Does Ultra Sensitive PSA have any value after SRT?

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Carlos
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Date Joined Nov 2009
Total Posts : 486
   Posted 2/3/2011 9:51 AM (GMT -6)   
I finish SRT next week and will resume PSA testing soon after.  My uro doesn't care which test I use.  Insurance covers either one and both labs are convenient.  I have found little literature that suggests the ultra sensitive has any value at this point.  Does anyone have any thoughts about this?
 
Carlos

Dx 2/2008, age 71, PSA 9.1, G8,T1c. daVinci surgery 5/2008, G8(5+3), pT2c. LFPF, good QOL. PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months, SRT 12/2010.

Steve n Dallas
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Date Joined Mar 2008
Total Posts : 4829
   Posted 2/3/2011 9:59 AM (GMT -6)   
There's not much difference between a .02 and a .022222222 .

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 2/3/2011 10:14 AM (GMT -6)   
Thanks for the optimism.  I guess the same holds true for 2.0 vs 2.02.  Maybe I should just delete the post.
 
Carlos

Putt
Regular Member


Date Joined Aug 2010
Total Posts : 154
   Posted 2/3/2011 10:29 AM (GMT -6)   
.022222222 ?????????

Carlos
There are a lot of opinions as to which test one should use. Some men do NOT wish to monitor any type of PSA creep and be alerted only after a level of 1.0, or higher. Others wish to be able to estimate a period of time when additional treatment should be considered.
By using the more sensitive test and for example the level increases every three months (0.01, 0.02, 0.04, 0.08, 0.16, etc.) you can establish a doubling time and be able to predict when to return to some type of treatment.
Some believe this is stressful, others are interested. Nothing wrong with either choice.
PSA at Dx 105 at age 68, 4/04. ADT (Lupron only), RRP, 5/04. Gleason 4+5=9, Staged pT3bc NO MO, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09, 0.19 12/09, 0.30 4/10, 8/10 0.42, 12/10 47. Will start ADT3 after PSA reaches 1.2.

Post Edited (Putt) : 2/3/2011 9:33:36 AM (GMT-7)


compiler
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Date Joined Nov 2009
Total Posts : 7203
   Posted 2/3/2011 11:31 AM (GMT -6)   
Carlos:
 
I don't know the answer, but on a related topic (somewhat) can you indicate how things are going regarding SE from the SRT. My SRT journey looms ahead, methinks.
 
Also, are you using the Varian Trilogy RapidArc?
 
Mel

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/3/2011 11:53 AM (GMT -6)   
Both my uro and the radiation oncologist wanted me to continue with .xx PSA tests after my SRT, due to my history of PSA velocity, how quickly I had BCR, and due to the low estimated odds of the SRT working. I don't have any problems with that line of thinking.
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 marg
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 11/10 Not taking it
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 9/23/10

F8
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Date Joined Feb 2010
Total Posts : 3800
   Posted 2/3/2011 11:58 AM (GMT -6)   
i've fired all my curative bullets and i'm using regular testing (i think).  anyhow i had blood drawn on monday and the results are probably ready now but i'll get them when i see my uro next tuesday.  in fact i had forgotten all about the PSA test -- a good thing -- until i read this thread.
 
ed
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 2/3/2011 11:59 AM (GMT -6)   

Carlos,

You are absolutely right; there is an abundance of discussion on standard vs ultra-sensitive PSA testing after primary treatment, not so much discussion (that I've seen) about which test to use after SRT.

The recommendation that I give to men after RP is dependent on whether they were categorized high-risk pre-RP, or whether they have any adverse pathological outcomes post-RP.  A significant number of men are low- or intermediate-risk before surgery and have negative margins, no SVI, no EPE, etc.; and for these men I recommend the standard PSA test.  All others, I recommend the ultrasensitive PSA test.

So, I’ll offer my opinion to your question below, plus my reason for this opinion.  As a “bonus”, my reply also includes some additional discussion on things you probably already know, but might be beneficial to others less knowledgeable who might read this thread as a reference in the future.

 

Undetectable post-RP baseline (shortly after surgery) PSA test results which later become detectable and progressively rise to, or above, 0.2ng/mL (followed by a 2nd test which confirms this rise) suggests local recurring PC (BCR) which exists in the prostate “bed” (a.k.a. local recurrence).  This is the scenario you presented with after two years of undetectable PSA (standard test, with lower detection limit, LDL, of 0.1ng/mL).  Salvage Radiation Therapy (SRT) which is focused on the prostate bed is the most common 2nd-line treatment for patients who likely have a local recurrence, and in fact SRT will only benefit those patients with local recurrence.

By contrast and for completeness of discussion only (albeit not your case), a detectable PSA level (and more specifically a detectable PSA level above the standard PSA test LDL of 0.1ng/mL) at post-RP baseline that also shows further progressive increases over time likely represents micro metastatic PC elsewhere…a progression which was likely present prior to RP.  A systemic salvage treatment using hormone therapy (ADT) would likely be the appropriate 2nd-line treatment in this case.

 

Some recent studies have examined the effectiveness & benefits of SRT.  A wide range of SRT successes/failures exists, so further studies broken-down factors that were predictive to SRT outcomes.  For example, the Gleason 8 (you), 9 & 10 guys had predictably worse outcomes from SRT, as did guys with faster PSA doubling times (with 2-years less than 0.1, you’re good here). 

You have at least one adverse factor.  From what you reported, your highest standard PSA test was 0.2ng.ml.  The standard test results would only yield 0.2, 0.1 or less than 0.1 (or higher results).  To me, these are reasons for you to use the ultra-sensitive PSA test which can be useful to track further possible relapse.

My opinion only…



Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 2/3/2011 1:10 PM (GMT -6)   
Putt, thanks for your comments.  You have done well in spite of your initial PSA and high GS.  IF I can squeeze out another 6 or 7 yrs that would put me in the 80+ range.
 
Mel, I haven't had any significant issues at this point.  My only concern is a noticeable lower flow rate that may indicate my old stricture is trying to make a comeback.   If that turns out to be my only problem I will be delighted.  Just like fairwind, am using the Var. RapidArc.
 
David,  Aside from calculating your doubling time a little sooner, what are you going to do with the info?  What difference does it make if your PSA is 1.2 or 1.15. 
 
F8, I'm in the same boat, my curative bullets are gone.  I'm trying to remember, did you use Dr. Sartor in New Orleans?  It is a 3 hr drive for me and am not sure I it is worth it.  Now, a trip to Bourbon St., that is something else.
 
Casey, thanks for confirming the lack of info. Either Sholtz or Strumm mentioned some value with his IHT protocol on the PCRI site but that was all I could find.  In the end it all depends on how the numbers get used.  I will probably stay with my local uro onc but have not had much of a discussion about HT.  I will start it as soon as necessary because i'm just in too good of health to throw in the towel. 
 
Carlos

F8
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Date Joined Feb 2010
Total Posts : 3800
   Posted 2/3/2011 1:37 PM (GMT -6)   
Carlos -- i was treated by urology associates of silicon valley and northern california prostate cancer center (radiation).  good luck to you!
 
ed
 
 
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/3/2011 1:51 PM (GMT -6)   
Carlos,

My next PSA test will be known on 2/28. If it has risen again, as even the doctors suspect, then there won't be any point after that text for .xx readings. If I continue to test after that, I will probably choose to go to a once a year test as part of my regular physical like I did in my pre-PC days, and have it just be a .x test. If my SRT has failed, there is nothing left curative for me, and its still my intention not to go down the HT path. If my doctors are correct, HT wouldn't work for long with me, and I am not willing to sacrifice the remaining quality of life I have on my own. So this may be my last .xx PSA test ever.

David in SC
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 marg
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 11/10 Not taking it
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 9/23/10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/3/2011 2:19 PM (GMT -6)   
David,
Just a point to clear up for others considering HT...

You stated:
"If my doctors are correct, HT wouldn't work for long with me, and I am not willing to sacrifice the remaining quality of life I have on my own."

It is my understanding that doctors are not able to predict on whom and for how long HT will work. In very rare cases it does not work well at all, and and on others, the patient never fails. It is highly unpredictable.

@all,
Back to the topic on ultra-sensitive PSA testing. I personally do not want the headache of micro-managing this disease. And I am glad about that. My last PSA test was the first ultra-sensitive PSA test and it still showed no PSA detection. I don't know if I had always used this test that it might have fluctuated. If it would have, it would have been completely unnecessary worry that I am glad I missed.

I have followed various study propaganda on ultra-sensitive PSA tests and there is very little evidence I can find supporting a benefit in managing prostate cancer. Many doctors suggest that there is but controlling PSA earlier is about all I can find. I found nothing on it leading to earlier therapy that improves prostate cancer specific mortality...of course versus following the more standard Bayer assay...

Tony
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

Treatments:
Da Vinci Surgery ~ 2/17/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Post Edited (TC-LasVegas) : 2/3/2011 1:22:47 PM (GMT-7)


Casey59
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Date Joined Sep 2009
Total Posts : 3172
   Posted 2/3/2011 2:58 PM (GMT -6)   

 

Also to the point of clarification raised by Tony for others possibly considering HT...

Purgatory said...
...and its still my intention not to go down the HT path...
 
David,
 
Last summer, you initiated a thread in which you essentially asked for the collective experiences of others who have experienced HT.  More specifically, you speculated that HT might turn "me into some kind of insensitive, uncaring emotional monster" (your words).
 
You received lots of heartfelt replies, none (from any responders who had actually been on HT) came close to your worst-case vision for HT.  Specifically:
 
  • dkob131 said:  "...the side effects have been minimal for me"
 
  • IdahoSurvivor tolded about a friend's experience:  "I don't know if this helps you, but I talked to a friend on Sunday that has been on HT for quite awhile and he is tolerating it well. "
 
  • pa69 talked about his brother's experience:  "He holds a full time job as an excavation contractor and has suffered essentially no side effects from the RT or the HT. "
 
  • Geebra said:  "I am enjoying life and small unpleasant side effects are nothing compared to being together with my wife, seeing my grandson turn one, sailing with friends or even putting in an honest day of work."
 
  • sancarlos put it this way:  "It is certainly no bed of roses to be on HT...However, with the exception of sexual functions, which I hope are temporary and will go away when I go off HT, most of the side effects are "manageable"."
 
  • kak (wife) added this perspective:  "The only things I have noticed and he talks about is, hot flashes, which he handles very well. He is more emotional, but I am not sure if it is from the diagnosis or from the HRT. He has a little bit of nipple swelling, but that has disappeared...but in our case I just want him around and it's crazy, but in a way we are closer than we were before."

 

  • And F8 pointed out:  "...if it really gets to you you can stop treatment"
 
Later, James C emphasized that the surgical route was yet another card to play which largely avoids many side effects.
 
 
 
 
Did anyone reply to you elsewhere that HT is intolerable and turned them into a "monster"...because that was not the flavor of the replies in your thread from last summer?  Why the marytr complex?


 

 

edit: typo

Post Edited (Casey59) : 2/3/2011 3:13:51 PM (GMT-7)


compiler
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Date Joined Nov 2009
Total Posts : 7203
   Posted 2/3/2011 6:37 PM (GMT -6)   
TC:
 
Got a question for you. You say that there is no evidence that the ultra-sensitive test improves the ultimate outlook for PC. Now, I assume you are talking about the 2-digit test vs. the 1-digit test. (If not, then I agree that the 3-digit test is not going to make a difference).
 
But, in my case, if I have another increase in 2 weeks (expected) I will be starting SRT within 10 days. That will be MUCH SOONER than if I used the 1-decimal test. Now, studies HAVE shown that starting SRT sooner improves one's chances of survival (at least in terms of BCR within 10 years). Depending on the actual PSA, the figures fluctuate from 20% (starting very late) to 51% (starting very early) at least according to the MSK nomograph. So, it seems that since using the 2-decimal test gives one a heads up, it would impact survival.
 
Any thoughts?
 
Mel

Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 2/3/2011 7:20 PM (GMT -6)   
Mel,
There is very strong evidence that starting SRT sooner is helpful, but what would be that cutoff point is unclear. If a man has a 0.05 and in three months it is 0.1 and he begins SRT he may have at best a 3 months head start over the Bayer Assay. In the Bayer case he would not have seen the rise until it was at 0.1 and with a doubling time of 3 months it would be then at 0.2 and most doctors would say that's when you should start considering SRT. Maybe it helps to start 3 months earlier, but maybe it doesn't. If the PSADT was instead 24 months, one might ask if SRT is even necessary. Many doctors won't recommend SRT until the PSA is at least at 0.2 and the PSADT is identified...And most studies on when to start SRT are based on the Bayer test.

However the question being asked is "Does Ultra Sensitive PSA have any value after SRT?".

This would indicate that Carlos is asking when he might start hormonal therapies and he wants to know if it matters to use the ultra-fine test to possibly start earlier if it can be detected earlier. I don't know the right answer except to say that what we do know for sure is that the ultra-fine PSA tests, anything finer than by the tenths of a ng/ml, can possibly drive that other PSA up (the PSA in this case is prostate specific anxiety).

I have seen various arguments about it, but every time I see a study they flood me with BCR information and lack survival benefit information. I chose to say to my oncologist that I really don't want to go through what I have seen many here go through. A test comes in at 0.04. Then 6 months later its 0.05. I am enjoying my string of undetectables. I'd rather have another undetectable than start worrying about relapse sooner.

Tony
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

Treatments:
Da Vinci Surgery ~ 2/17/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/3/2011 7:33 PM (GMT -6)   
Casey, I guess its just your nature to be rude, the "marytr complex". You are very insensitive in how you word things to people in general, this superiority bit is very unbecoming in a support group in my opinion.

You have made still another false assumption. Do you really think that the only opinions I have gathered on HT have been here on HW? Did it occur to you that I phone and e-mail people from HW, that share views that are not posted here? That I know people in real life that are in different stages of cancer? That my wife is a nurse and deals with men on HT on a daily basis? That I read a vast spectrum of information that isn't even share here on HW?

You shouldn't assume how someone else feels or thinks, that's not within your abilities.

My feelings on HT run deep and hard, and weighs heavy on my heart. Has nothing to do with any silly marytr's complex, I am not afraid to die, and realize that we all have to go one way or the other. How I evaluate the quality of my life, with all I have endured since age 28 is only known to myself, and perhaps my wife. It will be a personal decision I will have to make, when and if the time comes.

If you really want to help people here, learn some heart felt empathy and understanding first.

David in SC

Post Edited (Purgatory) : 2/3/2011 6:37:05 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/3/2011 7:43 PM (GMT -6)   
Tony:

Just passing on the opinion of my uro, remarks made by my radiation oncologist, and a medical oncologist who dealt with me 10 years ago with my other cancers. They are collectively big believers in the danger of rapid PSA velocity before treatment, and based on their thinking, its not uncommon to blow right through surgery into BCR (as happened) and then blow right through SRT (which we will know soon in my case), and then become refractory quickly with HT. I have a terrible reputation with side effects in general (as evidenced in what I have been through here, let alone what I dealt with in the past), have a hard time with medications in general, etc. Not saying that outcome will be a fact, you are right, there is some unpredicatableness to the whole thing. Still not convinced I want to go there. I entered SRT with great apprehension based on what happened in the past, and my worse fears all became reality for me. And as I drain this urostomy every 30 mins to an hour that I am awake, I hate the thought that I went through all that pain and suffering with the SRT, for absolutely nothing, and then ending up with a destroyed bladder and bladder neck to boot. If I only knew for sure in advance, should have ditched the SRT too. It was too high a price to pay as it is.

David in SC
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 marg
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 11/10 Not taking it
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 9/23/10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/3/2011 7:44 PM (GMT -6)   
"If you really want to help people here, learn some heart felt empathy and understanding first."

David, I actually believe that if Casey was not trying to help he would just forget about how you feel about HT and move on. You shouldn't take it personally. Perhaps he can say it better, but you painted a gruesome picture about HT that would absolutely not apply to anyone here.

I think Casey is trying to help you by outlining several experiences that have tolerated the regimen well.

Tony

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/3/2011 7:58 PM (GMT -6)   
So Tony, you are saying no one at HW Prostate Cancer has had any rough, or as you put it, gruesome experiences with HT? I would find that hard to believe, as its easy to find such stories outside of HW.

And it still boils down to a personal decision, doesn't it? I have never trashed anyone here for undergoing HT, or any other curative or non-curative treatment. I respect each man's decision.

And on the other matter, kind of hard not to take it personal, when there is usually a snide remark or condenscending remark thrown in along the way. I think I have the right to react as a normal human being that has been insulted. And he does assume too much.

David in SC
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 marg
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 11/10 Not taking it
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 9/23/10

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/3/2011 8:30 PM (GMT -6)   
David,
I am not questioning your decision in the post above. And I think Casey probably should not have made the martyr comment.

But I have been here four years and I guess I need to understand who the gruesome monster HT stories you have seen apply to. I have not seen it. I have always said that of my therapy choices to date that thus far the HT was the most difficult to deal with. But I digress to a teacher at my church who told me about her 81 year old husband who is incontinent, and not just urologically due to his radiation from 8 years ago. I don't like hearing that stuff after doing it adjuvantly. And my goodness, after all you have endured over the last two years, I would bet that HT would be a walk in the park next to it.

Still I respect your feelings. I was just saying that I think Casey is trying to help you and the group. The only gruesome monsters here are prostate cancer cells. And I am for anything that can make a bad day for them.

Tony

Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 2/3/2011 8:32 PM (GMT -6)   
PS:
Let's try to stay on topic here. But I offer you a live conversation if you'd like. I think I gave you my number in the past. But if you'd like to have it again just send the email and I can call you or let you have mine.


Peace

Tony

BillyMac
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Date Joined Feb 2008
Total Posts : 1858
   Posted 2/3/2011 8:52 PM (GMT -6)   
I am afraid I must agree with Purg. While the body of Casey's post superficially could be seen as pointing out that other posters thought HT may not be all that intolerable, the punch line of "why the martyr complex" was snide and completely unnecessary------ unless of course it was deliberately meant to be insulting.
Bill

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 2/3/2011 8:58 PM (GMT -6)   
Bill what we really need in this thread is an answer to the following question:
"Does Ultra Sensitive PSA have any value after SRT?"

LOL...now I know you are heading out to play golf in 2000 degree weather, taking about serious hot flashes... but perhaps you might be able to help Carlos here before the first tee...

Tony

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/3/2011 9:10 PM (GMT -6)   
Thinking about the original question again, and .xx or .xxx PSA reading probably has little meaningful value after the SRT card has been played, since there wouldn't be anymore curative means left to monitor that closely.
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 marg
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 11/10 Not taking it
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 9/23/10

BillyMac
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Date Joined Feb 2008
Total Posts : 1858
   Posted 2/3/2011 10:55 PM (GMT -6)   
The only value I see in ultrasensitve testing is to see try try and get abetter idea if initial treatment was curative. Although certainly not set in stone a result of <0.01 is a mighty fine start. It's other value is as an earlier indicator of recurrence -------- up to 2 years earlier than the standard test. This could be of value when important life decisions are to be made ------ ie continue working or retire ......... get involved in a new business or not. Two years advance notice could be mighty handy in such cases. In my own case I went ultrasensitve for this reason ------ at the first sign of relapse I would have pulled the pin and retired ---- I didn't so I continued working for a crust. The other value is an early indicator of doubling time ------ PSA must double quiet a few times from an undetectable level to becoming detctable on the standard test. I guess once you have relapsed and had SRT, if it becomes <.01 then you could assume the SRT was probably curative. If it did not then I shouldn't see that there was much value in persevering with the ultrasensitive.
Bill
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