At age 68 when my PSA rose from 3.7 to 4.1 within 6 months, I wasn't too worried because it was just a little over the high side for men my age and there had been no positive DRE or sign of enlarged prostate. After another 6 months, at age 69 in Jan 2012, I switched to a new primary care physician and he insisted on a biopsy and then with another test I found out my PSA had risen to 7.3. The biopsy results: 7 of 12 cores positive each with Gleason Score 7 (3 + 4) and % 100, 95, 80, 50, 50, 50, 20. The urologist said I could have either surgery or radiation therapy, but wouldn't make a recommendation. He made an appointment for me to see a radiation oncologist.
I got a feeling from the urologist that he wasn't anxious to perform surgery on me: perhaps because of my age or weight (270). The radiation oncologist did a DRE (something the urologist hadn't done) and noticed a small nodule. He said I was a stage 2 (I am not sure about the a, b, or c). He said I couldn't have seeds, but was a good candidate for IMRT. So I signed up for 42 sessions of IMRT which completed in June 2012 with no side affects.
One month after completion of IMRT: PSA was 4.1. Will do another test in 4 months.
PSA five months after IMRT treatment is 2.32. The radiation oncologist still felt a nodule with DRE but stated that it was getting smaller and that the treatment was working with my continued lowering of PSA; he said the PSA may continue to get lower for two years and another visit is scheduled in 6 months.
Had my one year follow-up exam with rad onc. Everything still OK. The only problem is that he still felt a small nodule. He didn't seem concerned, though, and said that this may be just scar tissue and may never go away.
My PSA continues to drop. It was down to .89 after 1.5 years since the IMRT. At age 71 now I noticed a little more ED but it works well enough to get the job done.
Two years after imrt, PSA is down to .55. RadOnc said it may not go any lower. Have a little ED, but some of that may be due to my age (71).
For my 3 year checkup, my PSA was down only slightly (from .46 to .44) and the radiation oncologist said I was bottoming out on that. Each year my ED gets a little worse and I use Cialis (I get generic from India) which solves the problem. My primary care physician suggested that I skip going to the radiation oncologist any more (as long as I am symptomless) and just get my PSA checked thru him with my semiannual bloodwork, so I will be doing that.
After 4-1/2 years, my PSA has bottomed out at around 0.5. I get it tested every 6 months during a routine checkup. I have no side-effects and everything still works, though the orgasms are mostly 'dry'.
In January (2017) my PSA jumped a little from .5 to .7. I just started using a different lab, so my pcp thought that there was no problem, but he had me get tested one month later to be sure. So the next month my PSA was 0.6 and it stayed at 0.6 for my next regular test in June. I still have no major side-effects after 5-1/2 years.
Jack's e-mail address is: jackdewe AT yahoo.com (replace "AT" with "@")