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What should PSA be 6 months after radiation?

Median PSA at 6 months was 0.1 ng/ml (range, 0-19), and 397 patients (74.6%) had a 6 month PSA ≤ 0.1 ng/ml. Patients with PSA > 0.1 ng/ml had worse bRFS, DMFS, and PCSM compared to PSA ≤ 0.1 ng/ml (see Table).

redjournal.org - Post-Treatment PSA 6 Months After Radiation and Androgen ...

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Materials/Methods We reviewed an IRB-approved, prospectively maintained database of prostate cancer patients treated at a single institution. We identified 532 intermediate- and high-risk patients treated with definitive radiation therapy and concurrent ADT from 1996 to 2012 who had at least 3 PSAs after EBRT including a PSA value 6 months after EBRT. All patients received either 3D conformal RT or intensity modulated RT to a dose of either 78 Gy in 39 fractions or 70 Gy in 28 fractions. Kaplan-Meier analysis was used to estimate bRFS and DMFS, and cumulative incidence was used to estimate PCSM. Results The median follow-up was 7.5 years (range, 1-16.25). Median initial PSA was 13.0 ng/ml (range, 0.37-255) and the median duration of ADT was 6 months (range, 1-78). Median PSA at 6 months was 0.1 ng/ml (range, 0-19), and 397 patients (74.6%) had a 6 month PSA ≤ 0.1 ng/ml. Patients with PSA > 0.1 ng/ml had worse bRFS, DMFS, and PCSM compared to PSA ≤ 0.1 ng/ml (see Table). Multivariate analysis (MVA) confirmed that a post-EBRT 6 month PSA of > 0.1 ng/ml was an independent predictor of bRFS (HR = 2.518, p < 0.0001), DMFS (HR = 3.743, p < 0.0001), and PCSM (HR = 5.435, p < 0.0001). In the MVA’s, Gleason 8-10 and T stage also correlated with a worse bRFS (p < 0.05), and Gleason 8-10 correlated with a worse DMFS and PCSM (p < 0.05). Conclusions Oral Scientific Abstract 344; Table 5and 10 Year bRFS, DMFS and PCSM Stratified by PSA 6 Months Post-Treatment (6m PSA) 6 m PSA ≤ 0.1 6 m PSA > 0.1 p value bRFS 5 Year 82.2% 64.1% p < 0.0001 10 Year 63.2% 45.1% DMFS 5 Year 92.1% 81.4% p < 0.0001 10 Year 82.8% 66.3% PCSM 5 Year 3.4% 9.4% p < 0.0001 10 Year 6.0% 20.2% A PSA value of > 0.1 ng/ml taken 6 months after completion of EBRT with concurrent ADT is predictive of worse bRFS, DMFS, and PCSM. The 6 month PSA value after combined modality therapy may help identify patients who are at higher risk for disease progression, and for whom early salvage treatment may be considered to improve clinical outcomes. Article info Publication history Footnotes Author Disclosure: M. Naik: None. C.A. Reddy: None. K.L. Stephans: None. R.D. Tendulkar: None. Identification DOI: https://doi.org/10.1016/j.ijrobp.2014.05.638 Copyright © 2014 Published by Elsevier Inc. ScienceDirect Access this article on ScienceDirect

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Can you have an erection after prostatectomy?

mountsinai.org - Sex After Robotic Prostate Surgery | Mount Sinai - New York

Most men who have normal sexual function and receive treatment for early prostate cancer regain erectile function and can have satisfying sex lives after robotic prostatectomy. However, it is a gradual process and may take up to a year. Very few of our patients experience erectile dysfunction, but we work closely with those who do. Penile rehabilitation can help you resume sexual functioning. Studies show that going for too long without blood flow to the penis can damage the muscle and tissue, which can affect your ability to have erections on your own. The goal of penile rehabilitation is to keep the penile tissue and muscles oxygenated and stretched to preserve erectile function while the nerves in the penis fully recover. We encourage our patients to start working on penile rehabilitation even before surgery. Pre-operative visits could include early evaluation, penile Doppler studies (a test of blood flow into and out of the penis), and testosterone level estimations, if our experts feel that your particular case could benefit from these evaluations. Occasionally, we start penile rehabilitation using medications a few weeks before surgery in order to enhance the blood supply to the penis and “jump start” sexual rehabilitation. Post-operative rehabilitation usually starts a few weeks later and may include the following treatment options to maximize your chances of recovery.