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Prostate Cancer Test 'Bounce' No Worry

Temporary Rise and Fall in PSA Levels After Radiation Does Not Affect Survival

Survival, Risk of Spread Not Affected

The researchers studied men who were treated with either external beam radiation therapy or radiation seed implants.

In external beam radiation therapy, a beam of high-dose radiation is aimed at the prostate to kill cancer cells.

In radiation seed implant therapy, or brachytherapy, surgeons implant tiny radioactive seeds into the prostate gland. The seeds deliver high-dose radiation directly to the prostate for a predetermined length of time.

Over the 10 years following treatment, 902 of the men in the study who were treated with external beam radiation therapy and 470 of the men given seed implants experienced a PSA bounce.

But the study showed no significant difference in success rates among patients who had a bounce and those who did not. Among its findings:

  • Of the men given external beam radiation therapy, 67.5% who had a bounce were alive at 10 years vs. 64.5% of those who did not have a bounce. Cancer recurrence was similar in both groups.
  • Of patients given seed implants, 66.3% who had a bounce were alive at 10 years vs. 62.5% of those who did not have a bounce. Again, cancer recurrence was comparable in the two groups.

The chance of cancer spreading elsewhere was also similar in both groups.

Horwitz says the reason men with the seed implants fared better is they tended to have earlier-stage cancer.

PSA Readings Every 3 Months

No one knows for sure why men treated with radiation experience a temporary rise and fall in PSA levels, but Cole says most doctors believe it's associated with the death of cancer cells.

"It's like when you throw water on a fire," he tells WebMD. "At times there may be a whole lot of smoke and you think the fire is getting worse. But eventually it calms down and the fire is out."

So what should you do if have a rise in your PSA level after radiation?

"You have to get a few readings over the next year," Horwitz says, adding that most doctors recommend screening every three months or so.

"But try to relax and realize that it's OK, that this happens, and that a bounce does not mean your cancer has recurred," he says.


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