Psa Rising After Brachytherapy

I was diagnosed with prostate cancer 2 years ago (psa 7.4, gleason 7,     2Tb). I choose to be treated with 6 months of Lupron, 5 weeks of whole pelvic external beam radiation with a brachytherapy boost.  10 months after the brachytherapy my psa was .15 then every 3 months since it has elevated .37, .58, .73. 1.47.  My general doctor thinks I should start Lupron treatments to keep it under 2.  My radiation oncologists assures me this is just a typical jump that 37% of brachy patients experience. He believes the psa will eventually come down but sometimes it takes 2 years or more. He also believes it would be foolish to begin hormone treatments with psa so low.  Are there other survivors who have experienced similar rises after brachytherapy? What was your experience?

Crafty:

I am so sorry to hear of your results. You had the radiation treatment for  men with medium to high risk prostate cancer and it appears to have been unsuccessful. The radiologist may be referring to the "bounce" that some radiation patients experience, usually 6-18 months post treatment. Somewhere around a quarter of successfully treated patients see a nadir in their psa measurements and then a slow rise for a time followed by a final settling to a low number, preferably below 1.0. A serial rise over a year, as you describe, is outside the definition of "bounce" though it cannot be discounted. Another treatment option should be considered. One way to determine your course is to have a biopsy of the prostate
gland, similar to before treatment. This will tell your doctors if
there is active growing cancer in the area available for biopsy. If so,
then you may consider surgery to remove the gland if it is considered
surgically possible to eradicate your cancer. This is a sensitive and
difficult operation and must be done by only the best surgeons.

There are clinical trials for men with rising psa prior to hormone treatments and you may qualify for one or more of them. If you consider such a decision then time is of the essence with a doubling time currently of three months if I read your post correctly. 

Your GP is concerned with the psa getting away from you and his trigger of 2.0 is reasonable from his viewpoint. Consulting a medical oncologist would be an excellent idea, preferably one with experience in prostate cancer. Your radiologist, urologist and GP are essentially out of the picture at this point from a treatment standpoint, They diagnosed, treated and monitored your condition and may now be superseded by one with more experience in dealing with what may be a chronic condition. Certainly so since you have conflicting opinions from your current treatment professionals.

Please keep us posted. 

Thank you for your response. My Radiation Oncologist is one of the best in the country. However, I like hearing from other patients who have experienced similar numbers.  I appreciate you taking the time to express your opinion on my situation. I want to believe things will get better but I  just don't believe the trend is in my favor.  I am going in for a bone scan and a chest x-ray and then in 5 weeks another psa test.  If there are any other survivors who have had a similar situation, I would like to hear from you. Thanks.