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Cancer: Prostate Message Board


Cancer: Prostate Board Index


[QUOTE=gpgscott;3542987]...'Bounce' is a documented occurance with radiation as the primary treatment but not really understood as near as I can determine after radiation post radical. My Dr is really not sure, I am the first patient he has had to have this experience and I like you cannot find reference to it with my particular circumstance.
...Scott[/QUOTE]

I'm glad to hear your spirits have improved. I think it's often harder on our wives. I believe you are going to do well and that your wife will feel better when she too realizes that. It may take some time.

Though there isn't much on bounce in your particular circumstances, there is a lot on bounces generally after radiation for prostate cancer. I got 28 hits on the Government site [url]www.pubmed.gov[/url] with this simple search string: " bounce AND radiation AND prostate cancer ".

By the way, the book "A Primer on Prostate Cancer" describes the "PSA bump" (alternate terminology) on pages 103-105. Among other things, the book notes that about 35% of patients experience "a temporary rise in PSA after first having a decline in PSA after completion of brachytherapy."

Have you read the book by Peter D. Grimm, D.O., John C. Blasko, M.D. and John E. Sylvester, M.D., The Prostate Cancer Treatment Book ? As you would expect from these experts on RT (especially seeds) from Seattle, it is especially strong on seeds, and the bounce phenomenon is well-covered from pages 150-153. Here's a brief excerpt from what they write, somewhat paraphrased in my notes: Occurs in 24% - 40%, usually 12-36 months post seeds, usually a few tenths to several points. One patient increased to 13 then down. A second bounce occurs in about a quarter of these patients a few months to a few years after the first. Cause of bounces unknown; may be cells dying. Should repeat PSA in 2-3 months. Most bounces are short, but some last many months. (Monitor carefully.) Younger men have more likelihood of bounce and higher bounces. Use the same lab and avoid ejaculation for two days prior to the test. There is no need for a new biopsy within two years of seeding as the cells are biologically active but reproductively dead - the cancerous cells look alive under the microscope but they are incapable of reproducing. A rapid PSA rise after two years signals need for hormonal therapy; no need for biopsy. If not rapid, may biopsy to see if local recurrence is likely. Probably also biopsy if patient is elderly. Salvage after seeds [believe they are addressing surgery as salvage]: need an expert as success is low and incontinence can be as high as 50%.

The 2005 book by Michael J. Dattoli, M.D., Jennifer Cash, ARNP, MS, OCN, and Don Kaltenbach, prostate cancer survivor, Surviving Prostate Cancer Without Surgery -- The New Gold Standard Treatment That Can Save Your Life And Lifestyle, is outstanding. On page 80 Dr. Dattoli notes that Pd-103 has a lower incidence of benign bounces than Iodine 125. Under the heading What is a PSA Bounce?, page 82, he writes: "About 30% to 40% of patients undergoing seed implantation experience a temporary rise in PSA after an initial decline in their PSA level following treatment. This phenomenon is known as a PSA bounce or flare. It generally occurs approximately 20 months after treatment and is not caused by a recurrence of cancer, but rather by radiation-induced prostatitis (inflammation of the prostate) with subsequent systemic release of PSA. These patients are still considered disease-free. The rise in PSA may be 0.1 or higher and can sometimes last many months, but it is usually of short duration. Studies have shown that the PSA bounce is more common with younger patients, those who receive higher implant doses, and those with larger prostate glands."

Hang in there,

Jim





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