RP 2007--Proton 2015---now 0.01 from <0.01--is it back ?

ccwierko1 · October 2019

Hi, I had Rp in 2007 via davince method. 2015 recurrence after 8 years of PSA = <0.01........Proton therapy 2015 and down to <0.01....PSA monitiored and was ,0.01 for 3 years.....today psa = 0.01 and NOT less than 0.01.........is Ca back ? .....scared and confused........any advise will help.......Thank you, Charlie C

ccwierko1 · October 2019

oops !..........psa monitored

oops !..........psa monitored and was less than <0.01 for 3 years

ccwierko1 · October 2019

psa was less than <0.01 for 3
psa was less than <0.01 for 3 years and now 0.01............does this mean Ca is back somewhere ?

ccwierko1 · October 2019

wher do I find link to read

wher do I find link to read "replies".....Thank you. Charlie C

ccwierko1 · October 2019

where do I read replies ?

where is link to read replies ?????

VascodaGama · October 2019

No recurrence at this level

CC,

Though the numbers are different in mathematics, the PSA of 0.01 equals the previous less than <0.001

This is still early to consider recurrence. You will need three increases to certify biochemical failure.

Best wishes for continuing remission.

VG

ccwierko1 · October 2019

VascodaGama said:
No recurrence at this level
CC,

Though the numbers are different in mathematics, the PSA of 0.01 equals the previous less than <0.001

This is still early to consider recurrence. You will need three increases to certify biochemical failure.

Best wishes for continuing remission.

VG

0.01 from <0.01
Thank you, my Dr. is sending me today for another U;tra Sensitive PSA test. Peace..........CC

ques: if I had RP via DaVince and the Ca came back. Then had Proton Therapy, 39 dyas, and Ca was gone based on PSA <0.01 for 3 years. But now it's 0.01 and if is is a recurrance is there anything they can do ? or do I just live with it as I'm 71 years old..............Proton again I think is out but maybe meds ?
Thank you again as I ahve always folowed your comments on this site.....again, PEACE

VascodaGama · October 2019

Oligometastatic treatment

The typical sequence on recurrences from failed RP and RT is hormonal treatment (ADT). Advanced cases with identified far places metastases (in bone and upper chest lymph nodes, etc, are recommended for chemo or a combination of chemo plus ADT. Those cases usually show very high PSA levels.

At this time your PSA doesn't show yet recurrence. The ultra sensitive assay (0,XXX ng/ml) will not be better than the traditional two decimal places (0,0X ng/ml). After failed radicals (RP + RT) earlier treatment have no particular benefit because these do not cure. Chemo or Hormonal are palliative so that these got the intent in extending the periods of control on the cancer. That can be done at higher levels of PSA. In my case with Gs6 I started ADT at a PSA of 1.0 but some guys start it at levels close to 5.0 ng/ml.

Another treatment that proved to provide cure after RP and RT is the so called Oligometastatic therapy. This involves spot radiation of localized lesions, usually found at the prostate bed and surroundings. Rads over rads is not easy so that those spots must be identified the best we can. Look for details on the therapy in this link and sub-links;

https://csn.cancer.org/node/320622

Best wishes,

VGama

Max Former Hodgkins Stage 3 · October 2019

VascodaGama said:
No recurrence at this level
CC,

Though the numbers are different in mathematics, the PSA of 0.01 equals the previous less than <0.001

This is still early to consider recurrence. You will need three increases to certify biochemical failure.

Best wishes for continuing remission.

VG

WAAAYY Not

CC,

The standardized point for defining relapse post prostectomy in the US is 00.20 or higher. This pertains to post-surgical treatment specifically, and may NOT be applicable following slavage/second line therapies such as your Proton, IMRT, or others.

Your result of 00.01 would have to get twenty (20) times worse to reach this threshold. You are a thousand miles from chemical recurrence in that view.

The following abstract from the United States Institute of Health summarizes a study of thousands of men over decades and their PSAs years after prostectomy. It concludes that most commonly a PSA of 00.4 or higher is nececessary (statistically) to suggest future relapse-related issues (FOURTY times your level today). It is a recent study (2016) from an outstanding facility (Mayo Clinic) and LARGE (over 13,000 prostectomy patients).

Of course, all of this is statistical evidence, and what transpires with any given individual is in essence unpredictable. But based upon the best current analysis, you seem to have nothing to be worrying about. Of course, your own urologist is the first person to enquire of.

https://www.ncbi.nlm.nih.gov/pubmed/26721226

ccwierko1 · October 2019

Max Former Hodgkins Stage 3 said:
WAAAYY Not
CC,

The standardized point for defining relapse post prostectomy in the US is 00.20 or higher. This pertains to post-surgical treatment specifically, and may NOT be applicable following slavage/second line therapies such as your Proton, IMRT, or others.

Your result of 00.01 would have to get twenty (20) times worse to reach this threshold. You are a thousand miles from chemical recurrence in that view.

The following abstract from the United States Institute of Health summarizes a study of thousands of men over decades and their PSAs years after prostectomy. It concludes that most commonly a PSA of 00.4 or higher is nececessary (statistically) to suggest future relapse-related issues (FOURTY times your level today). It is a recent study (2016) from an outstanding facility (Mayo Clinic) and LARGE (over 13,000 prostectomy patients).

Of course, all of this is statistical evidence, and what transpires with any given individual is in essence unpredictable. But based upon the best current analysis, you seem to have nothing to be worrying about. Of course, your own urologist is the first person to enquire of.

https://www.ncbi.nlm.nih.gov/pubmed/26721226

0.01 from <0.01
Thank you for your time and comments. I have read the related links and am becomming more educated as to my case due to your referrances.
Thanks again, CC
ps, I'll let you know of the outcome as I just returened from a re-take Ultra Sensitive PSA blood test at the Hosp. of Univ. of Penn (HUP).
Seeing the Dr next Tuesday.

ccwierko1 · October 2019

VascodaGama said:
Oligometastatic treatment
The typical sequence on recurrences from failed RP and RT is hormonal treatment (ADT). Advanced cases with identified far places metastases (in bone and upper chest lymph nodes, etc, are recommended for chemo or a combination of chemo plus ADT. Those cases usually show very high PSA levels.

At this time your PSA doesn't show yet recurrence. The ultra sensitive assay (0,XXX ng/ml) will not be better than the traditional two decimal places (0,0X ng/ml). After failed radicals (RP + RT) earlier treatment have no particular benefit because these do not cure. Chemo or Hormonal are palliative so that these got the intent in extending the periods of control on the cancer. That can be done at higher levels of PSA. In my case with Gs6 I started ADT at a PSA of 1.0 but some guys start it at levels close to 5.0 ng/ml.

Another treatment that proved to provide cure after RP and RT is the so called Oligometastatic therapy. This involves spot radiation of localized lesions, usually found at the prostate bed and surroundings. Rads over rads is not easy so that those spots must be identified the best we can. Look for details on the therapy in this link and sub-links;

https://csn.cancer.org/node/320622

Best wishes,

VGama

0.01 from <0.01
Thank you for your input and comments. Just got home from the Hosp. of the Univ. of Penn (HUP). The Dr. ordered a re-take of the Ultra Sensitive PSA test. I think he became aware of my concern that the test results might be wrong (ie, PSA = 0.01). I see him next week on Tuesday. I'll let you know what's going to happen with my case.
Thanks again, CC
ps, I have read the article links you provided and they are very interesting indeed. "May Remission Be with You"

ccwierko1 · October 2019

ccwierko1 said:
0.01 from <0.01
Thank you for your input and comments. Just got home from the Hosp. of the Univ. of Penn (HUP). The Dr. ordered a re-take of the Ultra Sensitive PSA test. I think he became aware of my concern that the test results might be wrong (ie, PSA = 0.01). I see him next week on Tuesday. I'll let you know what's going to happen with my case.

Thanks again, CC

ps, I have read the article links you provided and they are very interesting indeed. "May Remission Be with You"

VG and MAX --GOOD NEWS-- <0.01
Hi guys,
Had a re-take of the Ultra Sensitive PSA Blood test and the new results are GREAT. Less Than <0.01..........Dr. said the 0.01 happens at times ......Said it will happen again......But NOT to
Worry but call him with any questions.
Thank you for your support and PEACE..............CC

Clevelandguy · October 2019

Doing great

Hi CC,

Doing great, hope for many more undetectable PSA's, your 8 yrs. out and still no PSA, fantastic. Have a brewsky tonight to celebrate!!!

Dave 3+4

VascodaGama · October 2019

Charlie

Glad to know you are in peace now. This is another reason to celebrate. I prefer joining you with a glass of wine, but beer is okay too.

Best

VG

RP 2007--Proton 2015---now 0.01 from <0.01--is it back ?

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