I could address my answer specifically to you if you would create a signature with details of your diagnosis and treatment history.
Your question is "If not is the conclusion there was metastis( table claims 47% mortality at 8 yrs if PSA nadir was greater than 0.5) or some other reason, the RT itself was not succesful? "
I can only repeat what I wrote there:
A nadir of only 0.5 ng/ml among those taking ADT in this clinical trial suggests that the ADT was not working completely. I assume that ADT was begun 2 months before the EBRT, continued during the 2 months of EBRT, and was continued for 2 months after that (6 months total). If the first PSA was taken 3 months after EBRT completion, the effect of the ADT had not worn off yet. Some of the cancer must already have been castration resistant. Patients received a bone scan, but some must have already had metastases that were too small to be detected by it.
We see this reflected in how quickly the metric predicted mortality. In as quickly as one year from the start of treatment, mortality was 20% among those who had already reached a nadir, and it was over 0.5 ng/ml vs. 0% in those who hadn't reached it. At year one, the percent who had met the endpoint was negligible for the other endpoints. Clearly, patients with a PSA that never goes down below 0.5 ng/ml after radiation +ADT are at greater risk.
Is there anything I can further clarify?
You also asked: " is another PSA done at some point prior to commencing the RT, perhaps just prior to show the 2 month effect of the ADT on the PSA? would that be a good date point to have."
Yes. That is standard of care. Testosterone level should be measured prior to commencing RT to assure that castration has been achieved, and the PSA has responded. If not, an alternative hormone therapy may be employed.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
•SBRT 9 yr onc. results
•SBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEsmy PC blog