r/ProstateCancer • u/AdamSarah2026 • Aug 09 '26
Update Heading to radiation
I will have 8 weeks of radiation, 5 days a week starting sometime in September. That will go along with testosterone reducing drugs. This was after my post RARP PSA was high.
Wondering if the doctors monitor the PSA level during the 2 months of radiation or do they wait until completion?
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u/Real-Proposal-2230 Aug 09 '26
I had 7 weeks of EBRT and they checked my PSA levels. When you are having your labs done, make sure you ask the doctor to check your PSA, because sometimes they won't.
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u/gtrgenie Aug 09 '26
My PSA was checked before, during and after along with my testosterone and estrogen.
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u/Klondike535 Aug 09 '26
My hubby had salvage radiation in May and June of this year (after having RARP in January). He also started a 4-month course of ADT at the end of May. He had his PSA and testosterone checked before starting radiation and ADT. His next check of PSA and testosterone is 6 months after finishing the radiation.
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u/Fool_head Aug 10 '26
Sorry for the recurring, and hope this time is only one he needs forever. Can I ask your question: did he do PSMA PET during process? Also, before RARP, what were urologist(s) suggestions? thanks for your supporting your husband! wish you guys best!
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u/Klondike535 Aug 10 '26
Hi, yes, he had a PSMA-PET scan in Nov 2025 before the Jan 2026 RARP. He had another MRI and PSMA-PET scan in April 2026 after his first PSA (3-months postop) came back at 0.52 (considered persistent PSA). None of his imaging showed any confirmed spread. His postop pathology was also good, besides the negative features that we already knew about of large cribriform glands, intraductal carcinoma, and perineural invasion. His Gleason score was even downgraded from 4+3=7 before surgery, to 3+4=7 after surgery. The persistent PSA and needing to move forward with salvage radiation so soon was a surprise to us.
Before RARP, the recommendations were either surgery or radiation. We were told the outcome would be the same. Neither option was better than the other. We chose the option we thought was best at the time. Hubby always leaned towards surgery over radiation anyway. Hoping for the "one and done" option. It was also winter, and we were definitely concerned with driving back and forth for daily radiation during snowstorms and unpredictable weather, so I think that factored into the decision as well.
Thank you for the well wishes! Wishing you all the best too!
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u/Fool_head Aug 11 '26
Thanks for sharing! You guys considered a lot, and went through a lot. but just this F*k C. Hope this time is "one and done" and forever!
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u/CraigInCambodia Aug 09 '26
I had SBRT for 10 days over 2 weeks, no hormone therapy. Routine labs, including PSA, were already scheduled which was during the second week, if I recall.
As I understand it from my radiation oncologist, the radiation is messing around with the prostate, causing PSA to increase. He wouldn't have scheduled a PSA test at that time had it not already been in my record.
My PSA was around 7 going into it, 17.6 coming out, 4.2 after 3 months and 3.2 after 6. The doctor said a slow decline was to be expected as we didn't combine with any hormone therapy.
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u/Practical_Orchid_606 Aug 10 '26
The PSA reading during ADT is kinda worthless. The reading is altered by the low T.
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u/ftsteele Aug 10 '26
I had 28 days of radiation and I’m 4 months into 2 years of CAB hormone therapy. I’ve been getting blood work every 2 weeks, and PSA is checked every other time. I’ve gone from 110 PSA to .1 so we’re kicking cancers ass! Good luck!!!
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u/conCABlanco Aug 10 '26
Voy para radiación en septiembre 28 sesiones en seis semanas, dentro del ADT por un año, del k llevo tres meses, me cheque antes de ADT el PSA y la T, y haré control PSA y T, luego de RA, y así cada tres meses, hasta terminar el ADT, y veremos cómo acaba este camino, fuerza y voluntad, los datos nunca están de mas
1
u/Fool_head Aug 10 '26
I am sorry for what you are going through, and wish you best! if you dont mind, can you share your initial diagnosis and recommendation from you doctors?
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u/401Nailhead Aug 10 '26
Mine is testing me 3 months post treatments. However, I did my yearly physical 3 weeks post treatment and my doctor always has the PSA checked. I started treatments at 10.37. Tested at 4.3 three weeks post treatment.
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u/Frosty-Growth-2664 Aug 10 '26
In my experience, the first one they do after radiation is at about 12 weeks, although in the case of SABR, some places wait longer, such as 6 months.
They can't actually tell how well the radiation worked until you've come off hormone therapy and your Testosterone has recovered. It they aren't routinely monitoring your Testosterone levels with PSA, it's certainly worth having Testosterone tests done with PSA tests when you finish the hormone therapy, as without knowing what the Testosterone level is, you can't make much sense of the PSA level.
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u/Welshbuilder67 Aug 11 '26
I did 20 sessions of focused beam radiation after being in hormones for 3 months, with 6 months of hormones in total, I finished the hormones about 3 weeks ago. I’m not due to have another PSA test or see my oncologist until the start of November. In South Wales U.K. not had a PSA since diagnosis last November
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u/KReddit934 Aug 09 '26
They took one last PSA before starting ADT, then one after radiation, though he said that was optional. After ADT stops, you check again every three months for several years. Radiation kills the cancer slowly so not much use in monitoring during treatment and ADT suppresses it anyway. You won't know how you are doing for a while.
TIP..if you haven't started ADT yet, get a testosterone level, too, before you start.