How PSA Responds to #ProstateCancer Treatment | #MarkScholzMD #AlexScholz #PCRI

I was diagnosed with prostate cancer in 1993. My PSA was around 300 - cancer spread to every part of my body and given 6 months to live. 300 years later I’m still here❤on Lupron/elegard the entire 30 years. No sign of cancer. OSA started creeping the last few years to a recent 3.3. Began Nubeqa 2 months ago. Psa today down to 0.5. Very happy with results.

PCRI videos are extremely helpful in understanding the issues, the choices, and in navigating the cross-currents of competing interests. Thank you for empowering us.

I'm 69 years old and I am currently in the middle of being treated for prostate cancer. Initially, my PSA was 9.88 as measured through a routine blood test. Of course, that led to me having a prostate biopsy. 14 of the 16 biopsy cores showed various low levels of cancer. My risk factor was put at "intermediate". So, I chose NOT to have surgery. Instead, I went through 4 weeks of daily radiation and received testosterone blocking shots. My most recent PSA reading is now 0.038. In 3 more months my hormone treatments will be complete and my doctor says my PSA will probably be zero. Then, going forward, my PSA will be monitored to ensure it does not start creeping up.

Thank you so much for your videos! I learn great information about my husband's prostate cancer!!

@2:00 My PSA only went to 0.3 so my radiotherapist increased the intensity of my androgen suppression and got it to 0.1. They did delay radiation until the PSA got lower. I did have Gleason Scores of 9 so that fits in with what the doctor was saying. My PSA took 3+ years to get to 0.2 ng/ml. Turns out that longer intervals to nadir are actually favorable, which was a surprise to me. I would have preferred a lower nadir, but I'm now six years out and my PSA is low and stable. This is great information. I give this compliment from the perspective of a physician who has studied this problem extensively.

I just had two firmagon injections this week. I learned a lot from this video. Thank you, Dr. Scholz!🙏

This is my favorite site, thank you Alex and Dr. Scholz, da' best

Never miss a discussion with Alex and Doc Scholz! Such valuable info. Love from South Africa 🇿🇦

Thank you all for this channel. My husband and I have been watching your educational videos since he was diagnosed in July 2019. I have always researched everything you all have discussed. Went to his oncologist and discussed all the different treatments he could receive. Even through his case was extremely different from most other men he had a first psa of 356 at the age of 45. We were told his cancer was already an aggressive advanced stage of 4 and a Gleason score of 8 and 9. His fight against prostate cancer ended this past Saturday. He fought until the very end. Even though it’s very hard to stay positive that how he kept going. Thank you all again. 🙏🏻💙🙏🏻

Thanks for posting . Very informative

In August 2007 I got a private health check and my PSA was 5.64. Early this year 2023 I went ot the doctor for frequent visits to the toilet during the night and the doctor took a blood sample for a PSA test which was foun to be over 10 at 11.5. So my PSA went from 5.64 to 11.5 over a period of 15 to 16 years during which I have been very healthy other than the frequent visits to the toilet during the night for a wee. Anyway this was followed up from early this year ...scans, biopsy etc to find that I have Gleeson 4/3 and now I am on Hormone therapy for 6 months during which I will receive radiation therapy over 3 weeks. My testostorone level is going down and I feel aged, body sweats and fatigued. I read that my PSA should come down to near zero after Ratiation Therapy, but if it goes up slightly, I could be back to square one as it indictes that the cancer could still be present. Is there no escape for this nightmare?

Very useful video. I am seven months post external beam irradiation and need a PSA next month! We will see.

I really appreciate these videos. You have helped me immensely on my PCA journey. It would be helpful to do a video on BPH and PCA. I have Gleason 3+4 tumor in the peripheral zone and a 80cc prostate. This limited my options for certain focal therapies. Brachy therapy has a limit of 60cc. HIFU and TULSA can depend on the location of the cancer. FLA seems to have the fewest limitations in this regard. Thank you for your information you provide.

I completed MRI-linac radiation treatment (Viewray) in October. My 3 month PSA went from 7.7 to 4.3. Dr. Perloe had this treatment and now he is one of your patients. My treatment schedule was altered to one day on, 4 days off, then 3 straight days on, then one day off, then the final treatment, so 5 total treatments. This is not the usual every other day and I wonder if Dr. Scholz has any comment about this schedule as I cannot find any information on anything but the soc for this treatment but was told it is safe. My genetic profile is intermediate risk so no ADT at this time. Thanks Jim

Such a fantastic site, Alex and Mark you have helped me so much over the last year with my Cancer. I do have one question which is after a year of hormone and proton treatment. Now with PSA of < 0.01. I have stopped the hormone tablets, will the PSA rise again regards English Gent ..

Thanks for these videos. Very informative and will inform my next weeks' discussion with my hormone therapy oncology team. Diagnosed in May, Gleason 10, T3b (yes, I'm one of those unicorns - not how I imagined this to be a competitive sport). Coming to the end of six weeks radiation, I see the PSA 'pop' that happens during radiation, I am on three week PSA tests, last one was 0.66, the one before 0.48. I started at 60 in April. My insurance, with all this urgency coming from my oncology team, refused to pay for PSMA PET scan, so we did it the 'old fashioned way'. Working the plan here, will report back somewhere, when some more developments occur, if they are interesting.

My husband has T3 PSA 19.5 two tumours one in each lobe mri gradex 5 and 4. After 4.5 month of hormone therapy prostap hus PSA was 3.2. Should it have been lower. He then had one month radiation therapy, after 6 weeks history PSA Was 1.6. We are seeing oncologist in a coupe of weeks for 12 week post radiation PSA. What questions should I ask because after seeing your video his PSA doesn't seeing low enough post treatment. Thank you. Your videos are so helpful and really clear.

Very informative, as usual. I do have one suggestion/request, though. In this and many of your other videos, you omit discussion about what may happen in a salvage therapy scenario. I had a radical prostatectomy and saw first signs of biochemical recurrence about 5 years after surgery. I had salvage radiation therapy (SRT) with concurrent androgen deprivation therapy that was started two months before the radiation (ADT; single six-month dose of Eligard). My radiation oncologist told me that it would be a minimum of 12-18 months before we saw the true results of the radiation, and that aligns with what Dr. Scholz presented in this video. But where things get fuzzy for me is when you have multiple treatments that impact PSA simultaneously and can do so in opposing ways. For example, as the ADT wears off, it would make sense that the PSA would start to increase again. But the effects of the radiation will begin to kick in and slowly drive the PSA downward. I'm guessing that that may actually show a small, short-duration increase / bump in PSA again that I shouldn't overreact to. For specifics, I was given the six-month Eligard dose 10 months ago on 3 May 2022, and the SRT ran 7 July - 26 August 2022. Three months after the completion of the SRT and seven months after receiving the ADT, my PSA on 1 November 2022 was 0.05 ng/mL. Of course, we attributed that PSA to the ADT and not the SRT at that point. I have no idea where to set my expectations for my next PSA test coming up this month. As long as it's considerably lower than when I started ADT/SRT, I guess I'll be happy.

3 months after my Cyberknife treatment (with no other hormonal treatment) my PSA has dropped from 45 to 4.1. Hardly any trace of the cancer (was Gleason 3+4) is visible in my PSMA PET scan and MRI scan. Absolutely no side effects so far. I have become a strong votary of the Cyberknife treatment (though it is very important to identify a good doctor with an excellent track record on Cyberknife).

Great info!