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fluctuating psa
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fluctuating psa

I am not taking hormones or diatry suppliments now, I was on hormones for 6 months 2004 to 2005 could this still be in my system?

DO you think there is a benefit to radiation at this time for me with a psa<0.04?
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A PSA rising after surgery could be an indication that the disease has spread. A recent Cleveland Clinic study (Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy.  J Clin Oncol. 2007 May 20;25(15):2035-41.) Showed that half of their cohort responded salvage Radiotherapy at the earliest signs of recurrence. Furthermore, in the Catalona study (Salvage radiation therapy for prostate specific antigen progression following radical prostatectomy: 10-year outcome estimates. J Urol. 2005 Oct;174(4 Pt 1):1282-6.) At 10 years, the estimate is for progression free survival is 25%. Finally, a recent Johns Hopkins study indicated that men who had a preoperative PSA doubling time of 6 months or less benefited from salvage radiotherapy if it was administered within two years of initial treatment (Prostate cancer-specific survival following salvage radiotherapy vs observation in men with biochemical recurrence after radical prostatectomy.  JAMA. 2008 Jun 18;299(23):2760-9.).

A reading of the literature would suggest that a PSA response would be expected after radiotherapy in the salvage environment.

Thank you for your question. Best of luck.

Sincerely,

Ashutosh (Ash) K. Tewari, MD
www.cornellroboticprostate.org

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