I had seeds only in January 2004.  My original PSA was 4.08, Gleason 6.  Six
months after seeds it was 1.1; one year after was 0.6.  Latest reading after
18 months was 0.93, that is higher than six montlhs ago.  My oncologist says
it is typical for PSA to rise in the 2nd year as the prostate recovers
somewhat and begins producing PSA again.  Like your doctor, mine says this
is OK.  We just keep monitoring every 6 months.  He says there is nothing to
worry about unless it starts to go above 2.5 (which he says is very
unlikely).  One of the disadvantages of seeds vs. surgery is that there can
be a PSA bounce afterwards, but as I understand it, this is more of a
psycological rather than medical concern!  And with your low levels, the
difference between 0.15 and 0.2 could be a rounding issue.  I'm not sure if
they can measure that accurately at such low levels.

Bob

Hi, Mike!  or is it "Welcome, Mike!"?  I don't recognize your email address
as a previous poster.  Not important.

After radiation, your PSA should go down slowly and eventually level off at
your "nadir".  So, if your cancer cells and PSA were exactly relative to
each other, a one-time rise of .05 might be alarming.

However, no doc can really tell what's going on with two consecutive PSA
readings.  It takes three to be minimally predictive.  Four is better.  So,
your 0.2 means nothing.  So, what's a doctor to say?  He can say, it might
be a bad reading.  Or, he can say, it's okay.

For now, it's okay.  If the next one is 0.3, it's not okay -- probably.

Since you did not give your initial Dx PSA score or Gleason scores, etc.  I
will make an assumption that you were probably in the PSA 4-5 range with a
Gleason 6 (3+3) and you're probably somewhere between 55-65 years old.
Typical brachytherapy treatment for someone in that category. And you did
not mention ever using any sort of hormone blocker such as Lupron during
before or after treatment.

Your PSA dropped fast, very fast! That is very good news. What you probably
experienced is a slight bump or bounce in PSA which is considered normal and
will happen at anytime in the first 2 years and can still happen any time in
the next 2 years after treatment although it is rarer in the later 2 years.
PSA drops on a curve not a straight line and it does not fall the same way
as a man who has had a RP.

I will ask if at any time after your treatment if there was a cat scan
performed to double check your seed placement and to make sure you did not
accidentally lose a seed or two? These scans are usually done 3-6 weeks
after seeding. If all your seeds are in place then you should have nothing
to worry about at this time.

You still are way below the "normal" one year drop post brachy. It takes a
while before the prostate is completely destroyed in the meantime it is
trying desperately to survive and function. The bounce is often the last
heave ho before the prostate dies.

Just keep in mind that if your PSA does begin to rise then the cancer long
ago escaped from the prostate and even a RP with salvage radiation would not
have stopped the PC. The tiny wiggle you saw could have been caused by
almost anything as it is not a much of a bounce. If you had come back with a
1.5 it might have raised a few eyebrows but you are only looking at a
difference of a 0.05. You could ask to have the PSA test repeated in a month
or three instead of waiting another 6 months. We had one guy out here who
spent the weekend with an old girlfriend prior to his PSA test on a Monday
and he raised his PSA Big time!!! But when the test was repeated a week
later it was right back to its normal lower level. :-)

My husband passed the 3 year mark May '05 with a PSA test result of 0.04 and
hopefully still dropping. I'm planning on keeping him around for at least
another 25 years.

If you have any questions you are more then welcome to ask via email.

Bev (hubby had 25 EBRT treatments on IMRT and then brachytherapy May 3,
2002)

You did not mention whether you had ADT hormonal treatment over the
top of the RAD, so we cannot determine if your PSA readings were
masked by ADT or not.

It's usual to have a PSA bounce after the hormones leave your body in
9-12 mths after having the final shot, which normally works actively
for 3 mths.

Doctors cannot put an accurate figure of where the bounce will peak,
but do say it can preferably remain flat or take a slight downward
curve after settling out as your body takes on testosterone again.

You didn't supply your Dx entry details, so  we cannot opine where you
should be.


-- Reader to complete...
-- Please reply to this ng as my email adress is fake:

-- Regards

-- CC

Mike,

In my inexpert opinion you are doing extremely well and have nothing
right now to worry about.  I had HDR brachytherapy plus external beam
radiation.  I also had Lupron.  My PSA readings after the Lupron wore
off were:

   .8 .6 .9 .8 1.8 .5 .6

Your "bounce" from .15 to .20 really is nothing.  If I remember
correctly, patients who get below .2 after radiation hardly ever
have a recurrence of cancer.

PSA can bounce around for 3 years or so after brachytherapy.
Furthermore, PSA can vary up to 30% from day to day.  So even
if we assume your readings are 100% accurate (and they might not
be - there is some possible error percentage in the test), you
really have no real evidence of a bounce, much less a recurrence.

I agree with your doctor.  You're in excellent shape.  A lot of men
who are essentially cured have much higher PSA readings than you do.

    Alan