This study was mentioned in the Uroalert
email I get periodically. The link here is for the free full-text version of the article. It explores the idea of using Circulating Tumor Cells (CTCs) as indicators of metastatic disease status. They find various cancers are better or worse about
releasing CTCs. Prostate cancer is more prone to exhibiting CTCs, according to this.
From the article: In a disease-to-disease comparison when reviewing the percentage of patients exhibiting CTCs, CTCs are seen in a higher percentage of breast and prostate cancer patients than in colorectal cancer patients. Pancreatic and ovarian cancers, regardless of their stage and aggressiveness, rarely reveal CTCs.
The smart guys can comment on this, I'm sure. It's at least an interesting research avenue, and may one day be good enough to help people make better treatment choices up front. This is one aspect of the "liquid biopsy" idea we sometimes hear about
Also from the article (cfDNA is "cell free DNA"):Can CTCs and cfDNA be combined in such a manner to aid in the cure of metastatic disease? Yes, and used in combination and including a control of whole blood to detect somatic mutations, CTCs—the “silent” predictor of metastatic disease—and cfDNA can serve to monitor the progression of primary disease to a metastatic state and this combination can be used for every tumor type.Circulating tumor cells: silent predictors of metastasis
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3T mpMRI: Bilateral EPE, NVB+, SV-, LN-)
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex, ended 3/16
PSA <0.1 : 8/13 - 5/16;
steadying? - 0.2-8/16, 0.5-12/16, 0.7-3/17, 0.8-5/17, 0.8-7/17