Low PSA = no growth in cancer

ralph.townsend1
ralph.townsend1 Member Posts: 359 Member
In the case of my metastasis Prostate cancer and with a PSA of only 0.2 now and taking ZYTIGA. One would think that there is no growth in the tumor's which is in the Lymph Nodes.

If that is the case, then why would MD Anderson would want me to do a full CT / bone scan in July. Is it money or is it to check the size of the tumor's or is it that there can be more growth of this cancer and that just because it is 0.2 psa it can still grow?

The last CT/Bone scan was in Oct. 2011.
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Comments

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Tumor growth rate may increase despite stable PSA
    Ralph

    You can get an answer from the guys at MD Anderson. The trials’ protocols include tests which in your case may be a CT scan done at certain periods. What is surprising is your comment regarding “money”. I thought that you were having it for free.

    I also tend to believe that a stable PSA level equals to negative growth of cancer, but it seems that the theory is not totally correct. Some guys report on metastases while having stable PSA marks.
    RoxysDad is an example (http://csn.cancer.org/node/239231)

    Dr. Glenn Tisman presented at the PCRI Conference, evidences that tumour growth is specific to each patient. Cases can be considered similar but not equal. When discussing about the benefits of intermittent modality for hormonal treatments, he says that guys should monitor developments not only through the PSA. His reasoning is that “tumor growth rate may increase despite slowly rising or stable PSA”.

    I do not know if you can get a copy/DVD of his presentation but in PCRI site there is a summary with references to 5-ARI drugs where they write about his discussion topics;
    http://www.prostate-cancer.org/pcricms/node/356

    I would appreciate if you could inquire about that at MD Anderson. Can any comrade forward information on this matter?

    Best
    VGama
  • Samsungtech1
    Samsungtech1 Member Posts: 351
    Tests
    Ralph,
    There are plenty of people on this site who are tested every three to six months. No one knows exactly what is going on so they have tests to see if everything is in sync. Good for you. Better than doctors who know everything so do not test.
    Saw a press release for your drug, did not mention liver problems. On another note I had a customer come into shop today who knows about my condition and told me about a friend of his who had metastis to bones and was going into kidney failure. They gave him MD3100. He claims that his friend was cancer free in seven days and kidneys were fine. Gave me name of doctor who did the recommendation for trial. Gave me name and number of his friend to call and see what happened. Sounds too good. Not sure but will follow up.

    Good luck,

    Mike
  • Samsungtech1
    Samsungtech1 Member Posts: 351
    Tests
    Ralph,
    There are plenty of people on this site who are tested every three to six months. No one knows exactly what is going on so they have tests to see if everything is in sync. Good for you. Better than doctors who know everything so do not test.
    Saw a press release for your drug, did not mention liver problems. On another note I had a customer come into shop today who knows about my condition and told me about a friend of his who had metastis to bones and was going into kidney failure. They gave him MD3100. He claims that his friend was cancer free in seven days and kidneys were fine. Gave me name of doctor who did the recommendation for trial. Gave me name and number of his friend to call and see what happened. Sounds too good. Not sure but will follow up.
    By the way I use to get tested every three months ct including barium, and bone scan. I told them to do it every six months. That was when it doubled. I get all of them wednesday, and thursday. My right vein is getting worn out. Just had VA do blood, oncologist did blood and had these clowns trying to find my left vein and put the needle in and then poked it around trying to find the vein. Should have seen the bruising, classic.
    Good luck,

    Mike
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member

    Tumor growth rate may increase despite stable PSA
    Ralph

    You can get an answer from the guys at MD Anderson. The trials’ protocols include tests which in your case may be a CT scan done at certain periods. What is surprising is your comment regarding “money”. I thought that you were having it for free.

    I also tend to believe that a stable PSA level equals to negative growth of cancer, but it seems that the theory is not totally correct. Some guys report on metastases while having stable PSA marks.
    RoxysDad is an example (http://csn.cancer.org/node/239231)

    Dr. Glenn Tisman presented at the PCRI Conference, evidences that tumour growth is specific to each patient. Cases can be considered similar but not equal. When discussing about the benefits of intermittent modality for hormonal treatments, he says that guys should monitor developments not only through the PSA. His reasoning is that “tumor growth rate may increase despite slowly rising or stable PSA”.

    I do not know if you can get a copy/DVD of his presentation but in PCRI site there is a summary with references to 5-ARI drugs where they write about his discussion topics;
    http://www.prostate-cancer.org/pcricms/node/356

    I would appreciate if you could inquire about that at MD Anderson. Can any comrade forward information on this matter?

    Best
    VGama

    Paying
    I pay 20% co-pay the Zytiga and lupron is thought VA, which is free! It's late tonight talk to you tomorrow!
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member

    Tests
    Ralph,
    There are plenty of people on this site who are tested every three to six months. No one knows exactly what is going on so they have tests to see if everything is in sync. Good for you. Better than doctors who know everything so do not test.
    Saw a press release for your drug, did not mention liver problems. On another note I had a customer come into shop today who knows about my condition and told me about a friend of his who had metastis to bones and was going into kidney failure. They gave him MD3100. He claims that his friend was cancer free in seven days and kidneys were fine. Gave me name of doctor who did the recommendation for trial. Gave me name and number of his friend to call and see what happened. Sounds too good. Not sure but will follow up.
    By the way I use to get tested every three months ct including barium, and bone scan. I told them to do it every six months. That was when it doubled. I get all of them wednesday, and thursday. My right vein is getting worn out. Just had VA do blood, oncologist did blood and had these clowns trying to find my left vein and put the needle in and then poked it around trying to find the vein. Should have seen the bruising, classic.
    Good luck,

    Mike

    That's great on the MDV3100
    Mike,
    I in my heart that they are doing the right thing. It's about every six months that they do a full body scan ct,bone scan. They are good at the test, but it still not something I in joy. Your friend was at a state of condition that warranted the medicine. I do not think I qualify for the test with MD3100. My psa is to low. But if you have a doctor that will write a prescription to you. Then maybe VA will give the drug to you :-)! They always have hard time finding the vein!! :-(

    Good luck, and thank you for your service!!!

    GOD bless!!!!
  • Kongo
    Kongo Member Posts: 1,166 Member
    PSA and Metastasis
    Ralph,

    As prostate cancer advances the cells become more primitive and highly disorganized. At a certain point these prostate cancer cells no longer need testosterone to grow and they cease making PSA. This is how you can have low PSA scores but rapidly growing cancer. This is the stage where drugs like Zytiga become effective. Taking the scans will enable your medical team to determine the extent of cancer growth in other parts of your body since the PSA is ceasing to be a reasonable indicator.

    Best of luck with the scans.

    K
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member
    Kongo said:

    PSA and Metastasis
    Ralph,

    As prostate cancer advances the cells become more primitive and highly disorganized. At a certain point these prostate cancer cells no longer need testosterone to grow and they cease making PSA. This is how you can have low PSA scores but rapidly growing cancer. This is the stage where drugs like Zytiga become effective. Taking the scans will enable your medical team to determine the extent of cancer growth in other parts of your body since the PSA is ceasing to be a reasonable indicator.

    Best of luck with the scans.

    K

    CEASING
    Kongo, what are you saying that the cancer to could be growing??? I'm not sure that it is growing, because all the test ct scan in the past as the psa went up the cancer the lymph node's tumor's size went up and when the psa went down the lymph nodes tumor's went down.

    If your saying it could move to another area as a different cancer cell that is not psa cell.
    I'm still going to do all the testing they want. I trust MD Anderson, and will continue on there direction.
  • Kongo
    Kongo Member Posts: 1,166 Member

    CEASING
    Kongo, what are you saying that the cancer to could be growing??? I'm not sure that it is growing, because all the test ct scan in the past as the psa went up the cancer the lymph node's tumor's size went up and when the psa went down the lymph nodes tumor's went down.

    If your saying it could move to another area as a different cancer cell that is not psa cell.
    I'm still going to do all the testing they want. I trust MD Anderson, and will continue on there direction.

    Low PSA and Advanced Cancer
    Ralph,

    Yes, of course the cancer can be growing. That's why your doctors want to do these additional imaging tests even though your overall PSA score is low. When cancer cells advance and become significantly non differentiated the are more primitive than the early cancer cells that act much like a regular prostate gland cell. These irregular cancer cells produce very little PSA and when they become castrate resistant they no longer need testosterone to grow.

    There are several types of prostate cancer (at least 25 variations as I recall) and they have different evolutionary paths and symptoms but it is entirely possible to have a growing prostate cancer with low PSA as the disease advances.

    Ask your doctor about it.

    Best,

    K
  • muckdown
    muckdown Member Posts: 27

    Tumor growth rate may increase despite stable PSA
    Ralph

    You can get an answer from the guys at MD Anderson. The trials’ protocols include tests which in your case may be a CT scan done at certain periods. What is surprising is your comment regarding “money”. I thought that you were having it for free.

    I also tend to believe that a stable PSA level equals to negative growth of cancer, but it seems that the theory is not totally correct. Some guys report on metastases while having stable PSA marks.
    RoxysDad is an example (http://csn.cancer.org/node/239231)

    Dr. Glenn Tisman presented at the PCRI Conference, evidences that tumour growth is specific to each patient. Cases can be considered similar but not equal. When discussing about the benefits of intermittent modality for hormonal treatments, he says that guys should monitor developments not only through the PSA. His reasoning is that “tumor growth rate may increase despite slowly rising or stable PSA”.

    I do not know if you can get a copy/DVD of his presentation but in PCRI site there is a summary with references to 5-ARI drugs where they write about his discussion topics;
    http://www.prostate-cancer.org/pcricms/node/356

    I would appreciate if you could inquire about that at MD Anderson. Can any comrade forward information on this matter?

    Best
    VGama

    the money
    No there not doing it for free.However was the test necessary or "hey lets run this test,just to see whats going on " to many doctors order test and procedures wihtout knowing whats really going on . I went in the doctors office at Urology of austin and the doc order IMRT treatments. There was no way knowing if the treatment would be effective becase the ptostate was already taken out.So 39 treatment days later the PSA was were it was before.There was a good bit of money spent on nothing.
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member
    muckdown said:

    the money
    No there not doing it for free.However was the test necessary or "hey lets run this test,just to see whats going on " to many doctors order test and procedures wihtout knowing whats really going on . I went in the doctors office at Urology of austin and the doc order IMRT treatments. There was no way knowing if the treatment would be effective becase the ptostate was already taken out.So 39 treatment days later the PSA was were it was before.There was a good bit of money spent on nothing.

    Free medicine
    Muck, the way it works for me is that MD Anderson cancer center write the prescription to VA Hospital to fill. Since I'm 100% disabilty with VA all medicine is free.

    I agree about the 39 wasted treatment that did not kill the cancer. Waste of money and time!! The side effect were terrible!

    Good luck with yours!
  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member
    Kongo said:

    Low PSA and Advanced Cancer
    Ralph,

    Yes, of course the cancer can be growing. That's why your doctors want to do these additional imaging tests even though your overall PSA score is low. When cancer cells advance and become significantly non differentiated the are more primitive than the early cancer cells that act much like a regular prostate gland cell. These irregular cancer cells produce very little PSA and when they become castrate resistant they no longer need testosterone to grow.

    There are several types of prostate cancer (at least 25 variations as I recall) and they have different evolutionary paths and symptoms but it is entirely possible to have a growing prostate cancer with low PSA as the disease advances.

    Ask your doctor about it.

    Best,

    K

    July
    I go to treatment first to VA on the 6 of July for blood test to get free Zytiga. As long as my blood test comes back normal, they will supply Zytiga free. Then I go to MD Anderson on the 9th of July for full body CT and Bone scan, blood test. Its all done in a half of a day. Wham bam thank you mam.

    I keep you inform, and good luck and God bless.
  • Trp911
    Trp911 Member Posts: 8
    Kongo said:

    Low PSA and Advanced Cancer
    Ralph,

    Yes, of course the cancer can be growing. That's why your doctors want to do these additional imaging tests even though your overall PSA score is low. When cancer cells advance and become significantly non differentiated the are more primitive than the early cancer cells that act much like a regular prostate gland cell. These irregular cancer cells produce very little PSA and when they become castrate resistant they no longer need testosterone to grow.

    There are several types of prostate cancer (at least 25 variations as I recall) and they have different evolutionary paths and symptoms but it is entirely possible to have a growing prostate cancer with low PSA as the disease advances.

    Ask your doctor about it.

    Best,

    K

    I'm new here and not sure if

    I'm new here and not sure if you all are still on this thread. This is information I have been seeking for years. Can the cancer progress in spite of only a small rise in PSA.  I will read the info you provided and see what, if any, updates there may be. 

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Aggressivity of PCa as seen from its genes.

    Trp911,

    You are correct. The aggressivity of one's case is never verified by the PSA. At present one can get a genes test that provides a more accurate understanding of one's type of cancerous cells. It is known that there are at least 25 varieties of PCa. The Gleason provides just a clue on the pattern of the cells comparing them with the pattern of a normal cell. Those poorly differentiated (more disfigured) tend to be more aggressive and with tendency for multiplying and spreading. Some are not hormonal dependent (do not respond to ADT) and some do not produce PSA at all.

    Researchers are also involved in discovering newer therapies that practically involve curing the genes (conversely saying it). Here are links that may be of your interest;

    https://www.cancer.gov/types/prostate/hp/prostate-genetics-pdq

    https://www.multivu.com/players/English/8098751-genomic-health-oncotype-dx-genomic-prostate-score/

    http://www.news-medical.net/news/20170619/Scientists-develop-new-three-in-one-blood-test-that-could-transform-prostate-cancer-treatment.aspx

    Best,

    VG

  • Miao
    Miao Member Posts: 6
    VascodaGama,

    VascodaGama,

    If some one has very low psa under 1 without any symptom, why they go to see doctor. I am newer here, many things make me confusing

    Thanks

     

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Each doctor got their own PSA thresholds

    Miao,

    I do not know which cases you have in mind but the PSA pre-treatment and after treatment should be considered differently. Patients that did surgery should have remission levels in PSA terms at lower levels less than 0.05 ng/ml. Post radition therapy one should also reach a similar low level lesser than 1.0 but it would take several months to get to such nadir. Any increase after a nadir PSA could be guessed as recurrence, typically named as biochemical failure.

    Recurrence thresholds to identify treatment failure differ from doctor to doctor and it can go from 0.03 to 0.06 in RP guys or up to 1.5 in RT guys. There are also those doctors that even prefer using ultra sensitive assays with three decimal places (PSA=o.XXX ng/ml) to judge an earlier recurrence, leading patients to start salvage therapies with PSA levels lower than 1.0 and most probably without symptoms.

    In fact each case is never equal to the other so that the PSA should not be the only marker to tell the story. Many patients with advanced cases of metastases are assymptomatic.

    Best,

    VG

  • Miao
    Miao Member Posts: 6
    VG,

    VG,

    Thank you very much for your explaining. i did learn more and more from here. I did biopsy today, and doctor gave me a PCA3 test as well. who here knows about PCA3?

    Thanks again

    M

  • xtim999
    xtim999 Member Posts: 2
    Zytiga & Lupron

    Diagnosed in May with Gleason score 9, 11/12 biopsy cores at 90%, PSA 26. No apparent matastisis and needle biopsy of "suspiscious lymph node" was negative. MRI showed possible seminal vessicle invasion. Bone scan negative. MD Anderson Doctors started me on Degerelix for 30 days along with Zytiga & prednisone. At 30 day checkup testosterone <20 and PSA was .9 Doctor seemed very pleased & replaced Digerelix with 90-day Lupron and sent me home with lab work orders for PSA test every 30 days. The plan is to reduce the tumor size and to return in January for bone scan & MRI and hopefully surgery in February. They say that they have not closed the door on a "cure" but it seems to me like the door is just barely open. I'd appreciate anyone's comments if you have had similar treatments. Thanks

  • Clevelandguy
    Clevelandguy Member Posts: 978 Member
    edited October 2017 #19
    PCA3

    Hi Miao,

    A PCA3 test is a urine test where most PSA tests are blood tests.  The doctor massages the prostate then takes a pee sample,  the massage stimulates the prostate to release PCA3(prostate cancer gene) into the urine.

    Dave 3+4

  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    edited October 2017 #20
    .

    Surgery is effective for localized cancer, that is if the cancer is within the prostate.

    With extensive, aggressive cancer as you have been diagnosed with, without a doubt, the cancer has escaped your prostate, and surgery will not be effective. You will still need other treatment(s) that would be a combination of radiation and hormone treatment, or hormone treatment only. The side effects of each treatment modality is cummulative.

    Please note that the perimeter of  radiation treatment can be extended beyond the prostate, so that it can treat cancer that is outside the prostate...this may or may not be all of the cancer.

    Please make sure that the MRI that you will receive will be a 3T multiparametric MRI...uses a 3.0 magnet, the best definition in clinical use. 

    Also inquire about a PET scan.

    Wishing you the best

     

  • VascodaGama
    VascodaGama Member Posts: 3,638 Member
    Shrinking to dissect ! Why?

    XTIM999,

    I agree with the opinion of Hopeful above. Your doctor's suggestion for surgery should have the purposes of cure. That is proper when the case is diagnosed as contained, otherwise surgery will just serve to debulk the "big tumor" therefore, with low assurances of cure.

    I also cannot understand the need in reducing the tumor size to perform surgery. This is typically done in radiation interventions to avoid the risks for collateral damage of closed tissues/organs. Probably you have miss-listen his suggestion. Can you tell what did they read from the MRI image, what was the size of the prostate?
    I would think that your doctor wants to accommodate your organ to facilitate a robotic surgery because open RP style doesn't require such reduction.

    Your comment on the possibility of seminal vesicle invasion turns your case worse and still leaning further toward a bad prognosis for a surgery approach. In your shoes I would get a second opinion from a radiologist. In any case, you can continue with this initial ADT protocol because it wouldn't alter any future treatment decision. Apart from showing already success in the control of cancer advancement, ADT (Zytiga + Lupron) would always be part of your treatment. However, some surgeons doing open surgery do not like the sticky feeling caused by ADT when dissecting the tissues.

    Best wishes and luck in your journey.

    VGama