Four Years Post Treatment Yesterday I visited my urologist for my 6 month checkup, digital exam, and PSA test. It has been four years since I was diagnosed with prostate cancer and went to Loma Linda University Medical Center for proton radiation treatment. I know that I have had at least 20 PSA tests since my treatment. I was disappointed at first that my PSA wasn’t lower. It was 1.56 just 6 months after treatment. I expected it to be less that 1.00, maybe even less than .20. After a lot of research, I “discovered” that after radiation treatment, it may take 2-4 years for your PSA to reach the “nadir” or the lowest point. I then began to look forward to successive PSAs and to plot them to track the trend of my PSA. The trend has continued to be “down” now for these four years. My PSA yesterday was .45. I am extremely pleased. This is an example of how each person’s PSA is different and you cannot compare yourself to others. You need to keep records, track your PSA, find out what YOUR “standard” is. Your PSA is not an absolute measurement, it is peculiar to you. Six months ago, my PSA was 0.42. Yesterday it was 0.45. Am I concerned? No. Yesterday the doctor did a digital exam BEFORE the PSA test. In addition, he had an intern that did a digital exam. The literature says that a digital exam, sexual activity, and maybe activities such as bicycle riding can cause a temporary rise in your PSA. (A study demonstrated that running a marathon DID NOT cause a rise in the PSA that was statistically measurable.) I am sure that if I had not had two digital exams prior to the PSA test my number would be as low or lower than the previous number. You also have to take into consideration the accuracy of the equipment, when it was last checked against a standard, etc. I am sure that 0.42 and 0.45 are within the limits of testing accuracy, all things considered. For additional information on PSA, nadir, PSA accuracy, check my previous entries.