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PSA bump-post surgery and adjuvant hormonal and radiation

Berco
Posts: 7
Joined: Feb 2012

Post RP this year in April my PSA was undetectable (< 0.03). However started with hormonal (Zoladex) in May and then Radiation(Prostate Fossa( in September-completed Nov 7th. Post radiation PSa test done 4 days later was 0.04. Will have another PSA test next week to determine if the previous test was a bump or recurrence .

Has anyone had a similar experience and what was the outcome.have you heard of a PSa bump post radiation-without the prostate? Would appreciate any information/help. Any other tests I should ask for now?

RP Biopsy- Gleason was 9(5+4), one Positive Margin and 1 Cancerous Lymph node(out of the 17 removed) and substantial extra capsular extension-both SV invaded. hence started with Hormonal (Zoladex) and adjuvant radiation (Prostate Fossa-33 x 2Gy each) to reduce chance os recurrence.

Thanks

berco

VascodaGama's picture
VascodaGama
Posts: 1734
Joined: Nov 2010

Berco

 

For a reliable answer of the meaning of “bump”, you need to inquire with the doctor that told you such.

Some guys use the expression insignificantly with the meaning of a “little rise”. However, the term “bump PSA” refers to the bounce behaviour of the PSA expressed in periodical results.

 

Bounce is common in cases of radiotherapy done with the prostate in place, probably due to infection of benign tissue. In cases of prostatectomy, rises of PSA may occur if any prostatic cell (benign or cancerous) is left behind, but the periodical results do not represent the typical rise and fall aspect of a bounce. Results would be in the 0.005 bounce levels.

In many cases of prostatectomy, the PSA is erratic (bouncing) during the short period just after surgery (1 to 6 weeks) due to the time the body takes to clean up the death cells in the blood.

 

In saying that, I would like to comment that your latest result of 0.04 ng/ml could represent an increase due to assays’ LLD. You could inquire if the laboratory has used the same maker of previous tests. In any case, a single result has no meaning in the judgement of disease progression. At least three results are recommended to declare recurrence.

 

PSA results cause anxiety. Your case is delicate for the high risk but you need to give it time to find out if your treatment has failed or if it has freedom you from the bandit. It has for sure knocked it down.

 

The PSA is the most reliable marker of cancer progression after treatments. But I would recommend you to have periodical image studies of the whole body, for the positive lymph node found after surgery (occult cancer at the lymph nodes are still existing probabilities). Bone density scans are also required to check on bone health, particularly at the iliac (due to SV invasion). Cancer metastasizes easily in weak bone. A testosterone test should be performed with the PSA to verify drugs’ effectiveness.

 

Wishing you continuous low PSAs.

 

VGama  Wink

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