Guest guest Posted August 16, 2009 Report Share Posted August 16, 2009 , you are saying you did pursue a hormonal approach after 4 years and that it did have sig. side effects. Was it successful? This is different than SRT right? Thanks DougSubject: Re: Rise in PSATo: ProstateCancerSupport Date: Sunday, August 16, 2009, 1:16 PM The questions that should be asked of the urologist or radio-oncologist is if any additional primary treatment can be offered at that point. A move to hormone manipulation may not be the patient's immediate choice at that PSA level. I waited 4 years before I started, to minimise side effects. Best wishes RR Prostatectomy in 1996 - [ProstateCancerSupp ort] Rise in PSA I would like to withdraw some of my rebuttal on and 's post by saying, simply that much rise in PSA that they had would worry me, but I have no scientific knowledge to base my concern on and I tend to be anxious and a worrier as well as somewhat argumentative too. Thanks for the support. Doug No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2306 - Release Date: 08/16/09 06:09:00 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2009 Report Share Posted August 16, 2009 Doug A very brief history 1996 RRP Slow PSA rise to 9 2000 Double to 19 in 6 months 2000 start bicultamide (casodex) Down to 0.5 2002 PSA rising start Vaccine trial (kept in 2 to 10 range) 2004 PSA rising about 18 at end of trail - short trial on low dose cyclohexadine - regrowth found Oct 2004 on Zoledex and in 2005 Shaped Beam Radiation PSA falling up to 2008 then rising Added Low dose Diethylstilbesterol with clopidogrel as blood thinner 2009 PSA Hovering around 40 - just recently gone down [ProstateCancerSupp ort] Rise in PSA I would like to withdraw some of my rebuttal on and 's post by saying, simply that much rise in PSA that they had would worry me, but I have no scientific knowledge to base my concern on and I tend to be anxious and a worrier as well as somewhat argumentative too. Thanks for the support. Doug No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2306 - Release Date: 08/16/09 06:09:00 No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2306 - Release Date: 08/16/09 06:09:00 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2009 Report Share Posted August 16, 2009 , I am sorry to hear about that. Did the cancer get outside of your prostate? Otherwise I would have just had it cut out with all those high numbers. It looks like you have had alot of non-surgical regimens. Do those have significant side effects? Thanks Doug From: Metcalf <bryan.metcalf@ virgin.net>Subject: Re: [ProstateCancerSupp ort] Rise in PSATo: ProstateCancerSuppo rtyahoogroups (DOT) comDate: Sunday, August 16, 2009, 1:16 PM The questions that should be asked of the urologist or radio-oncologist is if any additional primary treatment can be offered at that point. A move to hormone manipulation may not be the patient's immediate choice at that PSA level. I waited 4 years before I started, to minimise side effects. Best wishes RR Prostatectomy in 1996 - [ProstateCancerSupp ort] Rise in PSA I would like to withdraw some of my rebuttal on and 's post by saying, simply that much rise in PSA that they had would worry me, but I have no scientific knowledge to base my concern on and I tend to be anxious and a worrier as well as somewhat argumentative too. Thanks for the support. Doug No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2306 - Release Date: 08/16/09 06:09:00 No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2306 - Release Date: 08/16/09 06:09:00 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 I had the op in 1996 but they found it was fibrous and close to the utethra thus causing inflammation. It was touch and go as to if they had got it all - they hadn't quite. The area was too inflamed to give follow up radiation, but hey ho, 13 years on I'm still about and working part time! Best wishes [ProstateCancerSupp ort] Rise in PSA I would like to withdraw some of my rebuttal on and 's post by saying, simply that much rise in PSA that they had would worry me, but I have no scientific knowledge to base my concern on and I tend to be anxious and a worrier as well as somewhat argumentative too. Thanks for the support. Doug No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2306 - Release Date: 08/16/09 06:09:00 No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2306 - Release Date: 08/16/09 06:09:00 No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.392 / Virus Database: 270.13.58/2309 - Release Date: 08/17/09 06:08:00 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 Doug and Rodger,Three rises of the PSA post treatment is consider to demonstrate a recurrence of prostate cancer. Although the numbers are very low you have not given information about the time period involved between each PSA test. We need to know this to better gain an understanding about the level of the aggressiveof the recurrence. There are salvage treatments available both post surgery and post radiation which can still bring a cure to the disease, but you need to start working now with an oncologist. Since we do not know your doubling time (because you did not supply dates of the PSA tests) it is impossible to know how quickly you need to respond, but respond you should. Hi Guys,After surgery 19 months ago my PSA was .05, the next .07, .09 and the latest in June this year .14. It has risen very slowly since surgery. I also was worried about the increase. My urologists comments are that is very low and not to worry about it. I believe we can make ourselves sick worrying about things. Doug, Canada unfortunately my last reading at family doctor was also .01. In other words although most PSA's were done at the hospital urologist, the previous one and another one about a year ago at the family doctor were the same as the hospital reading of .01. Thnaks for the support. I have an appointment on the 15 of Sept. with hosp. urologist and will get their PSA again. Doug Subject: Re: Rise in PSATo: ProstateCancerSupport Date: Sunday, August 16, 2009, 3:04 AM > > On my recent PSA the reading is .07. Normally it has been .01. I had surgery successfully in 12/03. I am concerned about this and probably can attribute it to my decision to go back on calcium. Nevertheless I would like advice on how I should proceed investigating this. I chose to have my family doctor's office do this last PSA so my urologist does not even know about it. Is there a test that would identify what is going on in the rise? Thanks Doug > Hi Doug, Just one point at this stage. Since you have had the most recent PSA result done through your local doctor, I am wondering whether the 0.01 and the 0.07 results weere conducted through the same laboratory. These results are very small and there can actually be a variation between labs on the same sample...I ask this because you state that one result was through your urologist and the other through your local doctor. If perfomed at different labs, I suggest you use the same lab as the earlier 0.01 result (since this was the earlier result). In Australia, results < 0.05 are simply stated as such and a result of 0.01 would not be recorded as such but would be reported as <0.05 Cheers, Chris -- T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.com - information and support about prostate cancer http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 > Alan, thanks for the info and support. I am very discouraged > with this. What are the typical side effects of this salvage > radiation? I hope I can get the doctor to agree with the once > a month checks. I already have an appointment with both > doctors, got the rad. oncologist this morning. Is that the > right oncologist? Meantime dropped calcium supplements, and > have bought some broccosprouts which are supposed to fight p. > cancer. Doug I had radiation of two types, but I had a prostate at the time and I don't know to what extent the side effects I had are similar to those for men whose prostates have been removed. You might be able to find some information on the YANA website from men who have been through this. And yes, I think a radiation oncologist is the right person to see. You don't necessarily want radiation until a recurrence is confirmed. Your rise to .07 might be a fluke and not a recurrence. But if it is a recurrence, radiation has the possibility (not the certainty) of curing it. Best of luck. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 > I sense the need for a reality check. Men without PCa can > often have a " normal " PSA reading of up to 4, without it being > a matter of concern. Right, but not after radical prostatectomy. I think there is general agreement that if the PSA goes above 0.2 after surgery, it's a recurrence. Another standard, used mainly with radiation patients, is three successive rises in PSA, three months apart. > ... The evidence simply does not exist to allow one to say that > a rise from 0.01 to 0.07 means anything at all. There is debate about this. IIRC, Steve Jordan quoted a study that showed that the ultra-sensitive tests are reliable and repeatable. I don't know who's right, but at least some experts argue that the ultra-sensitive tests do work and are useful for detecting recurrence when it has the best chance of being cured. However, I agree that we don't know if the rise to 0.07 is a recurrence or not. Hence we both agree that repeated PSA tests are desirable to find out if this is going anywhere. > My discussions with medical oncologists tell me that if the > numbers advance rapidly into whole numbers: PSA 1+, 2+ and so > on, then consider possible next steps, but PSA bounces or > wobbles at the sub PSA 1.0 level (and maybe higher than that) > probably mean nothing at all. If your primary treatment was radiation, then rises up to 1.0 and even beyond, especially in the first three years after treatment, may be okay. Even with radiation, rises above 1.0 after three years are, at best, problematic. With surgery however, 1.0 is too late. I read a study of salvage radiation that said the odds of success go way down above 1.0, are significantly better below 0.4, and are best below 0.2. Remember that we're talking about PSA after radical prostatectomy. The other sources of PSA besides prostate tissue are real, but very small and, in most men, undetectable even with ultra-sensitive tests. As I understand it, a PSA of 0.2, much less 1.0, definitely indicates the presence of prostate tissue. If the whole prostate was excised (something that may not be guaranteed by surgery), then the only source for that much PSA would be prostate tumor cells that grew after the surgery. > As usual, these are just the comments of a layman, an old time > mathematician, but laymen are sometimes better than experts at > viewing the big picture, plus they are guidelines by which I > judge my own future, so you'd better believe that I buy into > what I've just written! , If you've had surgery and your PSA is climbing, I think a consultation with a radiation oncologist is desirable. It may be that you have a recurrence but don't really need more treatment because it's slow growing and you're old enough not to worry about it. Or it may be that it's already become systemic, in which case radiation will be a waste of time and money and cause side effects for nothing. But it might be worth a consultation. It's a tough call. Much depends on age and the current aggressiveness of the cancer. If I remember correctly, the SEER statistics indicate that the great majority of men with an early (i.e. PSA based) diagnosis of PCa will be alive ten years after diagnosis. But the story changes significantly at 15 years and gets really bad at 20. That doesn't necessarily mean that all younger men should be treated. Some have especially slow growing cancers. Some may get treatment and then die anyway. Cancer is a tricky disease and both our knowledge of it and our treatments still leave a lot to be desired. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 Remember too folks that PSA rise can be due to infections. We have said before that one swallow doesn't make a summer and one PSA test is not a major thing. We are really interested in doubling time. There is some good reason to react within a few months of certain and sure need to consider salvage treatment. There is also an argument for not being too excited about small numbers that stay small. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 On August 17, Alan Meyer replied to , in pertinent part: (snip) > There is debate about this. IIRC, Steve Jordan quoted a study > that showed that the ultra-sensitive tests are reliable and > repeatable. I don't know who's right, but at least some > experts argue that the ultra-sensitive tests do work and are > useful for detecting recurrence when it has the best chance of > being cured. Here's an essay on PSA, including the utility of the ultrasensitive test: http://www.prostate-cancer.org/education/preclin/McDermed_Using_PSA_Intelligentl\ y2.html or http://tinyurl.com/kdp7c A clinical study: Strum S., et al.: " Intermittent androgen deprivation in prostate cancer patients: factors predictive of prolonged time off therapy. " (yes, it covers US PSA testing): " Hormone-naïve patients who achieve and maintain a UD-PSA (undetectable PSA) for at least one year during ADT may initiate IAD (intermittent androgen deprivation) and anticipate a prolonged off-phase duration. Attainment of a UD-PSA on ADT may serve as an in vivo sensitivity test of a patient's tumor cell population, and allow for better selection of those best suited for IAD. " See, www.pubmed.gov and search on ID # 10706649 (snip) > As I understand it, a PSA of 0.2, much less 1.0, definitely > indicates the presence of prostate tissue. If the whole > prostate was excised (something that may not be guaranteed by > surgery), then the only source for that much PSA would be > prostate tumor cells that grew after the surgery. Nit-picking: And those are PCa cells, not prostate tissue. Frex: I have a met at T-3 (third thoracic vertebra), rather primitive. It includes prostate *cancer* cells but is a long way from my groin. PCa cells might metastacize (sp?) anywhere. Regards, Steve J Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 > Remember too folks that PSA rise can be due to infections. Yes, when there is an intact prostate. After a radical prostatectomy there should be no prostate tissue left and no prostate infections. As far as I know, a man who has had a radical prostatectomy and who has a rising PSA, especially if it goes above 0.2, has prostate cancer. The surgery did not cure him. The cancer might never kill him, but it is definitely cancer. > We have said before that one swallow doesn't make a summer and > one PSA test is not a major thing. The test could be the result of an error. If the PSA is higher than before, but still very low, the patient should wait and see what the next test says. But if the test is above .2 or if a succession of tests shows a steady rise, it seems to me that it's time to consider further treatment. I'm not arguing that everyone with a rising PSA should seek treatment. Terry H has done very well for 13 years with minimal treatment - ADT, and only for a short period and only after clear evidence of metastasis. But I think treatment should be considered. If a patient has a steadily rising PSA, or a PSA above .2, he should probably consider that he still has prostate cancer and make his decision in that light. He may decide that he wants to forego radiation and instead wait, as Terry did, to see if the cancer spreads and becomes dangerous, then take whatever drugs are available for that - currently mainly ADT. Or he may decide to try salvage radiation in hopes that he can catch it before it escapes the prostate. What I think a patient should *not* do is imagine that the rising PSA is not symptomatic of cancer. It is cancer. And if the patient wants to take a shot at curing it with radiation (probably a less than 50/50 shot, but still a shot), he has to do it before the cancer grows and spreads. If he just waits and sees, he has effectively made the choice to give up the radiation option. I think every surgery patient with a rising PSA after surgery would be wise to at least consult with a radiation oncologist before it is too late. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 > Remember too folks that PSA rise can be due to infections. Yes, when there is an intact prostate. After a radical prostatectomy there should be no prostate tissue left and no prostate infections. As far as I know, a man who has had a radical prostatectomy and who has a rising PSA, especially if it goes above 0.2, has prostate cancer. The surgery did not cure him. The cancer might never kill him, but it is definitely cancer. > We have said before that one swallow doesn't make a summer and > one PSA test is not a major thing. The test could be the result of an error. If the PSA is higher than before, but still very low, the patient should wait and see what the next test says. But if the test is above .2 or if a succession of tests shows a steady rise, it seems to me that it's time to consider further treatment. I'm not arguing that everyone with a rising PSA should seek treatment. Terry H has done very well for 13 years with minimal treatment - ADT, and only for a short period and only after clear evidence of metastasis. But I think treatment should be considered. If a patient has a steadily rising PSA, or a PSA above .2, he should probably consider that he still has prostate cancer and make his decision in that light. He may decide that he wants to forego radiation and instead wait, as Terry did, to see if the cancer spreads and becomes dangerous, then take whatever drugs are available for that - currently mainly ADT. Or he may decide to try salvage radiation in hopes that he can catch it before it escapes the prostate. What I think a patient should *not* do is imagine that the rising PSA is not symptomatic of cancer. It is cancer. And if the patient wants to take a shot at curing it with radiation (probably a less than 50/50 shot, but still a shot), he has to do it before the cancer grows and spreads. If he just waits and sees, he has effectively made the choice to give up the radiation option. I think every surgery patient with a rising PSA after surgery would be wise to at least consult with a radiation oncologist before it is too late. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 Alan, forgive me if I have forgotten, is the SRT the only option, or is chemotherapy and hormone therapy an option? Doug in Durham > Remember too folks that PSA rise can be due to infections. Yes, when there is an intact prostate. After a radical prostatectomy there should be no prostate tissue left and no prostate infections. As far as I know, a man who has had a radical prostatectomy and who has a rising PSA, especially if it goes above 0.2, has prostate cancer. The surgery did not cure him. The cancer might never kill him, but it is definitely cancer. > We have said before that one swallow doesn't make a summer and > one PSA test is not a major thing. The test could be the result of an error. If the PSA is higher than before, but still very low, the patient should wait and see what the next test says. But if the test is above .2 or if a succession of tests shows a steady rise, it seems to me that it's time to consider further treatment. I'm not arguing that everyone with a rising PSA should seek treatment. Terry H has done very well for 13 years with minimal treatment - ADT, and only for a short period and only after clear evidence of metastasis. But I think treatment should be considered. If a patient has a steadily rising PSA, or a PSA above .2, he should probably consider that he still has prostate cancer and make his decision in that light. He may decide that he wants to forego radiation and instead wait, as Terry did, to see if the cancer spreads and becomes dangerous, then take whatever drugs are available for that - currently mainly ADT. Or he may decide to try salvage radiation in hopes that he can catch it before it escapes the prostate. What I think a patient should *not* do is imagine that the rising PSA is not symptomatic of cancer. It is cancer. And if the patient wants to take a shot at curing it with radiation (probably a less than 50/50 shot, but still a shot), he has to do it before the cancer grows and spreads. If he just waits and sees, he has effectively made the choice to give up the radiation option. I think every surgery patient with a rising PSA after surgery would be wise to at least consult with a radiation oncologist before it is too late. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 good advice Alan,I have had prostate surgery and Iam due for another PSA the Ist after surgery was .01 Iam not into the technical aspects of the numbers readings or any thing else. Cancer is cancer however and from what I have read here any treatment is going to carry side effects and I wouldn,t look forward to anymore treatment. I would take whatever treatment and and just suck it up and hopfully the quality of my life wouldn,t change that much. > > > > >> Remember too folks that PSA rise can be due to infections. > > Yes, when there is an intact prostate. After a radical > prostatectomy there should be no prostate tissue left and no > prostate infections. > > As far as I know, a man who has had a radical prostatectomy and > who has a rising PSA, especially if it goes above 0.2, has > prostate cancer. The surgery did not cure him. The cancer might > never kill him, but it is definitely cancer. > >> We have said before that one swallow doesn't make a summer and >> one PSA test is not a major thing. > > The test could be the result of an error. If the PSA is higher > than before, but still very low, the patient should wait and see > what the next test says. But if the test is above .2 or if a > succession of tests shows a steady rise, it seems to me that it's > time to consider further treatment. > > I'm not arguing that everyone with a rising PSA should seek > treatment. Terry H has done very well for 13 years with minimal > treatment - ADT, and only for a short period and only after clear > evidence of metastasis. > > But I think treatment should be considered. If a patient has a > steadily rising PSA, or a PSA above .2, he should probably > consider that he still has prostate cancer and make his decision > in that light. > > He may decide that he wants to forego radiation and instead wait, > as Terry did, to see if the cancer spreads and becomes dangerous, > then take whatever drugs are available for that - currently > mainly ADT. Or he may decide to try salvage radiation in hopes > that he can catch it before it escapes the prostate. > > What I think a patient should *not* do is imagine that the > rising PSA is not symptomatic of cancer. It is cancer. And if > the patient wants to take a shot at curing it with radiation > (probably a less than 50/50 shot, but still a shot), he has to do > it before the cancer grows and spreads. If he just waits and > sees, he has effectively made the choice to give up the radiation > option. > > I think every surgery patient with a rising PSA after surgery > would be wise to at least consult with a radiation oncologist > before it is too late. > > Alan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 good advice Alan,I have had prostate surgery and Iam due for another PSA the Ist after surgery was .01 Iam not into the technical aspects of the numbers readings or any thing else. Cancer is cancer however and from what I have read here any treatment is going to carry side effects and I wouldn,t look forward to anymore treatment. I would take whatever treatment and and just suck it up and hopfully the quality of my life wouldn,t change that much. > > > > >> Remember too folks that PSA rise can be due to infections. > > Yes, when there is an intact prostate. After a radical > prostatectomy there should be no prostate tissue left and no > prostate infections. > > As far as I know, a man who has had a radical prostatectomy and > who has a rising PSA, especially if it goes above 0.2, has > prostate cancer. The surgery did not cure him. The cancer might > never kill him, but it is definitely cancer. > >> We have said before that one swallow doesn't make a summer and >> one PSA test is not a major thing. > > The test could be the result of an error. If the PSA is higher > than before, but still very low, the patient should wait and see > what the next test says. But if the test is above .2 or if a > succession of tests shows a steady rise, it seems to me that it's > time to consider further treatment. > > I'm not arguing that everyone with a rising PSA should seek > treatment. Terry H has done very well for 13 years with minimal > treatment - ADT, and only for a short period and only after clear > evidence of metastasis. > > But I think treatment should be considered. If a patient has a > steadily rising PSA, or a PSA above .2, he should probably > consider that he still has prostate cancer and make his decision > in that light. > > He may decide that he wants to forego radiation and instead wait, > as Terry did, to see if the cancer spreads and becomes dangerous, > then take whatever drugs are available for that - currently > mainly ADT. Or he may decide to try salvage radiation in hopes > that he can catch it before it escapes the prostate. > > What I think a patient should *not* do is imagine that the > rising PSA is not symptomatic of cancer. It is cancer. And if > the patient wants to take a shot at curing it with radiation > (probably a less than 50/50 shot, but still a shot), he has to do > it before the cancer grows and spreads. If he just waits and > sees, he has effectively made the choice to give up the radiation > option. > > I think every surgery patient with a rising PSA after surgery > would be wise to at least consult with a radiation oncologist > before it is too late. > > Alan > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 > Alan, forgive me if I have forgotten, is the SRT the only option, or is > chemotherapy and hormone therapy an option? Doug in Durham Doug, As I understand it, SRT is the only option that might " cure " the cancer after failed prostatectomy, where " cure " means that there is no subsequent rise of PSA or other indicator of cancer, and no further treatment is ever required. The track record for SRT is not great. I saw an article that said, under the best conditions (IIRC 0.2 PSA after surgery), SRT has a 45% success rate. The rate gets worse as the PSA goes up - presumably because with higher PSA values the likelihood increases that the cancer has already spread beyond the radiated field. Of the other two options you mentioned, neither one is curative in the above sense. Hormone therapy is the one that is almost always given first because it is easier to take the chemotherapy and generally gives better results. Chemotherapy has been used mainly as a last ditch treatment when everything else has failed, though some doctors are reconsidering that view. Chemotherapy is now being used early in breast cancer cases and some doctors think it makes sense to do the same thing for PCa. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 > ... Hormone therapy is the one that is almost always given > first because it is easier to take the chemotherapy ... ^^^ Slip of the fingers (or the mind) there. I meant to say: " ... it is easier to take THAN chemotherapy ... " __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 > ... Hormone therapy is the one that is almost always given > first because it is easier to take the chemotherapy ... ^^^ Slip of the fingers (or the mind) there. I meant to say: " ... it is easier to take THAN chemotherapy ... " __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 Alan, thanks for the info. With those outcomes you outlined I may prefer to go the alternative route. As you probably have picked up by now I spend alot of time in the alternative field such as supplements. They have their research too. Actually it is not necessarily alternative, I am speaking of research on Green Tea, Vit D, Broccosprouts, Fish oil and more for fighting prostate cancer. I did not study these reports when they came out because I thought my p. cancer was stable. Now that I think it is no longer in remission, I will get serious about taking all those supplements. Some I remember have specifically been shown to be effective against aggressive prostate cancer. Perhaps I could do both. Is there any drawback to having the SRT since even if it did not cure it one would be no worse off. Doug > Alan, forgive me if I have forgotten, is the SRT the only option, or is > chemotherapy and hormone therapy an option? Doug in Durham Doug, As I understand it, SRT is the only option that might "cure" the cancer after failed prostatectomy, where "cure" means that there is no subsequent rise of PSA or other indicator of cancer, and no further treatment is ever required. The track record for SRT is not great. I saw an article that said, under the best conditions (IIRC 0.2 PSA after surgery), SRT has a 45% success rate. The rate gets worse as the PSA goes up - presumably because with higher PSA values the likelihood increases that the cancer has already spread beyond the radiated field. Of the other two options you mentioned, neither one is curative in the above sense. Hormone therapy is the one that is almost always given first because it is easier to take the chemotherapy and generally gives better results. Chemotherapy has been used mainly as a last ditch treatment when everything else has failed, though some doctors are reconsidering that view. Chemotherapy is now being used early in breast cancer cases and some doctors think it makes sense to do the same thing for PCa. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 Alan, thanks for the info. With those outcomes you outlined I may prefer to go the alternative route. As you probably have picked up by now I spend alot of time in the alternative field such as supplements. They have their research too. Actually it is not necessarily alternative, I am speaking of research on Green Tea, Vit D, Broccosprouts, Fish oil and more for fighting prostate cancer. I did not study these reports when they came out because I thought my p. cancer was stable. Now that I think it is no longer in remission, I will get serious about taking all those supplements. Some I remember have specifically been shown to be effective against aggressive prostate cancer. Perhaps I could do both. Is there any drawback to having the SRT since even if it did not cure it one would be no worse off. Doug > Alan, forgive me if I have forgotten, is the SRT the only option, or is > chemotherapy and hormone therapy an option? Doug in Durham Doug, As I understand it, SRT is the only option that might "cure" the cancer after failed prostatectomy, where "cure" means that there is no subsequent rise of PSA or other indicator of cancer, and no further treatment is ever required. The track record for SRT is not great. I saw an article that said, under the best conditions (IIRC 0.2 PSA after surgery), SRT has a 45% success rate. The rate gets worse as the PSA goes up - presumably because with higher PSA values the likelihood increases that the cancer has already spread beyond the radiated field. Of the other two options you mentioned, neither one is curative in the above sense. Hormone therapy is the one that is almost always given first because it is easier to take the chemotherapy and generally gives better results. Chemotherapy has been used mainly as a last ditch treatment when everything else has failed, though some doctors are reconsidering that view. Chemotherapy is now being used early in breast cancer cases and some doctors think it makes sense to do the same thing for PCa. Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 This string has become somewhat confusing, between two Dougs and the sometimes contradictory thoughts. I want to help bring the thinking together. 1- PSA dynamics are different post treatment from pretreatment. Prior to treatment the tolerance for a higher PSA is reasonable as a normal prostate does make PSA and as we age the prostate tends to get larger and make even more PSA. In this case an elevated PSA doesn’t necessarily mean that there is prostate cancer or that it is in need of treatment. 2- PSA tolerance changes post surgery and post radiation from the pretreatment time period. After treatment a nadir PSA level is reached (a baseline, background PSA level.) If the treatment has been successful this number is either undetectable or extremely low (measured in the hundredths) in the case of surgery or a little higher post radiation (the prostate gland remains in the body after radiation so more PSA is often generated). Nadir is usually reached more quickly post surgery, but post radiation it can take up to a year to reach nadir. 3- Once nadir is reached PSA needs to be monitored regularly to insure it stays at nadir. Schedules should be every 3 months for the first few years and then can go to every six months for the rest of your life. 4- If there is a change in PSA levels post treatment even more careful and more regular monitoring needs to be performed. Most docs consider three (3) rises after obtaining nadir means there has been a recurrence. It does not matter how low or how high these rises are, even if they are measured in the tenths of a point, three rises means there is a recurrence. 5- Delaying or denying a recurrence can be fatal. One should never wait. Most docs feel that a recurrence with a PSA level below 1.0 to 1.4 probably means (but does not guarantee) that there is a good chance the recurrence is still localized. This means that the cancer is still in the prostate bed or the gland itself in the case of men who had been treated with radiation. If the cancer is still localized then a targeted treatment (salvage radiation, surgery or cryo) might still “cure” or adequately control the cancer. 6- In the case where the PSA has been allowed to exceed the target 1.0 to 1.4 numbers the cancer has probably moved beyond the immediate area and a targeted therapy will not work. In these cases, the proper treatment is a system wide treatment such as hormone therapy. This is the reason it is necessary to jump quickly on a recurrence while the PSA remains under 1.0. In cases of the PSA level being below the target numbers the sooner the treatment the better the shot at stopping the cancer. 7- Do not get lulled into ignoring a recurrence while the PSA is low because there is no positive imaging (no mets seen). It takes millions of cells to become visible on our scans, so you can say you do not have metastatic disease, but you still have prostate cancer running through your body, we just can not see it. 8- Always make sure that the PSA tests are performed with the same reagents, ideally at the sane lab. A PSA rise using a different reagent may not be a rise; it could easily reflect a difference in the testing protocol and fool you into thinking that you have a recurrence. 9- Prostate cancer recurrences can be controlled, but it must be done very early on in the PSA number game. 10- PSA in the post treatment world is different than in the pretreatment world, don’t confuse the issues. Recent Activity 5 New Members Visit Your Group Give Back Yahoo! for Good Get inspired by a good cause. Y! Toolbar Get it Free! easy 1-click access to your groups. Yahoo! Groups Start a group in 3 easy steps. Connect with others. T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.com - information and support about prostate cancer http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer-- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 This string has become somewhat confusing, between two Dougs and the sometimes contradictory thoughts. I want to help bring the thinking together. 1- PSA dynamics are different post treatment from pretreatment. Prior to treatment the tolerance for a higher PSA is reasonable as a normal prostate does make PSA and as we age the prostate tends to get larger and make even more PSA. In this case an elevated PSA doesn’t necessarily mean that there is prostate cancer or that it is in need of treatment. 2- PSA tolerance changes post surgery and post radiation from the pretreatment time period. After treatment a nadir PSA level is reached (a baseline, background PSA level.) If the treatment has been successful this number is either undetectable or extremely low (measured in the hundredths) in the case of surgery or a little higher post radiation (the prostate gland remains in the body after radiation so more PSA is often generated). Nadir is usually reached more quickly post surgery, but post radiation it can take up to a year to reach nadir. 3- Once nadir is reached PSA needs to be monitored regularly to insure it stays at nadir. Schedules should be every 3 months for the first few years and then can go to every six months for the rest of your life. 4- If there is a change in PSA levels post treatment even more careful and more regular monitoring needs to be performed. Most docs consider three (3) rises after obtaining nadir means there has been a recurrence. It does not matter how low or how high these rises are, even if they are measured in the tenths of a point, three rises means there is a recurrence. 5- Delaying or denying a recurrence can be fatal. One should never wait. Most docs feel that a recurrence with a PSA level below 1.0 to 1.4 probably means (but does not guarantee) that there is a good chance the recurrence is still localized. This means that the cancer is still in the prostate bed or the gland itself in the case of men who had been treated with radiation. If the cancer is still localized then a targeted treatment (salvage radiation, surgery or cryo) might still “cure” or adequately control the cancer. 6- In the case where the PSA has been allowed to exceed the target 1.0 to 1.4 numbers the cancer has probably moved beyond the immediate area and a targeted therapy will not work. In these cases, the proper treatment is a system wide treatment such as hormone therapy. This is the reason it is necessary to jump quickly on a recurrence while the PSA remains under 1.0. In cases of the PSA level being below the target numbers the sooner the treatment the better the shot at stopping the cancer. 7- Do not get lulled into ignoring a recurrence while the PSA is low because there is no positive imaging (no mets seen). It takes millions of cells to become visible on our scans, so you can say you do not have metastatic disease, but you still have prostate cancer running through your body, we just can not see it. 8- Always make sure that the PSA tests are performed with the same reagents, ideally at the sane lab. A PSA rise using a different reagent may not be a rise; it could easily reflect a difference in the testing protocol and fool you into thinking that you have a recurrence. 9- Prostate cancer recurrences can be controlled, but it must be done very early on in the PSA number game. 10- PSA in the post treatment world is different than in the pretreatment world, don’t confuse the issues. Recent Activity 5 New Members Visit Your Group Give Back Yahoo! for Good Get inspired by a good cause. Y! Toolbar Get it Free! easy 1-click access to your groups. Yahoo! Groups Start a group in 3 easy steps. Connect with others. T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.com - information and support about prostate cancer http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer-- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 Thank you for the information .Cheers;) This string has become somewhat confusing, between two Dougs and the sometimes contradictory thoughts. I want to help bring the thinking together. 1- PSA dynamics are different post treatment from pretreatment. Prior to treatment the tolerance for a higher PSA is reasonable as a normal prostate does make PSA and as we age the prostate tends to get larger and make even more PSA. In this case an elevated PSA doesn’t necessarily mean that there is prostate cancer or that it is in need of treatment. 2- PSA tolerance changes post surgery and post radiation from the pretreatment time period. After treatment a nadir PSA level is reached (a baseline, background PSA level.) If the treatment has been successful this number is either undetectable or extremely low (measured in the hundredths) in the case of surgery or a little higher post radiation (the prostate gland remains in the body after radiation so more PSA is often generated). Nadir is usually reached more quickly post surgery, but post radiation it can take up to a year to reach nadir. 3- Once nadir is reached PSA needs to be monitored regularly to insure it stays at nadir. Schedules should be every 3 months for the first few years and then can go to every six months for the rest of your life. 4- If there is a change in PSA levels post treatment even more careful and more regular monitoring needs to be performed. Most docs consider three (3) rises after obtaining nadir means there has been a recurrence. It does not matter how low or how high these rises are, even if they are measured in the tenths of a point, three rises means there is a recurrence. 5- Delaying or denying a recurrence can be fatal. One should never wait. Most docs feel that a recurrence with a PSA level below 1.0 to 1.4 probably means (but does not guarantee) that there is a good chance the recurrence is still localized. This means that the cancer is still in the prostate bed or the gland itself in the case of men who had been treated with radiation. If the cancer is still localized then a targeted treatment (salvage radiation, surgery or cryo) might still “cure” or adequately control the cancer. 6- In the case where the PSA has been allowed to exceed the target 1.0 to 1.4 numbers the cancer has probably moved beyond the immediate area and a targeted therapy will not work. In these cases, the proper treatment is a system wide treatment such as hormone therapy. This is the reason it is necessary to jump quickly on a recurrence while the PSA remains under 1.0. In cases of the PSA level being below the target numbers the sooner the treatment the better the shot at stopping the cancer. 7- Do not get lulled into ignoring a recurrence while the PSA is low because there is no positive imaging (no mets seen). It takes millions of cells to become visible on our scans, so you can say you do not have metastatic disease, but you still have prostate cancer running through your body, we just can not see it. 8- Always make sure that the PSA tests are performed with the same reagents, ideally at the sane lab. A PSA rise using a different reagent may not be a rise; it could easily reflect a difference in the testing protocol and fool you into thinking that you have a recurrence. 9- Prostate cancer recurrences can be controlled, but it must be done very early on in the PSA number game. 10- PSA in the post treatment world is different than in the pretreatment world, don’t confuse the issues. Recent Activity 5 New Members Visit Your Group Give Back Yahoo! for Good Get inspired by a good cause. Y! Toolbar Get it Free! easy 1-click access to your groups. Yahoo! Groups Start a group in 3 easy steps. Connect with others. T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.com - information and support about prostate cancer http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer-- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 , thank you, very illuminating. In this sort of predicament it is nice to have a good idea of what is ahead. My only concern at this time is whether my doctor(s) will be sympathetic to monthly PSA checks. I noted that my family physician wrote on the test results of .07 " of no concern".  I already have surgeon and radiation oncologist scheduled., as well as another PSA tomorrow at the hospital. Can a radiation oncologist typically order a PSA at a hospital? Thanks DougSubject: Re: Re: Rise in PSATo: ProstateCancerSupport Date: Tuesday, August 18, 2009, 10:49 AM  This string has become somewhat confusing, between two Dougs and the sometimes contradictory thoughts. I want to help bring the thinking together.  1-    PSA dynamics are different post treatment from pretreatment. Prior to treatment the tolerance for a higher PSA is reasonable as a normal prostate does make PSA and as we age the prostate tends to get larger and make even more PSA. In this case an elevated PSA doesn’t necessarily mean that there is prostate cancer or that it is in need of treatment.  2-    PSA tolerance changes post surgery and post radiation from the pretreatment time period. After treatment a nadir PSA level is reached (a baseline, background PSA level.) If the treatment has been successful this number is either undetectable or extremely low (measured in the hundredths) in the case of surgery or a little higher post radiation (the prostate gland remains in the body after radiation so more PSA is often generated). Nadir is usually reached more quickly post surgery, but post radiation it can take up to a year to reach nadir.   3-    Once nadir is reached PSA needs to be monitored regularly to insure it stays at nadir. Schedules should be every 3 months for the first few years and then can go to every six months for the rest of your life.  4-    If there is a change in PSA levels post treatment even more careful and more regular monitoring needs to be performed. Most docs consider three (3) rises after obtaining nadir means there has been a recurrence.  It does not matter how low or how high these rises are, even if they are measured in the tenths of a point, three rises means there is a recurrence.   5-    Delaying or denying a recurrence can be fatal. One should never wait. Most docs feel that a recurrence with a PSA level below 1.0 to 1.4 probably means (but does not guarantee) that there is a good chance the recurrence is still localized. This means that the cancer is still in the prostate bed or the gland itself in the case of men who had been treated with radiation.  If the cancer is still localized then a targeted treatment (salvage radiation, surgery or cryo) might still “cure†or adequately control the cancer.  6-    In the case where the PSA has been allowed to exceed the target 1.0 to 1.4 numbers the cancer has probably moved beyond the immediate area and a targeted therapy will not work. In these cases, the proper treatment is a system wide treatment such as hormone therapy. This is the reason it is necessary to jump quickly on a recurrence while the PSA remains under 1.0. In cases of the PSA level being below the target numbers the sooner the treatment the better the shot at stopping the cancer.   7-    Do not get lulled into ignoring a recurrence while the PSA is low because there is no positive imaging (no mets seen). It takes millions of cells to become visible on our scans, so you can say you do not have metastatic disease, but you still have prostate cancer running through your body, we just can not see it.    8-    Always make sure that the PSA tests are performed with the same reagents, ideally at the sane lab. A PSA rise using a different reagent may not be a rise; it could easily reflect a difference in the testing protocol and fool you into thinking that you have a recurrence.   9-    Prostate cancer recurrences can be controlled, but it must be done very early on in the PSA number game.  10-  PSA in the post treatment world is different than in the pretreatment world, don’t confuse the issues.  Recent Activity  5 New Members Visit Your Group Give Back Yahoo! for Good Get inspired by a good cause. Y! Toolbar Get it Free! easy 1-click access to your groups. Yahoo! Groups Start a group in 3 easy steps. Connect with others. T Nowak MA, MSWDirector for Advocacy and  Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostat ecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare. com - information and support about prostate cancer http://health. groups.yahoo. com/group/ advancedprostate cancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer-- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 , thank you, very illuminating. In this sort of predicament it is nice to have a good idea of what is ahead. My only concern at this time is whether my doctor(s) will be sympathetic to monthly PSA checks. I noted that my family physician wrote on the test results of .07 " of no concern".  I already have surgeon and radiation oncologist scheduled., as well as another PSA tomorrow at the hospital. Can a radiation oncologist typically order a PSA at a hospital? Thanks DougSubject: Re: Re: Rise in PSATo: ProstateCancerSupport Date: Tuesday, August 18, 2009, 10:49 AM  This string has become somewhat confusing, between two Dougs and the sometimes contradictory thoughts. I want to help bring the thinking together.  1-    PSA dynamics are different post treatment from pretreatment. Prior to treatment the tolerance for a higher PSA is reasonable as a normal prostate does make PSA and as we age the prostate tends to get larger and make even more PSA. In this case an elevated PSA doesn’t necessarily mean that there is prostate cancer or that it is in need of treatment.  2-    PSA tolerance changes post surgery and post radiation from the pretreatment time period. After treatment a nadir PSA level is reached (a baseline, background PSA level.) If the treatment has been successful this number is either undetectable or extremely low (measured in the hundredths) in the case of surgery or a little higher post radiation (the prostate gland remains in the body after radiation so more PSA is often generated). Nadir is usually reached more quickly post surgery, but post radiation it can take up to a year to reach nadir.   3-    Once nadir is reached PSA needs to be monitored regularly to insure it stays at nadir. Schedules should be every 3 months for the first few years and then can go to every six months for the rest of your life.  4-    If there is a change in PSA levels post treatment even more careful and more regular monitoring needs to be performed. Most docs consider three (3) rises after obtaining nadir means there has been a recurrence.  It does not matter how low or how high these rises are, even if they are measured in the tenths of a point, three rises means there is a recurrence.   5-    Delaying or denying a recurrence can be fatal. One should never wait. Most docs feel that a recurrence with a PSA level below 1.0 to 1.4 probably means (but does not guarantee) that there is a good chance the recurrence is still localized. This means that the cancer is still in the prostate bed or the gland itself in the case of men who had been treated with radiation.  If the cancer is still localized then a targeted treatment (salvage radiation, surgery or cryo) might still “cure†or adequately control the cancer.  6-    In the case where the PSA has been allowed to exceed the target 1.0 to 1.4 numbers the cancer has probably moved beyond the immediate area and a targeted therapy will not work. In these cases, the proper treatment is a system wide treatment such as hormone therapy. This is the reason it is necessary to jump quickly on a recurrence while the PSA remains under 1.0. In cases of the PSA level being below the target numbers the sooner the treatment the better the shot at stopping the cancer.   7-    Do not get lulled into ignoring a recurrence while the PSA is low because there is no positive imaging (no mets seen). It takes millions of cells to become visible on our scans, so you can say you do not have metastatic disease, but you still have prostate cancer running through your body, we just can not see it.    8-    Always make sure that the PSA tests are performed with the same reagents, ideally at the sane lab. A PSA rise using a different reagent may not be a rise; it could easily reflect a difference in the testing protocol and fool you into thinking that you have a recurrence.   9-    Prostate cancer recurrences can be controlled, but it must be done very early on in the PSA number game.  10-  PSA in the post treatment world is different than in the pretreatment world, don’t confuse the issues.  Recent Activity  5 New Members Visit Your Group Give Back Yahoo! for Good Get inspired by a good cause. Y! Toolbar Get it Free! easy 1-click access to your groups. Yahoo! Groups Start a group in 3 easy steps. Connect with others. T Nowak MA, MSWDirector for Advocacy and  Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostat ecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare. com - information and support about prostate cancer http://health. groups.yahoo. com/group/ advancedprostate cancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer-- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2009 Report Share Posted August 18, 2009 Doug,If your doctor is not receptive to the PSA schedule you either need to change doctors or educate him. Most general physicians do not know about the need to change how PSA should be evaluated post surgery. Print out my comments and have him read it. Then ask him to confirm what I said, if he does his homework he will support you with the increased monitoring. Remember, it is your life that could be at risk. Do nor let a doctors lack of knowledge or ego put you at risk. Yes, a radiation oncologist can write a script for a PSA test, but remember that you need to compare results of the PSA tests with a test using the same reagent. On the report, after the test result there should be a statement that specifiies the testing method and reagents whu\ich were used. make sure they are the same otherwise you can not compare the results. , thank you, very illuminating. In this sort of predicament it is nice to have a good idea of what is ahead. My only concern at this time is whether my doctor(s) will be sympathetic to monthly PSA checks. I noted that my family physician wrote on the test results of .07 " of no concern " . I already have surgeon and radiation oncologist scheduled., as well as another PSA tomorrow at the hospital. Can a radiation oncologist typically order a PSA at a hospital? Thanks Doug Subject: Re: Re: Rise in PSA To: ProstateCancerSupport Date: Tuesday, August 18, 2009, 10:49 AM This string has become somewhat confusing, between two Dougs and the sometimes contradictory thoughts. I want to help bring the thinking together. 1- PSA dynamics are different post treatment from pretreatment. Prior to treatment the tolerance for a higher PSA is reasonable as a normal prostate does make PSA and as we age the prostate tends to get larger and make even more PSA. In this case an elevated PSA doesn’t necessarily mean that there is prostate cancer or that it is in need of treatment. 2- PSA tolerance changes post surgery and post radiation from the pretreatment time period. After treatment a nadir PSA level is reached (a baseline, background PSA level.) If the treatment has been successful this number is either undetectable or extremely low (measured in the hundredths) in the case of surgery or a little higher post radiation (the prostate gland remains in the body after radiation so more PSA is often generated). Nadir is usually reached more quickly post surgery, but post radiation it can take up to a year to reach nadir. 3- Once nadir is reached PSA needs to be monitored regularly to insure it stays at nadir. Schedules should be every 3 months for the first few years and then can go to every six months for the rest of your life. 4- If there is a change in PSA levels post treatment even more careful and more regular monitoring needs to be performed. Most docs consider three (3) rises after obtaining nadir means there has been a recurrence. It does not matter how low or how high these rises are, even if they are measured in the tenths of a point, three rises means there is a recurrence. 5- Delaying or denying a recurrence can be fatal. One should never wait. Most docs feel that a recurrence with a PSA level below 1.0 to 1.4 probably means (but does not guarantee) that there is a good chance the recurrence is still localized. This means that the cancer is still in the prostate bed or the gland itself in the case of men who had been treated with radiation. If the cancer is still localized then a targeted treatment (salvage radiation, surgery or cryo) might still “cure” or adequately control the cancer. 6- In the case where the PSA has been allowed to exceed the target 1.0 to 1.4 numbers the cancer has probably moved beyond the immediate area and a targeted therapy will not work. In these cases, the proper treatment is a system wide treatment such as hormone therapy. This is the reason it is necessary to jump quickly on a recurrence while the PSA remains under 1.0. In cases of the PSA level being below the target numbers the sooner the treatment the better the shot at stopping the cancer. 7- Do not get lulled into ignoring a recurrence while the PSA is low because there is no positive imaging (no mets seen). It takes millions of cells to become visible on our scans, so you can say you do not have metastatic disease, but you still have prostate cancer running through your body, we just can not see it. 8- Always make sure that the PSA tests are performed with the same reagents, ideally at the sane lab. A PSA rise using a different reagent may not be a rise; it could easily reflect a difference in the testing protocol and fool you into thinking that you have a recurrence. 9- Prostate cancer recurrences can be controlled, but it must be done very early on in the PSA number game. 10- PSA in the post treatment world is different than in the pretreatment world, don’t confuse the issues. Recent Activity 5 New Members Visit Your Group Give Back Yahoo! for Good Get inspired by a good cause. Y! Toolbar Get it Free! easy 1-click access to your groups. Yahoo! Groups Start a group in 3 easy steps. Connect with others. T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostat ecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare. com - information and support about prostate cancer http://health. groups.yahoo. com/group/ advancedprostate cancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer-- -- T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Fighting Cancer TogetherSurvivor - Thyroid, Recurrent Prostate and Renal Cancers www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.com - information and support about prostate cancer http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer Quote Link to comment Share on other sites More sharing options...
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