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PSA Still high after radiation - should I be concerned/worried....

bassoneman's picture
Posts: 58
Joined: Apr 2017

Prior to  radiation therapy PSA was 4.9.  4 weeks after radiation 4.4.. I just got test results. I haven't discussed this wirh Dr. yet.. I am concerned.. shouldn't it have gone down much lower like 1...




3+4 2 cores 50%  2 cores 3+3 10%    out of 12 cores

Posts: 1013
Joined: Mar 2010

PSA levels following radiation vary widely and it can take a year or more to drop below 1 which is generally considered the level at which radiation is "successful." 

Kongo, who was treated w/CK about the same time as I was and who use to be a very active member here, reported that his PSA level dropped below 1 w/in a year after treatment but I was not so lucky. 

Following my treatment with Cyberknife in Sep 2010, my 1st PSA reading was 12.30!  My PSA was "only 5.9 three months before treatment; so it more than doubled following treatment.  My PSA results declined the following year but were very erratic and started to climb again about 2 years after treatment (3 times in a row, which is an indicator for recurrence). 

When that happened I got an MRI/MRST 3T scan in Oct 2012, which determined that there was NO cancer and that the erratic PSA scores were most likely due simply to prostate irritation associated w/the treatment.

My PSA level started to drop again after the MRI/MRSI but did not finally dropped below 1 until 2 years and 9 months following treatment, which my doctor said was not unusual.

My PSA results have since continued to drop consistently. I was last tested in Aug 2016 with a PSA of .137.  I am back on an annual test schedule and my next PSA test is due at the end or Aug/beginning of Sept 2017, which will be about the 7th anniversary of my treatment.

So, I wouldn't be concerned w/your latest PSA test result only 4 weeks after treatment. Give at least a year and the trend should reflect a continuing decline in your PSA level indicating a successful treatment.  Hopefully, your PSA level will drop below 1 more quickly than it did for me.

Good luck!

Old Salt
Posts: 806
Joined: Aug 2014

Very briefly, it is my understanding that the radiation damages the DNA. The cancer cells are less likely to be able to repair the damage and will  die over time and release their PSA. Thus, one cannot expect the PSA to drop down precipitously right after radiation.

bassoneman's picture
Posts: 58
Joined: Apr 2017

The treatment made me a little paranoid. I had some nasty side effects from it.. Or it was from the biopsy. But what ever it was I didn't want that again..  I see the Urologist in two days..   The side effects have left me.. (except for hip pain) but I beleieve that is athritis and going to see about getting a cordisone shot in it.. Worked great 10 years ago..  I wonder if the radiation wrecks havoic with athritis. 

Posts: 12
Joined: Mar 2017

I've been attending some very useful lectures by radiation oncologists at the Radiotherapy Clinics of Georgia, and this question was actually addressed today.  It takes on average 2 to  2 1/2 years post-radiation therapy for the PSA level to drop about as far as it's going to drop.  Sometimes longer. 

bassoneman's picture
Posts: 58
Joined: Apr 2017

As mentioned I was having problems with my hip starting around the time of radiation. Onclogist thought I should see a Orthopedic for possible Atrhitis. Well Ortho orderd bone scan..  Had that today..  Seemed to be going pretty well until they said..  "Have you ever fractured your leg and arm before?".. Well "No" i haven't. Then they went in for a better scan of my skull..  Then they sat me up and said they wanted to call in the DR to look at the scan so waited an hour or so while Dr looked at scan..  Then they said ok you can go now..  Well most techs 'even though they shouldn't say ah looks good" Having heart issues I have a lot of tests..  But this tech says "good luck"!!!. I mean what do I need luck for... All this stuff lately has got me shell shocked..  I am diving back in the bunker and covering my head..  I hate waiting for results..  

Posts: 36
Joined: Mar 2013

Yeah, allow it some more time to pass. Give it another few weeks and i bet that psa will be significantly lower. Takes some time for these malignant cells to die follwing radiation. You still have a gland so you will likely not reach 0 on your psa, but that is ok. So long aa it continues to go down in the weeks ahead, that is what matters.

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