1st PSA test after radiation treatment

Hi all.  Just wanted to give you a quick update and ask for some feedback as well.

I received 37 daily radiation treatments and completed them late in May.  Last Thursday I went in to get my post PSA reading.

The good news is that my PSA has not gone up after the treatments.  Before the treatments it had doubled between the last two PSA readings, and had been on the rise for the last several PSA readings.  On the other hand, it is a little disappointing to me that my PSA has not gone down either.  It is the same as it was before my treatments.  I will go back in August for my next PSA test.  I sure hope that it has dropped by then.

My Dr said that it can take up to a year for the radiation treatments to have their full effect.  He also said that it is not unusual for the PSA to take some time before it goes down.

Can anyone provide me with their history regarding their PSA results after radiation treatments?

On another topic;

The cost for radiation treatments really surprised me.  After the first month of treatments, I received a hospital bill for over $38K and several Dr bills for several thousand each…  I thought, wow, that really cost a lot.. I was really floored when I received another hospital bill the second month which was over $38K along with the weekly Dr bills for many thousands more.

I am sure glad that I had a job which provided me insurance.  Regardless, by the end of March I had not only paid my entire year’s deductible, but also exhausted the entire year’s out-of-pocket maximum.

What about all those people out there that don’t have a job or insurance.  Hearth care should not be a “for profit” institution that is only made available to those that can afford it.

Radiation Oncologists AVERAGE $556,000/year...Everyone else involved with your treatment is making at least $85,000 a year and a couple of them closer to $150,000....A new linac costs at least $6 million, some of the fancy ones, over $10 million if you include the lead-lined room they must be housed in..

The cancer / prostate die-off is slow after SRT so the PSA decline is slow too..You said the number was unchanged but you didn't say what the number was...I'm sure you realize that SRT is not very successful at curing guys that had clean margins after surgery...At $100K a pop, The System needs to develop better ways to determine whether SRT is worth doing or not..

I bet if you were on Medicaid, the chances of ever receiving salvage radiation are pretty slim...I could be wrong...

Anyway, the best of luck to you as your journey continues...

If you only finished SRT im May I think that it is too soon to have a PSA test.

I had surgery in July 2009
Post op PSA in Nov 2009 was 0.1
In March 2010 my PSA was up to 0.4
I had 33 sessions of SRT (66Gy) which finished on 11 June 2010
They did not test my PSA again until September 2010 to give the SRT plenty of time to take effect.
My PSA in September 2010 was <0.1 and had stayed there for the time being. Next test in about a month.

At present I think you can take heart from the PSA not having gone up and hopefully look forward to a lower reading in a few months once the RT has had more time to damage to the DNA in the cancerous cells and stop them functioning.

Alf

Thank you all for the responses. I truly appreciate it. From the posts I received, I will consider myself on the right path for now and look forward to my next PSA in August.
Fairwind, at 57, it will be some time before I will be on Medicare. Regardless, there were a lot of guys that I met that are on Medicare and all of them had no issue in getting RT. At least we agree that the exorbitant cost of medical care is based more on greed for profits versus quality care for the individual.
Thanks again,
Ted

Question

What is scary to me is that your PSA was relatively low, your Gleason was low, you staging was low, yet apparently surgery was not successful.

Did you have PSA tests in after the 90 day .00?

Any in 2009 or 2010?

Good luck.

PVE

Thanks again for the recent replies. PVE, Yes, that is also a concern to me.   I took an aggressive approach and had such low numbers; I expected to be one of those perfect candidates for being cancer free for the rest of my life after surgery. I have had my PSA taken regularly over the three years following my surgery in December 2007.   The PSA readings were always .02, until the last three or so before taking RT.   It took several PSA results to be sure that it was going up.   If I remember correct it was something like; .04, then .05, then it jumped to .12.   That is when my Dr took action. For me, this is just as good of a reason as any to try to warn those that decide to take the AS approach.   I have even seen many a post here of guys that waited a year or to after knowing that their PSA was on the rise and even had positive biopsies, yet they decide to wait.   They think that by positive thinking, exercise, and making dietary changes, that they will beat the cancer.   I understand why some men do this, but as you can see, even if you have a low rate of cancer and you even get surgery, then all your margins are negative, there may still be a chance that some cancer cells escape the prostate and at some point in the future they will begin to multiply. First let me say that in many cases, they cannot really be sure how much cancer you have until they perform surgery.   In my case for instance, the cancer in the lower left apex of the prostate was not discovered by the biopsy, it was discovered only after surgery. Since it was on the apex, it involved the left nerve bundle.   You can imagine what may have happened if I had waited for a year or more, simply because I had a low rate of cancer when they did the biopsy. In my case, the theory is that when a nerve bundle if involved, the cancer cells can line up along the nerve like a train and some cells can escape the prostate.   Those few cells would not have shown up in the testing for the margins, therefore, would not have been known about until they simply start to multiply at some time in the future. If you have a detectable PSA after surgery, per my Dr, there is only two reasons; 1) they may have left a very small portion of prostate tissue, or 2) some cancer cells still exist that escaped the prostate.   In the first case, where there is a small bit of prostate tissue, as long as there are no cancer cells, your PSA would be stable over the years.   In the second case, once they start to multiply and the PSA goes up, then that is when you take the next treatment steps, especially if you are young and healthy like I am. I hope that helps, Ted

Thank you for the post Les. That was good informaiton to know.

Hi Tip,
Even though your PSA did double from .2 to .4, there is no way of telling if that was post SRT or not. The encouraging aspect is that your PSA has not risen in the 3 times you have been tested. As one who has had BCR, I have followed many cases in this forum who have had similar experiences in order to make informed decisions and to know what questions to ask my doctors. Most of what I have seen is that radiation failure is evident with a quick rise, and subsequent rises post-SRT. Although .4 is not a great number, your PSA trend is ok. Radiation keeps working for many months after treatments have ended. If you don't currently exercise, I would strongly encourage it. Your body is the best cancer fighter, and having it in top shape is crucial. If it does nothing else, it gives you a feeling that you are actively doing something in your battle against the disease, and, you get yourself in better health in general. Check with your doctor first. Mine offered to write me a prescription for a trainer at our local university. My insurance would have covered it, but I opted to work out on my own.

Good luck,
Paul

Hi Tip:

Are you in Michigan

Mel (Go Tigers!)

My PSA after SRT was the same as before, but after 6 months it was undetectable.  Give it some time.

Mel,

I had my surgery at the U of M Cancer center in Ann Arbor.

No, I am not in the TC area; I am near the middle of the state straight east from TC. How about you?

Dave (Tip)

April 2013 orig diagnosis with a PSA 19.1. Biopsy 12 of 12 showed Gleason at 4+5. Stanford Hospital radiation 37 days. Just finished my 2 months of waiting before first PSA test. Results show 1.6. A lil tear formed. I feel as though things will be OK. I'm done with it all (my choice). Not going back. I'll see my own doctor and get a PSA annually, but no more of the high price hope and wait stuff. I'm going to live life and be happy. The song "Don't worry be happy" is my motto from here on.