“Prostate radiation psa?”

Hi,
It depends on what your initial PSA was prior to treatment and when you completed your hormone therapy. The hormone therapy brings the PSA down quickly and the PSA can rise a mos when completed. It takes time for the radiation to decrease the PSA, be patient, repeat PSA in 3 mos.

A 1.7 PSA is low. It may continue to decrease more with the Lupron injection. I would continue to watch.

Dear Sir, The reading of 1.7 ng/mL itself is relative to what your pre-treatment PSA was. In most cases, Lupron brings the PSA value down somewhat quickly however, in some cancers, both Lupron as well as radiation can take more time than three months to bring the PSA down to a lower value. If your pre-treatment, PSA was high i.e. 8 or 10 or even greater, then the value of 1.7 at this time relative to your treatment would not necessarily be considered high. I would like to answer your question in more detail however, more information is needed for me to comment on whether this value in and of itself is meaningful. The first PSA sample approximately 12 weeks after treatment is usually not the lowest value that we see. It should, however point in a direction where it shows a downward trend of some significance. Some cancers take a little longer than others to show response, particularly to radiation. Slower moving cells (in terms of their cell cycle time) do you show more protracted downward trend. Faster, moving cells, i.e. those with higher Gleason scores or other signs of being more aggressive, well have PSAs that tends to reflect a greater downward slope. These points are general and meant to show you that more information is needed to concisely answer your question. 1.) what was your initial PSA prior to treatment along with PSAs obtained prior to the first biopsy, 2.) what was your Gleason score at the time of biopsy? 3.) finally what was your T stage ? This information is part of what I typically use to provide my patients a with a sound understanding of their condition. I hope that this was helpful. Thank you, Dr. Young.

If this is lower than the PSA level before EBRT and Lupron, then you’re ok. It will take many months for the PSA level to drop to it’s lowest level.

iI depends on prior psa. A psa rebound can occur just after radiation, but less likely with lupron. Again, it depends on prior psa.

Hello,

In order to better assess your current response, to androgen deprivation therapy (ADT) such as Lupron using the PSA test, it is important to look at the historical trend of prior PSA tests.

Depending how high your PSA before treatment, it will take time (1-2years) for PSA to go down to lowest level (usually below 1). With Lupron injection, it will be faster. As long as it will not go back up, it should be OK.

PSA normal range is 0 to 4.0 ng/mL. After radiation therapy of the prostate, PSA trend is established by a series of blood draws, every three months.

Following radiation treatment, the PSA drops slowly within a few months. Lupron may hasten the PSA response, but because the prostate is not removed, it will not be zero. Prognostication is based on the follow up on the PSA value and not on the individual test. In your case, you will need a follow up PSA test for comparison, which probably was ordered by your doctor.

In order to determine whether it is a treatment failure, we need 3 consecutive rising PSA. Right now, it is hard to judge whether EBRT + lupron is successful until you have two more PSA tests. You should continue follow up with your urologist to test PSA for the next few months.

The PSA in this situation depends on the value of PSA prior to initiation of RT and the timing of the last dose of Lupron. If the dose was a "3-month dose" and it was administered more than 3 months prior to blood draw, the effects of Lupron may be wearing off. At any rate, a repeat test would be helpful in another 3 months.