Post Hypofractionated RT no HT Annual Review - Dedalus

Dedalus 2 days ago

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Hi all

It has been about 11 months since I last posted. I waited until my annual review.

The following is an update on my progress since 7 sessions of hypo-fractionated RT only. It may be of interest to those considering RT without hormone therapy, and possibly more specifically hypo-fractionated RT.

My urination returned to normal very quickly. My flow is good, and improved on what it was pre RT I don't have any urgency and don't get up during the night to pee. I can have 8 to 9 hours sleep without interruption. I never had to resort to Tamsulosin or Cialis etc.

Bowels-wise, that too has been normal throughout. There has been nothing untoward. I have had recent slight constipation, but I should be drinking more water and fluids.

I had my first year review (11 months post RT) this week

The following are my PSA stats:

13.136 - Feb 2024 last known psa before treatment.

19 Apr 2024 - Last RT (7 Hypofractionated VMAT) - no ADT

The Following are Calculated as 28 day or 4-week months.

PSA

6.11 - 5 Jun 2024 (47 days or approx 1.67 months or 1 month 19 days)

3.424 - 5 Sept 2024 (139 days or approx 4.96 months or 4 months 27 days)

3.04 - 23 Oct 2024 (187 days or 6.8 months or 6 months and 19 days)

2.563 - 28 Dec 2024 (253 days or 9 months and 1 day)

2.255 - 17 Mar 2025 (331 days or 11 months and 23 days)

In my region as in many others, I'm sure, reviews are done via a specialist nurse over the phone. It is not possible to meet with the oncologist.

I found that specific feedback is scant and all I took from it, is that I am making good progress because I am on a downward trajectory. When I asked how I compared, I was told my downward psa results were average.

As I have not had HT, I hope that my eventual nadir (possibly within the next 2- 3 years) will be at least 1 or even better at 0.5 or less.

I would be interested to hear comparitively from others who opted for RT with no HT as the stats are obviously quite different for those who have had HT.

Best wishes to all on your journey.

Dedalus

Grundo 2 days ago

Yes I had RT with no HT in 2017, went ok and as of a few weeks ago PSA still going down albeit slowly.

When I was first diagnosed in 2013 I got the impression that with low PSA and low Gleeson and contained , HT not really required.

Steve

Dedalus 2 days ago in reply to Grundo

Hi Steve

Thanks for your reply.

Good to hear that your psa is still going down 7-8 years later!

Dedalus

Alwayshope 2 days ago

Hello Dedalus and good news that things are still on a downward trajectory. There is a phenomenon called the PSA bounce which can happen around the 12-18 month post treatment, particularly in men who have had Brachytherapy or SBRT but provided it goes back down then there is nothing to worry about - the exact reason for this is still not known. There has been a recent meta analysis (Jan 2025) which explains the PSA kinetics following SBRT treatment although some of the results used are with ADT. Some men show a rapid decline to nadir, others take a long time in terms of years.

https://www.sciencedirect.com/science/article/pii/S0167814024043044#:~:text=SBRT%20was%20characterized%20by%20a,(6%E2%80%9354)%20months.

Dedalus 2 days ago in reply to Alwayshope

Hi A.H.

Thanks for your reply and that useful reference. The discussion section is very interesting.

At this 11+ month stage I had anticipated a possible bounce. If it comes in June at my next 3 monthly PSA it will make me a bit anxious I'm sure. I had hoped to go below 2 at my next PSA!

Dedalus

Grundo 2 days ago in reply to Dedalus

I think you're doing ok D.

PSA been dropping everytime since you had the RT.

As long as it doesn't start an upward trend, apart from any bounce obviously , think you'll be ok.

All the best

Steve

Millibob 2 days ago

Hello Dedalus

Well thank you for the update. I am pleased your research has proved to be correct and the results are very positive - long may it continue.

Best wishes - Brian.

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Dedalus 2 days ago in reply to Grundo

Thanks for the positive words Steve.

Although I still have a month to go before I reach the 12 month stage, I must say I am a bit envious of your 0.93 at that point!

'Onwards and downwards'!

Dedalus 2 days ago in reply to Millibob

Thanks Brian.

Grundo 2 days ago in reply to Dedalus

I wouldn't take too much notice of that, you've had a big drop from about 6 to 2.

Unlike surgery were PSA has to be zero with RT it seems like PSA can be anywhere obviously the lower the better.

Good luck with next PSA, hopefully under 2

Steve

Dedalus 2 days ago in reply to Grundo

Thanks again Steve

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