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Cancer: Prostate Message Board

Cancer: Prostate Board Index

[QUOTE=elakovich;3732147]what does a .3 psa after radiation[/QUOTE]

I'm replying to your post in the middle of last month as you haven't had a response to date. (I have not had radiation, but I considered it, in fact it's still an option as I near the nine year point since diagnosis, relying only on intermittent triple hormonal blockade and supporting drugs, so I've learned something about it as a fellow survivor with no enrolled medical education.)

The bottom line: a PSA of .3 is not a clear indicator of success or failure after radiation. Unlike surgery, where, ideally, use of a highly capable ultrasensitive test will demonstrate that the PSA is less than 0.01, or at least less than 0.04, or where a conventional test will at least show it to be less than 0.1, some PSA-generating cells often remain after radiation.* Hopefully and commonly they are free of cancer. They often seem to produce a PSA in the low tenths of a percent. My impression is that that is normal and not a signal of a recurrence.

My impression is that leading radiation docs like to see the PSA finally settle down to 0.2 or below, though some radiation patients do fine with somewhat higher post-treatment PSAs. However, a PSA "bounce" or "bump" happens fairly frequently after both seeds and external beam radiation (proton too, daff?), and that can boost the PSA by a tenth or up to quite a few points for a while. Good books that cover prostate cancer radiation discuss the bounce. It's not a bad thing if it happens, as patients who have bounced before the PSA settles down seem to do at least as well in the long term as those who have not bounced. That said, seeing the bounce in PSA reports has got to be tough on the emotions. :confused:

Of course, a steadily rising PSA probably indicates a recurrence of cancer. My impression is that for most radiation patients it takes a series of PSA tests over a good part of a year to separate bounces from recurrences.

I hope our guys and gals that have closer experience with radiation for PC will chime in.

*Sometimes that happens after surgery too, and the PSA will be higher, but will not increase beyond a certain low level unless there is a recurrence.


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