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Adjuvant RT and Lupron

YerBlues
Posts: 5
Joined: Apr 2010

I had DaVinci Surgery on Sept. 2 2009. PSA was undetectable 3 months and more after surgery. I started adjuvant radiotherapy on April 14 2010. Had a PSA test the following week and it came back as 0.2. That was a very unwelcome surprise. Urologist put me on 3 monthly Lupron and we continued the RT which finished on June 2. Had a PSA test at end of June, PSA undetectable again. I have one more Lupron shot at end of July then PSA test every 3 months.

My Urologist said that after the Lupron wares off, if my PSA show up between 0 and .4 it is not unexpected as this is common for up to 2 years after RT by which time it should drop to undetectable. Can anyone point to literature that talks about this. He said if it goes up beyond .4 then we'll consider more Lupron therapy.

As far as bladder control goes, I'm pretty good but have to pee about every 1.5 - 2 hours but its always a full bladder.

The sexual function is still not there yet, I'm using the pump and Viagra, Sometimes I think its finally waking up but not enought for fun times. Its frustrating.

Going with the Flow!

All the best to everyone.

YB

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

YB, frequently there is a "PSA bounce" after radiation where there is a period of of slightly elevated PSAs at about the 12-18 month point and then they gradually decline. As the radiation interferes with the ability of a cancer cells ability to divide it takes awhile for all of the cancer cells to die.

The following link to an article on the ACS website has more information about the PSA bounce effect.

http://209.135.47.118/docroot/NWS/content/NWS_1_1x_PSA_Bounce_No_Reason_For_Concern.asp

Hope this helps.

The Naturalist's picture
The Naturalist
Posts: 6
Joined: Jun 2010

YB: I had IMRT radiation in 2007, and my PSA was never undetectable. It floats around .8,.5 and .7 (March 2010). My doctor didn't have any concern, and neither do I. I have posted in another response that a small "fraction" in PSA results may be the difference between laboratories, and/or the technician involved. There are always interns learning in laboratories, and I don't see how a .2 or .3 difference may need additional therapy.

That said, you should certainly follow the opinion of your doctor. But I would ask for "a second opinion," because specialists may over medicate people for the visits and therapy that
increase their income. Medicine, above all, is business first.

Sexual function after Da Vinchy or Radical Prostatectomy is usually worse than radiation - based on a friend of mine who had Da Vinchi and myself. But a positive attitude is a must since the psychology factor always weighs in. Good luck to you, and don't become terrified with fractional PSA fluctuations. All hormone levels in our body fluctuate somewhat daily.

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