Why does PSA increase after salvage radiation treatment?

tabby2 · New User Joined: 26 Oct 2007 Posts: 7

I had a prostectomy 8 years ago. Recently a palpable tumor could be felt upon DRE. I had IMRT of the prostate bed and now my PSA is rising. I was given the standard answer that PSA always increases for several months after radiation. This does not pass the sanity test in my mind. If I have no prostate, what is causing the PSA to rise? I was also told that the inflamation caused by radiation increases PSA. If I have an inflamed elbow my PSA does not increase! The adjacent bladder and rectum, if inflamed, do not produce PSA. My understanding is that the body produces PSA when tumor volume increases--even for metastatic tumors. Midway through my radiation treatment my PSA DECREASED, which to me signified a reduction in volume. Why would it get larger after treatment? Radiation does not kill cancer cells but it does prevent them from reproducing. Does this mean that a tumor will grow some before it dies off? Note: MRI, CT, and bone scan were normal in my case.
Has anyone experience the forecasted decrease in PSA after several months?

brainman

tabby2, good question for which I do not have an answer. Has your PSA been checked again? There is always a possibility of a false positive PSA result. Also, from what I have heard, there is a small amount of PSA produced be other glands. How high is your PSA? Free PSA?

Hopefully, someone with better information will reply.
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chas036

Tabby2 I am curious about what the pathology report said after you had your prostate removed? Did it say that you had negative margins and no cancer found outside the prostate?
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tabby2 · New User Joined: 26 Oct 2007 Posts: 7

Chas036; Yep, told me my margins were negative. Also took out one nerve bundle. I guess once the disease leaves the prostate it is hard to see, measure, detect, and remove. All it takes is a microscopic cell or two. In hindsight, that is why staging is so important before making a decision on treatment.

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