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my first PSA result, 3 months following my radiation treatments was 0.02 on the border of being non-existent… they use < 0.02 to denote undetectable. Even my oncologist was surprised at the sudden drop, as usually it takes about 6 months to see significant decreases in the PSA levels. So, a very positive result – in terms of my disease.
however, unfortunately, it wasn't the only result…
to explain a couple of the issues, you sort of need to understand how standard external beam radiation works. I'm not going into detail – you can use Google for that – but the principle in its simplest terms, is to focus a photon beam or a series of photon beams to a point in your body that is the target – typically a tumour or an area suspected of being cancerous. The problem is that this radiation has to pass through all the exterior mass of skin, fat, muscle (including organs) and bone to finally pinpoint on the target and exit out the other side. True the unfocused portion of the radiation isn't as intense, but it's still radiation and the closer it comes to the target the more focused and more potent it is. In other words a lot of other stuff is getting zapped in the process!
In my case, the beam(s) were targeting the prostate bed (area surrounding where the prostate used to be) and the line of site apparently started on my right buttock and went through from there. At the point it entered it was about 7 cm (2.8 in) in diameter – quite clearly identified by the lovely sunburned circle on my cheek, which after a few months darkened to a roasted walnut colour and eventually after a few years disappeared. While this "target" on my butt was a source of great amusement to my family it didn't (to the best of my knowledge) create any lasting damage.
however… also standing directly in the path of the radiation, and a lot closer to the target, was my sigmoid colon and rectum and "toasting" such a sensitive and mucosal part of the anatomy with a much more concentrated beam did not make for a comfortable result. Ten years later it's still a raw patch easily detected during my biennial colonoscopies, and frequently causing bleeding, which should normally be very alarming – unless you know for sure what's causing it – which I do.
I'm sure there was considerable additional collateral damage, none of which I have as yet become aware – although it may exact a price in the future. But, the overriding result being keeping my PSA readings at levels that didn't worry my oncologist again – until… tomorrow…