Anyone have Short PSADT but then success with HT

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compiler
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Date Joined Nov 2009
Total Posts : 5197
   Posted 7/15/2011 4:55 PM (GMT -6)   
My PSADT is lousy (2-4 months). I have failed surgery and SRT. I'm wondering if this augurs badly for HT or is it not so predictive.

My PSA is still very low (0.60) but moving up fast.

Mel

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 977
   Posted 7/15/2011 8:37 PM (GMT -6)   
I have not yet "officially" failed SRT. My PSA was .5 before SRT and HT. I am high risk (G8 with psadt < 6 months and BCR within 1 year). I did one year of HT with ADT3. PSA went to <.01 within 30 days, and stayed < .01 for a full year. As I understand it, this is a good response. I am now looking for a 2-3 year remission.
Dx Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4)
Robotic RP March 2009
Path Report: T2c, G8, organ confined, neg margins, lymph nodes - tumor vol 9%
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT/SRT .01, < .01
End ADT3 5/11 PSA < .01

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 713
   Posted 7/15/2011 9:30 PM (GMT -6)   
Mel,
Although a short PSADT has in general poorer prognosis, the response to ADT is more related to the androgen-dependent to androgen-independent ratio of the present tumor load. In the presence of metastatic disease, response to deprivation is poorer when more disseminated disease is present. After surgery, not much tumor should be present and your response to IADT should be as good as predicted by Dr. Scholz.

Try to get a PSA test done with the same assay as you have been using before SRT to be able to compare such results. Wish you the very best outcome.

RalphV
Phoenix, Arizona
DISCLAIMER: I am a prostate cancer survivor since 1992. The views or opinions expressed here are my own and are not endorsed nor supported by any agency or institution. Recommendations SHOULD NOT be construed as professional advice.
DX at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/m

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24179
   Posted 7/15/2011 9:47 PM (GMT -6)   
Mel, have I lost count, or is your PSA of .60 the first one since you completed your SRT? I wouldn't call it a failure yet, if it is just one reading, its possible you had a good increase during the time that you started and ended the SRT. Many doctors would want to see an increase trend post-SRT before declaring it a failure. Did Dr. Scholz say it had failed?

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 5197
   Posted 7/16/2011 2:49 PM (GMT -6)   
David:

You are correct.

Scholz said it was "not at all what he was hoping for."

He said we will test again in 30 days and MAYBE again 30 days after that. He wants to get a trend to make sure the SRT has failed. But clearly the indication is that it failed. Just not confirmed yet.

I know he would like to start HT if it gets to 1.0.

Mel

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24179
   Posted 7/16/2011 5:31 PM (GMT -6)   
I agree with what Dr. Scholz is telling you, you need that trend to really confirm. The real trick is knowing if the .60 is a new rise, or where it peaked out during SRT. My local rad oncologists and my new oncologist all agreed, that there should be no rise post SRT once it has peaked.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10
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