Yeah, this month’s post is late. I was really struggling to come up with something to write about to hit my normal publish-on-the-11th-of-the-month date, and then I remembered that it’s been two years since my salvage radiation therapy ended on 26 August 2022.
So here’s a quick update on how things are going post-radiation.
Impact on PSA
Of course, the biggest and most disappointing thing is that the radiation didn’t do what it was supposed to do, and my PSA dipped for a bit and then continued to rise to a level higher than when we started the SRT (0.52 ng/mL vs 0.37 ng/mL).
I’ll take my next PSA test in October, and we’ll see if another PSMA PET scan is in order to determine the location of any hotspots. If it’s identified, we’ll look at whether additional spot radiation is needed/desired, or if we consider starting androgen deprivation therapy. More to come.
Side Effects
For the most part, I believe that the side effects two years out from the SRT have been relatively minor.
Urinary Issues
I’m not sure if the radiation really impacted my urinary issues much at all. If anything, I have a slight increase in stress incontinence and sometimes a slight increase in urgency.
Frequency, on the other hand, seems to be all over the place. Some days, I go multiple hours without needing to urinate; other days—especially at night, unfortunately—I’m running to the toilet about once an hour. That can be quite annoying and have quite the impact on my sleep. It’s not every night, thankfully, but enough to have noticed a change.
Bowel Issues
A few months ago, I talked about how my bowel patterns had changed from a once-a-day movement to three to five movements a day. Thankfully, that has calmed down, too. I’m back to one or two trips a day now, and that’s a good improvement. Hopefully, it stays that way (or gets better).
Summary
The radiation failed to do what it was supposed to do and, thankfully, the cost of that failure in terms of long-term side effects caused by the radiation seems to be relatively low so far.
I have an appointment with my primary care physician on 4 November and one with the urologist on 14 November, so I’ll get another PSA test done the last week of October in advance of those appointments.
Be well!
Header image: Sunset at Imperial Beach Pier, Imperial Beach, California
Dan's Journey through Prostate Cancer 
Hi Dan, thank you for your update. I have found that a daily capsule of Tamsulosin taken at 3pm improved my urination. I had symptoms of frequent Nocturia and had a dynamic test of urination in the local hospital Urology department which showed that I was retaining urine in my bladder after urinating. This was shown by having an ultrasound scan of my bladder after I thought I had emptied it. I went to urology to learn how to self catheterise to empty my bladder fully. It had the positive effect of proving to myself beyond any doubt that my bladder was not emptying well – it could sometimes retain as much as 300 mls of urine after I had pee’d. It had the disastrous effect of giving me a UTI – urinary tract infection – within days of starting self catheterisation. The fact that my bladder was only working in a limited range of it’s true capacity explained to me how it was feeling full after a short period of time during the night. The UTI was such that I ceased doing that and have no plans to resume. The knowledge of what was happening means that I now try to double pee or triple pee. By that I mean that I pee, it seems to have ended I then try again and if successful I try again. I also measure my pee using a graduated container and weigh it and record it just before I go to bed and every time I wake up during the night. Recording what is happening gives me an external feedback loop. This has improved my understanding and I now generally only have to get up once during the night which is a great improvement for me. We are all individual and different so my experiences may not translate over to you but I thought I would share it with you.
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Hey Charles, thanks for sharing your experience. For the most part, I’m getting up once or twice during the night, but maybe once every 7-10 days, it’s 3 to 5 times in a night which is more than a nuisance.
I really try to watch my fluid intake after about 8 p.m. to give myself a better chance of success through the night, and that generally works. It’s a nuisance at this point, but if it worsens, I’ll speak to my doctor about it.
All the best,
Dan
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at what level were you able to have Pima I am in same situation 5years out from salvage but psa fluctuating from 0.03to 0.09 my oncologist Sid to early
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Hi Jack,
My first PSMA PET scan was at 0.22 and my second was at 0.37. Both scans were inconclusive at those levels.
For the first one, neither my insurance nor the VA would pay for it, so I paid $3,300 myself to have it done at UCLA.
By the time I needed my second scan, the VA was certified to do them, so I had it done there.
PSMA PET scans only have a 30%-40% success rate with a PSA <0.5, and about a 90% success rate with a PSA at 1.0.
Hope that helps.
Good luck to you.
Dan
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