How long does SRT take to work? - salvage radiotherapy

Have you not read my latest post on my own thread? The ultra sensitive test is now apparently being discredited - our hospital trust (which is one of the centres of excellence for cancer) has stopped all ultrasensitive PSA testing for the region.

I think your post is a bit muddled about your scores. If you had gone from 0.04 to 0.2 or 0.3 that quickly you would be in deep doo-dah. I take it you are only guessing it might have done that and no-one has actually told you that was the case?

Lyn, Interesting about the sensitive tests. In that case, I have not yet had a recurrence, but have had RT. But I think it was clear something was going on, so best I got it done.

Sounds like 9 weeks post RT is too soon to get a drop showing, is that what I'm inferring? I must say, others on here have been told to wait 6 months before a first test post RT...one or two PC UK nurses also thought it was a bit early...

Thanks

david

I agree with you. My oncologist recommended follow up RT when my PSA reached 0.087. Obviously she had the histology following the RP. According to google and this site I had not had a recuurance but I certainly was not going to go against her advice

Bri

I'm just worried that the excellent drop to 0.03 has now been followed 3 months later by this 0.05. I can't help feeling that it should have gone down, if cells are still dying, rather than up. Why should it fluctuate up, if the RT is still working? I can't help feeling there's a bit it missed. But maybe I'm still in shock, and this test is too sensitive, as you have implied.

David

Yes I think you are going to continue torturing yourself whatever any of us say. You were advised to have nerve sparing on only one side but you went against that advice and chose a surgeon who saved both sides. In the event, it seems the previous specialists may have been correct and I imagine that your oncologist took that into consideration when designing your RT, to ensure that the nerve bundles at that side were well and truly zapped. That being the case, you are trying to read something into tiny fluctuations in a PSA level which is similar to an average woman that has just had an orgasm. There is a possibility that you have had unnecessary salvage treatment based on a flawed test but you will never know for sure.

I can say the same things that I have said before but I don't think it will help you if you have decided to see the worst possible interpretation:
- scientists have shown that if you put the same blood sample in the same machine twice, the result can vary by as much as 0.04
- the testing equipment is calibrated at least every 6 months which can affect results and therefore how you interpret PSA trends
- a variation of 2 hundredths is tiny and could simply be down to a bit more adrenaline (perhaps due to anxiety?) at the most recent test
- sometimes dying cancer cells produce extra PSA which is why the PSA test at 18 months post RT is considered to be the important one

On holiday in Malta for a few days, nice but of course but guess what is in my head all the time!
Maybe hypnosis would help....

I know the official line of undetectable is 0.1 but of course the point of the sensitive test is to detect anything actually present below that. Actually my RT consultant said that, unlike surgery, RT usually does not take psa down to their lowest possible reading - <0.02. And he said they don't know why that is the case, but it may just settle somewhere a bit higher than that....0.0 something.....?

Unless you have made a mistake typing in the results, it seems that you are now detectable and will need to decide with your onco at what point you start hormones again. Some onco say to wait until it gets to 5 or 10 - Bri’s onco likes to wait until it gets to 20 and my dad has decided to wait until at least 10 and then think again at that point.

Not what you were hoping for but the fact that it goes up and down suggests it isn’t particularly aggressive.

Just check that you haven’t missed a 0 out of each result though.

Hi following salvage therapy in AUG 16  my first two PSA test.  in JAN  17 and JULY 17 where undetectable <0.1. Then a rise in DEC  17 too  0.1 and feb 18 again 0.1 very disappointed I saw the urologist who said it looks like salvage therapy may not have  been successful. I have been advised that it may take many years before further treatment is required saying that a PSA of 20 would be the indicator for HT etc. Now advised to continue PSA tests every 3 months with the doubling time being an important factor to watch for. I have tried to defeat this beast and I am trying to stay positive for the future. When I see other men on this site bravely facing much worse diagnosis I still consider myself fortunate. I hope this post helps  Andrew

That makes more sense.

A PSA of 0.11 is detectable though so there is no point continuing with the ultra sensitive tests. John was 0.11 at one point last year and although it has dropped back to <0.1 we have accepted that SRT didn’t eradicate it completely and HT will be needed at some point in the future.