PSA levels during and after hormone therapy.

I have found that nearly every health authority, every hospital and in some cases every Rad.Onc. has different ideas on how to deal with these issues when giving RT.  At one hospital I would have been on a diet all through RT but at the hospital I eventually went to no diet advice was mentioned and a micro enema given before each of the first 10 out of 20 doses of RT was given and the obligatory hugs glass of water for a full bladder - believe me that was the worst part for most of us waiting for the RT and every man rushing out of the RT room and rushing to the loo.  thankfully there were 3 loos within easy reach and only once did I have to make it all the way to the reception area loo - which thankfully was vacant.   I always eat sensibly and continued to exercise at least 4 days a week at the gym all through my treatment.  I am sure this helped with the fatigue and mood swings from HT.  I just carried on as normally as I could despite living away from home 5 days a week for a month to enable me to get to the hospital for My RT every day.  On the last day of my RT when I lay on the sun bed they found I had trapped wind so had to go back out into the waiting room and practice some yoga "downward dog" until all back to normal. 

I would have thought diet advice should be standard practice in order to minimise collateral damage, but I guess different hospitals have their own protocols.

I was hoping for an early appointment and thinking of missing breakfast until after the treatment, that way my digestive system should be quiet....and gas etc should be minimal?

I have been surprised at the number of people who have had to live away from home in order to fit in their treatments, that must be quite an imposition but I guess we have to fit in with their schedules.

Hopefully the new reduced 5 treatments regime should make life easier in the future, but for my stage 3a I think I'm still on for 38 treatments and 2 years HT :-(

I also exercise regularly by playing golf three times a week and going to the gym for the days in between, I hope the timing will still allow me time to do my golf.

Thanks for the info,

Good luck

Derek

Hello Derek

Interesting that - I am a T3a N0M0 and had 20 fractions on the sunbed and am on HT for 3 years - I think much depends on your oncologist.

I can agree with freefaller about every hospital doing the "sunbed" treatment their own way. Nearly everyone on here has been through "empty bowel - full bladder" and the second they are off the sunbed it's off for a pee!  At Oldham it was "empty bowel and bladder" so the question before the sunbed was "have you just been?".

You will be fine, keep up the exercise and the golf (you will be playing off scratch) by the end of your treatment!!.

Best wishes - Brian.

I'm not quite sure what you mean by staying under 0.3 is a better indicator of no re occurrence? I finished my HT over 14 months ago and my PSA is currently 0.4, my original diagnosis was 50.6! I have been told that 0.4 is fine and normal, bearing in mind I still have a prostate, so as testosterone returns then PSA will rise, and only if it reaches 2 above nadir, or doubles very quickly will it be cause for concern, so I really don't think 0.3 is in anyway relevant to suggest reocurrence. 

I have been on hormone treatment for 6 months and have been told I will not get a blood test until after my radiotherapy.

Hello Prostate sufferer . I don't think tunybgur is implying that levels above 0.3 are indicative of a recurrence but some of the more recent meta analysis does indicate that those who achieve a PSA of below 0.5, but preferably lower after radiotherapy tend to exhibit a longer time before recurrence occurs in the future. Some of the data it is based on is pretty old but things are also beginning to be updated as information comes through on the effects that second generation antiandrogens are having in addition to the radiotherapy for medium and higher risk groups. When to act, and how, once signs of a recurrence are seen is also being evaluated and measured against time to further recurrence so that men can hopefully remain on the curative pathway.

Yes I quite agree, achieving 0.5 or less while undergoing treatment, ie radiotherapy and HT is obviously a goal we all aim and hope for, but my point is, the quote used was , "The only numbers I have gleaned from my investigations are for when treatment is complete after a few years, apparently it's a good sign if your PSA is 0.3 or lower and stays there, as there's a very good chance you're cured.", which is totally different to what your numbers are after radiotherapy, and still on HT. The main thing being, that as HT leaves your system, over time your testosterone will return, and this in turn will raise your PSA without a doubt, so to stay at less than 0.3 is very unlikely, unless you are not producing testosterone normally. My nadir was 0.03 at the end of my treatment. 6 months later it was 0.16, re tested 3 months later it was 0.22, and again this week, 6 months later it is 0.4, and all described by consultant as very good and normal levels. 

As you might have read, we were initially concerned that my husbands PSA when ht just ceasing was 0.04. This week, 6 months after stopping ht, his PSA was 0.2 so this implied a big jump to me and I was quite anxious. Your posts here and those on my own post have given me a lot of reassurance! So - thank you!!!

Honestly I think that is normal, my first 6 monthly check after my HT had finished was 0.16, I was worried, especially as they then brought me back to 3 monthly checks, but 3 months later it was 0.22 and they said they were happy with that and all normal and as expected, then reverted to 6 monthly checks, which was this month, and 0.4 and happy with that and still 6 monthly, so I think you will be fine 

I think that a testosterone test plus a PSA at the point when it is expected that the hormone therapy is out of the body could be useful as establishing the new baseline. Some men find that their testosterone doesn't return to non castrate level and might benefit from additional therapy. Having established the new baseline could then be more informative if an increase in PSA is seen and the velocity of the doubling time would be more accurate and a better predictor of recurrence.