- post-op PSA levels and success rate for SRT

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tatt2man
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Date Joined Jan 2010
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   Posted 3/20/2011 1:31 PM (GMT -6)   
interesting research - 2007 -

jco.ascopubs.org/content/25/15/2035.full
Age: 55 - gay with spouse of 14 years, Steve
location: Peterborough, Ontario, Canada
PSA: 10/06/09 - 3.86
Biopsy: 10/16/09- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/09
Pathology: pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA: 04/08/10 -0.05 -Zero Club
PSA: 09/23/10 -0.05 -Zero Club
PSA: 03/24/11 - TBA

tatt2man
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Date Joined Jan 2010
Total Posts : 2842
   Posted 3/20/2011 1:38 PM (GMT -6)   

compiler
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Total Posts : 7205
   Posted 3/20/2011 4:55 PM (GMT -6)   
Tatt:
 
Good article. For me, this part of the second article was encouraging:
>>>>>>>>>>>
Recently, data on OS and SRT have become available. Interestingly, Trock et al showed in a group of men with a median follow-up of 9 yr after prostatectomy that the benefit of SRT for PCa-specific mortality was particularly seen in men with a PSA DT <6 mo who obtained SRT to the prostate fossa within 2 yr after a PSA rise [11]. These data suggest that local disease control may prolong PCa-specific survival in men formerly thought to be at risk for systemic disease progression and less likely to benefit from (salvage) RT. This finding may possibly be explained by the fact that men with slowly progressing disease—although at risk of systemic progression—may not benefit from SRT because the risk of development of lethal PCa in these cases may be low. Certainly, longer follow-up is needed to answer this question, but it seems in line with findings in, for example, breast cancer
>>>>>>>>>>>>>>>
 
Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64. Surgery: Dr. Menon @Ford Hospital, 1/26/10. Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- yes.. PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06; 1/4/11-0.13,3/1/11--0.27

Purgatory
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Date Joined Oct 2008
Total Posts : 25380
   Posted 3/20/2011 5:02 PM (GMT -6)   
Good articles, read them both.

Unfortunately, none of the encouraging parts did me any good.

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 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 2/11 1.24
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,

Worried Guy
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Date Joined Jul 2009
Total Posts : 3732
   Posted 3/20/2011 5:33 PM (GMT -6)   
I just checked the first article and looked at the graph.

Excerpted from the first article with my insertions in bold:
Fig 1. (A) Kaplan-Meier estimate of the overall progression-free probability after salvage radiotherapy. (B) Progression-free probability (I added the % at 5 years) after salvage radiotherapy stratified by preradiotherapy prostate-specific antigen 0.50 or less (blue) ~60% , 0.51 to 1.00 (yellow) ~50%, 1.01 to 1.50 (gray) ~40%, and more than 1.50 ng/mL (red) ~30%.
At all points along the time line it was far better to have the SRT done when the PSA was 0.50 or less. It seems the earlier the better. Why wait? Am I missing something?

Jeff

compiler
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Date Joined Nov 2009
Total Posts : 7205
   Posted 3/20/2011 5:35 PM (GMT -6)   
You are missing nothing. Best to do SRT ASAP.
 
I had everything in place and there are still delays. I hope to start this week, but I suspect it will be a week later!
 
Mel

Purgatory
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Date Joined Oct 2008
Total Posts : 25380
   Posted 3/20/2011 5:47 PM (GMT -6)   
I started it at .16, and it has still failed, so as usual, no guarantees, now up to 1.24 and climbing
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 2/11 1.24
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
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Date Joined Nov 2009
Total Posts : 7205
   Posted 3/20/2011 5:48 PM (GMT -6)   
We need articles on best tx. AFTER SRT fails. Maybe time until metastises?
 
I hate this disease
 
Mel

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/20/2011 5:55 PM (GMT -6)   
For all practical purposes, my entire life has been one on hold since my dx in 2008, its just been one thing after the next after the next. Sick of thinking about, worrying about it, fretting, dreading, nightmares, etc.

With the exception of no ED, there's nothing good I can say about this entire PC journey. No really a vent, not really a complaint, just stating the facts of the matter.

I haven't been even once on the good side of any PC stats.

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 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 2/11 1.24
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,

logoslidat
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Date Joined Sep 2009
Total Posts : 5823
   Posted 3/21/2011 2:10 AM (GMT -6)   
What's interesting about this is the .5. Note it is not .05, which is the usual rational for the ultra sensitive testing. I am aware of studies, made aware on this forum actually and do believe they are out there just haven't researched them. Heck I never did homework as a kid, so hard to do research, know what I mean. Just saying.... BTW having trouble editing profile, when I attempt to, it erases part of profile. In any case psa dec14 2010 0.0. Its a std test but they report it as 0.0 if its undetectable I guess. Really, on the paper, 0.0
age 67 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of Washington Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci, extensive PNI, That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " Francois de la Rochefoucauld, source courtesy of Tatt2

logoslidat
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Date Joined Sep 2009
Total Posts : 5823
   Posted 3/21/2011 2:13 AM (GMT -6)   
Aware of studies indicating good to start srt @ .05, that is
age 67 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of Washington Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci, extensive PNI, That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " Francois de la Rochefoucauld, source courtesy of Tatt2

tatt2man
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Date Joined Jan 2010
Total Posts : 2842
   Posted 3/21/2011 5:41 AM (GMT -6)   
- I am at PSA 0.05 and my doctor is very happy with that level and has NOT recommended SRT

-SRT usually starts entering the picture after a number of timed results with PSA 0.2 or better - some wait until 0.50... depending on the doubling time ...

hugs,
BRONSON
Age: 55 - gay with spouse of 14 years, Steve
location: Peterborough, Ontario, Canada
PSA: 10/06/09 - 3.86
Biopsy: 10/16/09- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/09
Pathology: pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA: 04/08/10 -0.05 -Zero Club
PSA: 09/23/10 -0.05 -Zero Club
PSA: 03/24/11 - TBA

An38
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Date Joined Mar 2010
Total Posts : 1148
   Posted 3/21/2011 7:00 AM (GMT -6)   
very intersting bronson, thank you.

An

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 3/21/2011 7:02 AM (GMT -6)   
logo - re: profile -
- you are only allowed so many characters now (400?) in your profile update - that is why some of it disappears when you try to redo it
... still don't know why some profiles are still way over the limit mark ...
Age: 55 - gay with spouse of 14 years, Steve
location: Peterborough, Ontario, Canada
PSA: 10/06/09 - 3.86
Biopsy: 10/16/09- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/09
Pathology: pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA: 04/08/10 -0.05 -Zero Club
PSA: 09/23/10 -0.05 -Zero Club
PSA: 03/24/11 - TBA

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/21/2011 8:53 AM (GMT -6)   
Couldn't imagine anyone having SRT at .05, unless they had terrible pathology. I have also been told, that SRT is most effective below .50, and basically not worth doing at 1.0 or higher. This is what my local doctors have said. And while the "official" definition of BCR talks about readings above .20, my local doctors spoke of 3 consecutive readings, every 3 months, above .10.
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 2/11 1.24
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,

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5823
   Posted 3/21/2011 10:26 AM (GMT -6)   
I could have been wrong on the .05, I still have trouble with these numbers and have to consult my wife, who draws the big box with all the little boxes inside darkened to illustrate it for me. Good lesson for newbies, always check with the person in the white coat, plus the other posters keep us, I wouldn't say honest, cause I believe we all are. but hopefully correct. Though do believe that sloan kettering definition of BCR is 0.05! Anyway this is where threads go astray! Aloha, Jack
age 67 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of Washington Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci, extensive PNI, That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " Francois de la Rochefoucauld, source courtesy of Tatt2

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 3/21/2011 10:41 AM (GMT -6)   
article - 2006-
Defining Biochemical Recurrence of Prostate Cancer After Radical Prostatectomy: A Proposal for a Standardized Definition

jco.ascopubs.org/content/24/24/3973.full

article- 2010-
Definition of biochemical recurrence after radical prostatectomy does not substantially impact estimates for prognostic factors
www.ncbi.nlm.nih.gov/pmc/articles/PMC2919806/


...

Post Edited (tatt2man) : 3/21/2011 10:46:34 AM (GMT-6)

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