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Anyone seen a jump in PSA after spinal radiation?

moonlitnight
Posts: 58
Joined: May 2013

My husband had 20 grays in 6 days following a base-of-skull met acting up. He went on Zytiga shortly before (in May) and the Ra was six weeks ago. Since then, his PSA has risen quite dramatically to 10.7. There was some discussion with a naturopathic oncologist that the dead cells could be spilling antigens. I know this to be true for chemotherapy, but has anyone experienced it after radiation for mets?

VascodaGama's picture
VascodaGama
Posts: 3041
Joined: Nov 2010

I have no such an experience nor have read anything about it to answer you, but the life cycle of affected benign cells from DNA damage (in chemo or radiation causes) is usually one year. Cancer multiplies faster so that results are expected earlier. I would suggest you to consult his radiologist and discuss about the possibilities by taking into account the time it takes cells to alter its ran and settle as benign or cancerous.

Best wishes and luck,

VG

Old Salt
Posts: 720
Joined: Aug 2014

It seems to me (not a medical specialist) that the explanation that the naturopathic oncologist gave makes sense. In other words, the rise could be a 'bounce'.

I hope that given some more time, the PSA will drop.

BTW, what's a naturopathic oncologist; is he/she an MD?

moonlitnight
Posts: 58
Joined: May 2013

Thank you...  A naturopathic oncologist has taken 6+ years of study and holds an ND (Doctor of Naturopathy). He or she must then take various specialty courses in oncology. The focus is on integrative medicine.

Vasco...I wasn't aware of this, or am I not quite understanding you? Could you please rephrase? Are you saying that the PSA rise must be cancer activity, or that it might be due to antigens being released by dead cells? I think I am missing the plot. I need more coffee.

VascodaGama's picture
VascodaGama
Posts: 3041
Joined: Nov 2010

Moon

I do not understand your meaning of “dead cells”, but my interpretation is the following;

Our life building blocks, the Human Cell, are pre-regulated (genome) to die or live. The “instructions” are divided into opposed sets; the Mitosis and the Apoptosis. The balance between these two groups equals of being healthy and perfect or sick.

The death of a cell occurs naturally in a series of coordinated events starting with the breakup of its membrane, and ends with the nucleus condensed and disintegrated into pieces taking these times to be clean from our system. We can say that the cell is dead but the “debris” are circulating in our blood until the immune system disposes of it. One of that debris is the PSA.
In the case of a “provoked” death, such as by a burst of radiation or an intake of chemo, the set up is renamed necrosis (unplanned cell death) starting with the swelling up of the cell that eventually bursts, releasing its contents into the tissue where it belongs. The immune cells then move in to clean the “mess”, but the chemicals cause the area to become inflamed, meaning that localized living cells are affected. The dispose of these materials take longer to be executed. The PSA is expected to stay circulating longer in our system.
I take a note here to inform you that the circulating tumour cell test (he is doing) should be favourable because of the lesser number of malignant cell in the body in spite of higher count of PSA.

To make things more intrigue, the outcome of a necrosis differs on the timing of the occurrence within cell’s life cycle. The burst could catch the timing when cells divide (mitosis) or at its Interphase (middle timing) when the chromosomes (the genetic material) are copied. Many may accidentally still divide with a defected DNA, becoming cancerous latter as it progresses its apoptosis.

I like express 100% Arabica.

Best

VG

 

moonlitnight
Posts: 58
Joined: May 2013

V, as well as being a wealth of information, you make me smile.  This is exactly my point...perhaps the cancerous cells have burst and released their antigens. Our local oncologist (NOT one of the closed-minded nit-wits at the cancer centre) said, "I am not sure whether to go with the PSA test, or the CTC test" in terms of what exactly is going on and if the cancer is getting more active. On the surface, it looks like it is becoming more active, but until the Ra took place, his PSA was going down on abiraterone - not by much, but a little. By "dead cells" I mean cells that are undergoing necrosis as a result of Ra or chemo (or any other agent that can cause their demise). Bulletproof Coffee for me.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3323
Joined: May 2012

Has your husband had an LDH test ? LDH (not to be confused with "LDL", the cholesterol marker) is primarily a gauge  of mass cell death. It can shoot up from many cancer types, as well as from trauma. It used to be commonly used in determining if someone had experienced a heart attact. While this does not directly address PSA levels,  it may perhaps be of some value in assessing your husband's condition -- just a thought.

http://labtestsonline.org/understanding/analytes/ldh/tab/test/

Max

moonlitnight
Posts: 58
Joined: May 2013

Hi Max,

My husband's LDH was over 700 right before radiation. It was presumed that this related to the lytic mets in his skull base causing problems as the bone dissolved away. At least that's what the cancer centre doc shrugged it off as. We didn't shrug it off as this is way too high. I haven't seen the latest test on the LDH yet. We see Dr. Myers on Tuesday morning. Hopefully he can figure all this out better than our doctors up here can.

Thank you for your input...much appreciated.

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