good read New Yorker

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Subdenis
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Date Joined Aug 2017
Total Posts : 95
   Posted 9/12/2017 3:32 AM (GMT -6)   
Worth the read

https://www.newyorker.com/magazine/2017/09/11/cancers-invasion-equation

Denis

NKinney
Veteran Member


Date Joined Oct 2013
Total Posts : 536
   Posted 9/12/2017 8:49 AM (GMT -6)   
Very good read.

We don't need another decimal point of PSA accuracy. We need better understand of the human biology variations which cause cancer. We should adjust our spending accordingly. Today, 90% is spent on early detection and treatment, and only 10% on causes.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3428
   Posted 9/12/2017 10:21 AM (GMT -6)   
Curing cancer would destroy the medical services industry...The most profitable real estate in medicine is the Chemo Lounge or infusion center..
Age now 74 . Diagnosed G-9 6/2010
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA <0.1 10/'11, <0.1 2/12, <0.1, 4/12 <0.1, 9/12, 0.8 3/13, 0.5 6/13, 1.1, back on HT. 5/16 stay the course, Lupron, Zytiga, PSA <0.1 10/16 no change <0.1 5/17 PSA 1.6 Chemo or Provenge next..

nepol
Regular Member


Date Joined Jul 2015
Total Posts : 133
   Posted 9/12/2017 3:11 PM (GMT -6)   
gosh darn it Fairwind don't sugar coat it tell it like it is!!!! NEPOL
Biopsy: 11 out of 12 G4+4
Clinical stage: PT3ANO
Bone scan, CT scan, clear Margins + Lymph Nodes, Vessels clear
RALP on October 7, 2014
Downgraded G4+3
PSA on January 14, 2015 .021
RT 39 sessions March 16th
PSA April 10, 2015 1.83
April 14th, started elligard
PSA June 12, 2015 0.01
PSA July 8, 2015 0.01
Next PSA in January 2016 age at dx 64 and 7 m0. UP GRADED 4+5=9

BillyBob@388
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Date Joined Mar 2014
Total Posts : 2453
   Posted 9/12/2017 7:58 PM (GMT -6)   
nepol said...
gosh darn it Fairwind don't sugar coat it tell it like it is!!!! NEPOL


turn

ddyss
Regular Member


Date Joined Apr 2017
Total Posts : 99
   Posted 9/12/2017 9:20 PM (GMT -6)   
its difficult to fathom what exactly is his point - I guess he is saying the environment (or our body ) causes the cell (or cancer cell aka zebra mussel) to be what it is (ie makes cancer cells attack other cells) and makes our immune cells ( aka the fish and ducks) not interested in eating the cancer cells. Is my comprehension correct?
DX@ 48 Yrs PSA 03/15 4.45 DRE: Firm Right Base
04/18 Biopsy Right: Base 4+3, Middle 3+4, Apex: HPIN
Left 6 cores : -ve
5/20 MRI: Pirads 5, ECE:+ve
RALP 05/26 Mt. Sinai Miami - Dr. A. Bhandari
Path:
Gleason downgraded to 3+4 !! Stage T2C
Prostrate Size: 49grams Tumor:20%
LN/SV/ECE: -ve PNI: +ve
Cath Removed : 6/1
Full continence: 7/4
PSA: 7/7 <0.1

Michael_T
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Date Joined Sep 2012
Total Posts : 2411
   Posted 9/12/2017 9:29 PM (GMT -6)   
He doesn't make this specific analogy, but I read it like this: 20 guys are exposed to ragweed. Five of them have an allergic reaction, but 15 don't. Similarly, 20 guys have Gleason 9 cancer. Five metastasize and 15 don't.

Did the guys that metastasize have something different in their bodies/immune systems? Of was it just that their cancer was more aggressive? He's advocating studying both sides of the equation.
Age 56, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
3/17: T = 167, PSA = 0.13

ddyss
Regular Member


Date Joined Apr 2017
Total Posts : 99
   Posted 9/12/2017 9:35 PM (GMT -6)   
no wonder my SAT scores were not high enough smile
DX@ 48 Yrs PSA 03/15 4.45 DRE: Firm Right Base
04/18 Biopsy Right: Base 4+3, Middle 3+4, Apex: HPIN
Left 6 cores : -ve
5/20 MRI: Pirads 5, ECE:+ve
RALP 05/26 Mt. Sinai Miami - Dr. A. Bhandari
Path:
Gleason downgraded to 3+4 !! Stage T2C
Prostrate Size: 49grams Tumor:20%
LN/SV/ECE: -ve PNI: +ve
Cath Removed : 6/1
Full continence: 7/4
PSA: 7/7 <0.1

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3428
   Posted 9/12/2017 9:52 PM (GMT -6)   
"Evidence suggested, for example, that most men with prostate cancer would never experience metastasis. What made others susceptible? The usual approach, Welch knew, would be to look for markers in their cancer cells—to find patterns of gene activation, say, that made some of them dangerous. And the characteristics of those cells were plainly crucial. Pienta was arguing, though, that this approach was far too narrow. At least part of the answer might lie in the ecological relationship between a cancer and its host—between seed and soil."

"Most Men" are diagnosed with Gleason 6 grade cancer...Therefore, most prostate cancer victims never suffer metastasis..Unfortunately, this does not hold true for G-8, 9, 10 patients. In this case, it would seem the "seed" plays just as important a roll as the soil..
Age now 74 . Diagnosed G-9 6/2010
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA <0.1 10/'11, <0.1 2/12, <0.1, 4/12 <0.1, 9/12, 0.8 3/13, 0.5 6/13, 1.1, back on HT. 5/16 stay the course, Lupron, Zytiga, PSA <0.1 10/16 no change <0.1 5/17 PSA 1.6 Chemo or Provenge next..

Michael_T
Veteran Member


Date Joined Sep 2012
Total Posts : 2411
   Posted 9/12/2017 10:11 PM (GMT -6)   
Fairwind, I don't think the article applies at all to G6s or maybe even G7s. But what about this question for our G9 friends (like you and me): why do some of G9s metastasize but others don't?

In my personal case, so far I seem to be dodging the bullet. Is it because I had a kick @ss treatment on my G9? Or is it because my host issue wasn't interested in having a CTC take up residence? No way to know that, of course. But I think the article raises interesting questions...
Age 56, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
3/17: T = 167, PSA = 0.13

BillyBob@388
Veteran Member


Date Joined Mar 2014
Total Posts : 2453
   Posted 9/12/2017 10:16 PM (GMT -6)   
Good article!
PSA 10.9 ~112013
Bx on 112013 at age ~65yrs, with 5 of 12 pos with one G9(5+4), 1 PNI, T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, SV+, G9 down graded to 4+5, cut wide, but 1 tiny foci right at the edge of margin ) Pros. 106.7 gms!
At 15 months, not wearing a pad most days, mostly dry
PSA <.01 on 6/14 and all until 9/15 = .01, still .01 9/16, .02 on 3/17,6/17

Subdenis
Regular Member


Date Joined Aug 2017
Total Posts : 95
   Posted 9/13/2017 2:22 AM (GMT -6)   
It may be wishful thinking and hope that I am tending the soil. I have been active and had a decent diet but now am stepping up my game. I don't wait well so getting my body as healthy as I can is something I can do. The worst outcome is I don't get heart disease, diabetes, have a stroke, etc. I think I can live with that! Denis
65 YO healthy man, PSA 4.1/2 for couple years PSA 5/1/17 4.6, Multiparametric MRI, 5/15/17 showed lesion. 13 core biopsy 3 positive 3+3 and one positive in lesion, may be overlap All cores less than 30% 8/22/17 - second opinion Yale pathology shows small amount of (3+4) in one core, < 5%, ordered decipher to inform next steps Leaning towards Active Surveillance. Thanks, Denis

halbert
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Date Joined Dec 2014
Total Posts : 2989
   Posted 9/13/2017 4:30 AM (GMT -6)   
In a general way, it raises the question about all cancers, not just PC. We've all known families where it seemed as if everyone died young of cancer of one kind or another. Why? And we all know other families where everyone seems extraordinarily long lived and who never seem to get any form of cancer. Why again?

What is going on with both groups? It has to have something to do with their individual family gene pool--not only on the genetic makeup that makes cancer more likely (like the presence of BRCA2), but also the individuals immune system. Makes sense to me.
Age at Diagnosis: 56
RALP on 2/17/15, BJC St. Louis, Dr. Figenshau
58.5g, G3+4, 20%, 4 quadrants involved
PSA 3/10/15: 0.10
5/18/15: <.04
8/24/15: <.04
11/30/15: <.04
2/29/16: <0.04
8/30/16: <0.04
2/15/17: <0.006
8/22/17: <0.006
My Story: www.healingwell.com/community/default.aspx?f=35&m=3300024

NKinney
Veteran Member


Date Joined Oct 2013
Total Posts : 536
   Posted 9/13/2017 11:28 AM (GMT -6)   
Can an obituary be a "good read?"

Typically not, but in Dr Willet Whitmore's NYTimes obit (>20 years ago), one of his famous quotes was given which applies to the topic of this thread. Whitmore held that PC survival had less to do with treatment than with the biology of individual tumors.
www.nytimes.com/1995/05/09/obituaries/willet-whitmore-78-specialist-on-tumors-of-urologic-tracts.html



Whitmore was witty, and whip smart. He is known as the father of modern urological oncology and former head of Urology at MSKCC—he taught many of today's best practicing urologists treating PC. Many of his insightful sayings about PC (such as the one above) were counter to popular belief at the time but have withstood the test of time.

Post Edited (NKinney) : 9/13/2017 11:31:24 AM (GMT-6)


BillyBob@388
Veteran Member


Date Joined Mar 2014
Total Posts : 2453
   Posted 9/13/2017 12:22 PM (GMT -6)   
Fairwind said...
"Evidence suggested, for example, that most men with prostate cancer would never experience metastasis. What made others susceptible? The usual approach, Welch knew, would be to look for markers in their cancer cells—to find patterns of gene activation, say, that made some of them dangerous. And the characteristics of those cells were plainly crucial. Pienta was arguing, though, that this approach was far too narrow. At least part of the answer might lie in the ecological relationship between a cancer and its host—between seed and soil."

"Most Men" are diagnosed with Gleason 6 grade cancer...Therefore, most prostate cancer victims never suffer metastasis..Unfortunately, this does not hold true for G-8, 9, 10 patients. In this case, it would seem the "seed" plays just as important a roll as the soil..


Very good point. But still, a small % of those G8-10s never met, or at least never advance clinically far enough to suffer greatly(maybe a very small % ? ), and still end up dying of something else. What is up with those guys?

EDIT: OOPS, I see Michael-T already asked the same question, maybe others also.

Post Edited (BillyBob@388) : 9/13/2017 12:25:28 PM (GMT-6)

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