Thanks for clarifying.
Yes, that's a big problem with relying on the "gee whiz" anecdotes to inform decision making. As I said, mets will sometimes show up if PSA is very rapidly rising. He selected the outliers to present, not the average patient.
Mayo does NOT have a very good PET scan, unless they've since switched to one of the better ones than the C11 Choline PET/CT. They certainly did not have one in 2014 when that video was made. Garyi got the best of the ones now in clinical trials, and his PSA is within the range that DCFPyL PET might detect it - yours is not. And you can't wait until mets are
PET-detectable -- that would be a self-fulfilling prophecy. You don't seem to want to acknowledge how curable a PSA recurrence is, even with no positive margins, as long as it's treated early enough. Your assertion that your recurrence, if
you have one, is already metastatic is quite frankly ridiculous.
As I recall, almost all of his selected gee-whiz slides were men who were followed for only 2 years after having very few (oligometastatic) mets. Two years is nothing. Prostate cancer metastatic development is almost always very slow at first. It's not uncommon for two or more years to pass without any new mets, even without zapping what is there. That's why the video is so deceptive - it doesn't show you the control group - what would have happened with no treatment.
If you want to understand just how misleading that video is, read this:/pcnrv.blogspot.com/2017/05/unwarranted-conclusions-about.html
We cannot draw any valid conclusions about
whether there is any survival benefit at all to metastasis-directed therapy until an RCT in the UK has data in 2021. Local radiographic control and PSA reduction are expected, but they are not useful endpoints.
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