then these get out of the system more quickly. The PSA can fluctuate a bit as the prostate cells recover but as the radiotherapy continues to work for 18+ months it is expected that the PSA should show a stabilisation or reduction once the hormone therapy is out of the system. It might be an idea to ask for a testosterone test to check whether these have recovered and give a better idea of whether this might be influencing the result. Also different labs can produce different results so it is best to try and keep it consistent.

Hi Brian, thank you for the reassurance.

The last 2 blood tests have been taken by the GP and use a form from the hospital so the results are meant to go to them. So hopefully it has been the same lab.and the results consistent. 

It's early days I know but I just want to know the treatment has worked. Anxious all the time but I'm going to have to find a way of living with this rollercoaster of waiting and tests.

Thank you again for helping. 

Enjoy the weekend x

Good morning 

He stopped HT in August and was on monthly injections for 6 months.

The GP has taken the blood for both of the post RT checks and the hospital give us a form that means the results are meant to go the the hospital instead of the GP. The GP have messed up this time and not used the form. So I think the lab used is the same.

We have our telephone appointment on Thursday so we shall see what they say then.

I suppose I just want to know the treatment has worked and it's a bit of a rollercoaster ride I need to get used to.

Thank you for your reply and enjoy the weekend x

Hello Willow

i well understand your anxiety as it is similar to what we are going through. My husband had 18 months of HT , finishing in May 2024, and 20 factions of RT in Feb/March 2023. While on ht his PSA was averaging about 0.04. His first test after ceasing HT was Oct 2024 and had risen to 0.2. The oncologist has recommended another blood test towards the end of January although we had been warned to expect a bounce once coming of HT. 

That said, we have a friend whose lowest PSA was 0.3 and the same oncology department is happy with this! We have another friend whose PSA after stopping HT rose to +1.0 and his ( different oncologis

t) was not unduly worried and the PSA did drop and steady at below 1.0 and has remained steady.

so, hopefully your husband and mine are in a good place? I guess time will tell for us all. There seems to be different PSA expectations for all patients!!! I do hope all turns out well for both our menfolk!

Good Morning although an extremely cold one!

I fully feel and understand your anxiety I'm on that journey too as a anxious wife.My OH had a Prostatectomy which needed to be followed up by RT & HT so not sure what to expect or what level of PSA is normal at his Ist test is in late Feb 10 weeks post RT and still being on HT for a further 18 months, as he doesn't have any prostate normal cells to recover quess it will differ from others on RT & HT only this we are unsure of.No appts have been arranged yet for Oncologist only Urologist in early March for follow up and PSA results. It is so nerve recking all this anticipation but unfortunately that's what's in store for along time to come yet!

Hello, I suppose we just want to know the treatment has worked. It seems to be a long road we are on and there is no one answer regarding the PSA levels. Definitely a rollercoaster. 

We just have to get on with life in-between these tests... easier said than done!

Best wishes to both our men and us too.x

Hello Ann. My understanding is that even though your husband has had a Prostatectomy he is now under the radiotherapy and hormone therapy rules so ideally you are looking for a PSA to become negligible within 6 months. Many men do not achieve this but provided the PSA remains stable or declined then all should be ok. The nadir following radiotherapy is usually around 18 months but it might still be subject to a bounce, especially once HT stops. Three consecutive rises in a short period or an increase of 2 above the nadir is an indication that further investigation is needed.

As you say, we have to get used to the anxiety when testing time comes round but at least they are monitoring things closely and can act quickly if necessary to keep things under control. Let us know how things go in March.