There seems to be a feeling here that hormone dependent versus hormone independent prostate cancer is determined at the onset of prostate cancer. "We all have hormone independent cells that eventually grow large enough to be troublesome"
I don't necessarily agree with this. It is my understanding that this is theory. While it may be partially true, I have also heard that hormone dependent prostate cancer can later become hormone independent. We do not have anyway of establishing what makes all prostate cancers become independent of hormones. If we did we may be able to decipher when some prostate cancers are aggressive versus indolent but there is no science that can provide us definitive proof.
What I have seen as a layman is those cases like this one that i have mentioned before. A 53 year old man having an RP with orchiectomy in 1981. Gleason unknown. 29 years later he has Gleason 10 invasion in his bladder. I think it is not reasonable to assume that he had some hormonally resistant Gleason 10 prostate cancer for so long. It is more reasonable to assume that he did have residual disease that eventually "morphed" into the more aggressive form of the disease.
I am certain that many can pull up opinions that vary, but for me I the likelihood of someone surviving for 29 years with aggressive G10 hormonally resistant prostate cancer is extremely nil. If even possible. I believe that Gleason can change, and I believe that resistance can as well.
So to answer the question? If we ever develop such a test to see what percentage of HRPC exists in a RP specimen, if even 0% was discovered, it does not mean that it won't change.
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas
Blog : www.caringbridge.org/visit/tonycrispino