It has been a year since I have gotten my radiation seeds put in. At the 6 month ck up my psa was down to 0.94 now a year later it is at 1.01 is that something to be worried about? My Oncologist is on vacation, so I saw a fill-in doctor and is having me go back in two months for a retest – should I be worried about this or is this somewhat normal?
It could just be a normal psa variation; psa can vary about 20% on a daily basis. It could also be psa bounce, which is normal at 1 to 2 years. The signal for a biochemical reoccurrance is three successive rises in psa over a period of time. Many patients who have been seeded have psa that fluctuates, but over time if the trend is stable or down then you have nothing to worry about.
All Radio Therapy Modalities have PSA bounces 0-24 months post therapy. Your PSA bounce of 0.07 ng/mL is nothing to worry about. Do a search for PSA bounce. Keep checking your PSA. I have mine checked every three months.
Just read something that may help. When Dr Scholz monitors radiation reoccurrance he takes a psa test monthly. If it is up and down for a few months it is bounce. If it consistantly trends upward it is a reoccurrance.
PSA bounce has many factors, patient age, younger tend to have higher bounces, lower RT dose tends to have higher bounces, Brachytherapy (seeds) tends to have higher bounces than IMRT. What is a bounce and what is recurrence, is the million dollar question. The definition of recurrence changes with information. Tricky question as the definition changes with new information for various treatments. It takes years to develop and analyze the data, in the mean time the dose is increasing and planning more focused. Testing our PSA every month is of little value unless there was a large increase of 1.4 to 2 ng/mL or more. Changes of 0.4 ng/mL are typical and not considered a failure unless the PSA continues to increase over 6-9 months. I am in a clinical trial (CyberKnife) where the PSA is checked every 3 months. There are many publications on pubmd about PSA bounce and radiation.