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-   -   How much should PSA drop after 6 months radiation seed implant? (http://www.healthboards.com/boards/cancer-prostate/760961-how-much-should-psa-drop-after-6-months-radiation-seed-implant.html)

rdog 07-29-2010 04:11 PM

How much should PSA drop after 6 months radiation seed implant?
 
I just got results from 6 month blood test after having radiation "seeds" implanted. I started with 6.4 PSA and am down only to 5.7. I'm 54. Anyone else have this experience?

kcon 07-30-2010 07:18 AM

Re: How much should PSA drop after 6 months radiation seed implant?
 
Hi rdog, and welcome to this site.

I did not have brachytherapy, so cannot add first-hand knowledge...hopefully some others who frequent this site will add first-hand knowledge later.

To your question "[I]How much should PSA drop after 6 months radiation seed implant?[/I]"...

What I do understand is that after radiation, either seeds, (brachytherapy), or external beam or cryotherapy the PSA will drop slowly, frequently reaching its nadir (low point) [U]after several years[/U]. Also, it is not uncommon to see a "bounce" in the first several years lasting several months, and then continuing to decline. Eventually, PSA levels should drop below 1.0 ng/mL and stay there.

After brachytherapy, an evenutal PSA nadir under 1.0 ng/mL is the goal according to [I]Brachytherapy Made Complicated[/I], the textbook by Drs. Wallner, Blasko, and Dattoli.

Your drop after 6-months is a little less than what I've seen among other brachytherapy patients after tha much time. What is your doctor saying?



----------------------------
added later as an edit...

Read this online at a Brachytherapy treatment center site:
[INDENT][B]PSA Response to Brachytherapy[/B]

The PSA response to prostate brachytherapy may be more complicated to interpret than after other forms of prostate cancer treatment. The usual PSA response includes a steep drop in the PSA level during the first 3 – 6 months, followed by a more gradual reduction, which may evolve slowly over a number of years. Eventually, most brachytherapy patients see their PSA nadir in the 0.0 – 0.2 ng/ml range, though this may take 5 years or more to fully develop. Too, some patients will never see their PSA drop to a level this low, and yet still be apparently cured of their disease. Rarely, unfortunately, patients will develop a persistently rising PSA after the treatment. If a patient develops a persistently rising PSA after the brachytherapy procedure, this may be diagnosed as “Biochemical failure of their disease.” If this happens, the following tests, care and recommendations will vary, depending upon the exact patient situation.

[/INDENT]

PopsTx 06-07-2012 07:05 AM

Re: How much should PSA drop after 6 months radiation seed implant?
 
What is your PSA now (6-2012)? I had the seed implants in 2-2011 & I have not had the typical rapid drop. In fact after 14 months my PSA has only dropped from 6.5 to 4.5 & seems to be leveling off. My radiation oncologist who has done over 600 implants says he has never seen this. The docs who trained him say that they have seen it in a very small % of patients & they expect it to eventually come down. They would not/could not provide me with any data on their PSA decilne rate expectations. I was a gleason 6 w/ 1 of 12 biopsy samples showing 5% cancer cells.

Can't help but wonder if the seeds I received were bad.

Johnt1 06-07-2012 09:39 AM

Re: How much should PSA drop after 6 months radiation seed implant?
 
Your intitial Dx of 1 core at 5% indicates a very small amount of cancer and that most of your psa was coming from your prostate and not the cancer. You still have an intact prostate which is throwing off psa. Your psa is high, and unusual, but it may be your natural psa level and not related to any cancer.
JohnT

PopsTx 06-07-2012 11:20 AM

Re: How much should PSA drop after 6 months radiation seed implant?
 
Tks. That is an interesting thought. If an implant patient's PSA may only drop to their prostate's base level (excluding PSA from cancer), why do most seed implant patients see a fairly rapid drop in PSA to less than 1 in 6-12 months? Help me understand.

Johnt1 06-07-2012 05:02 PM

Re: How much should PSA drop after 6 months radiation seed implant?
 
Pops,
I don't have an answer for you, except that individuals react differently. My psa dropped from 40 to .1 within 3 months after implants. This was an unusual reaction in the opposite direction. After radiation a prostate will still generate some psa.


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