Acid Phosphatase

PAP or prostatic acid phosphatase
PAP stands for prostatic acid phosphatase and if your result was 3 or under that is a good thing (according to Dr. Steven Strum). Rather than try to explain it here, just google PAP and prostatic acid phosphatase, which will give you a better understanding of it than if I tried to explain it. Dr. Steven Strum discusses the importance of this test in his book on PCa, which I recommend (a bit scientific, but a good book for anyone w/PCa). I was privileged to hear Dr. Strum speak (& got to speak w/him personally--I know, bragging...) this weekend at the PCRI Conference on PCa in L.A. that I attended with pjd. Will try to share some info from the conference in a future thread/post when it all has a chance to sink in--but overall, great conference on PCa!

bdhilton said:

Thank you for the
Thank you for the expatiation. Am looking at what guys had for readings, what their clinical and post surgery pathology was and what additional treatment if any they had…thanks

pre-treatment PAP
pjd's pre-treatment PAP was under 3. As I'm sure you are aware from reading elsewhere on this forum, he did not elect RP as his primary treatment modality for T3, locally advanced, non-metastatic PCa, so although this info may not answer your question, hopefully it might be useful for others.

mrspjd said:

pre-treatment PAP
pjd's pre-treatment PAP was under 3. As I'm sure you are aware from reading elsewhere on this forum, he did not elect RP as his primary treatment modality for T3, locally advanced, non-metastatic PCa, so although this info may not answer your question, hopefully it might be useful for others.

PAP Question
Mrs,

As I understand it, the PAP was the prevelant test before PSA was developed and has pretty much been replaced by PSA as a potential PCa precursor. The PAP can flucuate significantly over a single day and is not as accurate as PSA (which has its own issues about accuracy). From what I have read, PAP today is really only relevant as a possible indicator of metastasis before there are other symptoms or evidence from bone scans, chest x-rays, or other blood panel work and is used to help guide treatment decisons. From the information you've gathered, is that a correct interpretation or is there some other use for PAP that I don't know about.

BD: I wonder what study you are in that tracks PAP, how often is it taken, and what do they use it for? Are there levels which would trigger additional treatment?

mrspjd said:

PAP or prostatic acid phosphatase
PAP stands for prostatic acid phosphatase and if your result was 3 or under that is a good thing (according to Dr. Steven Strum). Rather than try to explain it here, just google PAP and prostatic acid phosphatase, which will give you a better understanding of it than if I tried to explain it. Dr. Steven Strum discusses the importance of this test in his book on PCa, which I recommend (a bit scientific, but a good book for anyone w/PCa). I was privileged to hear Dr. Strum speak (& got to speak w/him personally--I know, bragging...) this weekend at the PCRI Conference on PCa in L.A. that I attended with pjd. Will try to share some info from the conference in a future thread/post when it all has a chance to sink in--but overall, great conference on PCa!

About a year ago, I heard Dr. Strum speak
at the Orange County Prostate Forum in Fullerton.....this organization generally records the presentation made, and the Dvd's are available for rental.

I also read Dr. Strum's book, a few times over. It was very technical, and a lot of it went over my head, but I learned a lot from the parts that I understood. I believe that this book is best used as a reference ....This book is probably the most informative that I have read...I think that it's time to reread the book. Since I had lent the book I need to buy or relend.

If I remember correctly , Dr. Strum is now retired, and volunteers his time on prostate site, I think but not sure that it is PCRI.....please validate or correct this information.

Ira

mrspjd said:

Dr. Strum
Ira,
My understanding is that Dr. Strum is semi-retired and no longer accepts new patients. He is still very active in PCa research with doctors world wide. Strum is an extremely vocal advocate for PCa in many areas, including trying to get new legislation passed pertaining to how men should be counseled PRIOR to making tx decisions; and working with other well-known medical professionals in order to get the FDA to "fast-track" new PCa drugs that have shown promise, now especially, Abiraterone. He has been known, at times, to be a physician contributor on P2P (Physician to Patient). The Us Too website as well as the following link may give you more info: http://www.prostatepointers.org/mlist/mlist.html

Pre-Treatment Counseling
I certainly agree with any effort to upgrade and standardize required counseling prior to receiving treatment. Although every treatment in the USA requires "informed consent" that generally means the doctor has to advise you about potential side effects and other options, I know from my own experience and from those of other men I have met with personally or corresponded with that there is a wide, wide variation on how that information is delivered.

For example, one oncologist, when I asked him about potential penile atrophy with RP or radiation treatment said glibly.."sure, there is always 'some risk' but you have plenty to spare." I realized he was trying to make light of a subject near and dear to men but I didn't appreciate it and ended up being put off by his other suggestions just because of that one comment.

In general I think I received fairly comprehensive overviews from the six professionals I consulted with but in all but two cases, I had to press really hard for them to elaborate on side effects that I had already read about. If I hadn't done my homework before hand, I would have come away dazed and confused.

It's a complicated subject. I think some men really don't want to know...they just want it taken care of and are willing to follow their doctor's advice and no matter how much you try to standardize the pre treatment counseling, there is going to be a fairly large percentage of men who either don't want to hear it, or don't have the background to understand what they're being told.

This may be heritical to say, but if I was going to create my perfect cancer (as bad as that alone may be), I think PCa pretty much fits the mold. Most men, even men with advanced stages, do not die from this disease. When you compare what we go through (and I realize its pretty grim for many of us given the side effects of some of the treatments we have received) compared to a woman with breast cancer or a person with pancreatic or lung cancer...we come out pretty good overall. If I had to have a cancer, I am glad I had this one. Having said that, and please forgive me if I have offended anyone truly suffering from the effects of this disease and I'm certainly not implying that what we have isn't "real" cancer as discussed in an earlier thread a few months ago.

The complexity of this disease, the many nuances surrounding PSA, PAP, Gleason, sexual potency, testosterone, biopsies, DREs, and so forth and the wide variety of treatments along with the constant hard sells we are exposed to from across the spectrum of the professional medical community, conflicting medical studies, contradictory advice from "experts," all conspire to make this extremely difficult for us to assess rationally. All too often I believe too many men end up making emotional rather than rational decisions about how to deal with their diagnosis.

I don't think the FDA is doing us too many favors either. But that's a whole other topic.

Sorry for straying off thread.

Kongo said:

Pre-Treatment Counseling
I certainly agree with any effort to upgrade and standardize required counseling prior to receiving treatment. Although every treatment in the USA requires "informed consent" that generally means the doctor has to advise you about potential side effects and other options, I know from my own experience and from those of other men I have met with personally or corresponded with that there is a wide, wide variation on how that information is delivered.

For example, one oncologist, when I asked him about potential penile atrophy with RP or radiation treatment said glibly.."sure, there is always 'some risk' but you have plenty to spare." I realized he was trying to make light of a subject near and dear to men but I didn't appreciate it and ended up being put off by his other suggestions just because of that one comment.

In general I think I received fairly comprehensive overviews from the six professionals I consulted with but in all but two cases, I had to press really hard for them to elaborate on side effects that I had already read about. If I hadn't done my homework before hand, I would have come away dazed and confused.

It's a complicated subject. I think some men really don't want to know...they just want it taken care of and are willing to follow their doctor's advice and no matter how much you try to standardize the pre treatment counseling, there is going to be a fairly large percentage of men who either don't want to hear it, or don't have the background to understand what they're being told.

This may be heritical to say, but if I was going to create my perfect cancer (as bad as that alone may be), I think PCa pretty much fits the mold. Most men, even men with advanced stages, do not die from this disease. When you compare what we go through (and I realize its pretty grim for many of us given the side effects of some of the treatments we have received) compared to a woman with breast cancer or a person with pancreatic or lung cancer...we come out pretty good overall. If I had to have a cancer, I am glad I had this one. Having said that, and please forgive me if I have offended anyone truly suffering from the effects of this disease and I'm certainly not implying that what we have isn't "real" cancer as discussed in an earlier thread a few months ago.

The complexity of this disease, the many nuances surrounding PSA, PAP, Gleason, sexual potency, testosterone, biopsies, DREs, and so forth and the wide variety of treatments along with the constant hard sells we are exposed to from across the spectrum of the professional medical community, conflicting medical studies, contradictory advice from "experts," all conspire to make this extremely difficult for us to assess rationally. All too often I believe too many men end up making emotional rather than rational decisions about how to deal with their diagnosis.

I don't think the FDA is doing us too many favors either. But that's a whole other topic.

Sorry for straying off thread.

FYI
FYI

Prostate Cancer will kill 32,000 men in the US this year. It is the second largest killer of men of all of the types of cancer.

bdhilton said:

I totally agree that the
I totally agree that the FDA, America Medical Association and various “non-profit” cancer groups are not doing us too many favors…At the end of the rainbow it is all about the almighty dollar not us…It is tragic that we have to take the position of “caveat emptor”…

However, this cancer has 24 varieties and is deadly for many men with a fast and painful death too... Give often to the Prostate Cancer Foundation (the most active one out there for all of us with Prostate Cancers)…Best to all

Almighty Dollar
I do agree with BD that the financial aspects of this disease is a real turnoff for those of us who have suffered it. On the other hand, without the potential for making a buck off our prostates we probably would not have all the advances we have seen in recent years.

It's a double-edged sword for sure.

bdhilton said:

Perhaps it would be helpful
Perhaps it would be helpful if you posted his details on the “about me” section. My question was about any treatment results and the PAP score-thanks

info & details
Thank you for your suggestion, however, for now, I've intentionally opted not to post those details in the "blog" or "about me" sections of CSN--obviously, this is a very personal decision for each CSN member. (That is also why I don't list "friends.")The "details" you refer to are documented in my many posts on this forum. I'm no expert by any means, however, willing to help & share what I know re T3 locally advanced PCa. As for your questions, pjd is currently in primary tx, so there are no tx results to report/post (except for ADT, which I've previously written about), and I think I've already answered your question about PAP score. The PAP he had did not influence his choice of tx--what did influence his decision was a combination of: multiple doc consults, further testing including a second opinion on his biopsy lab slides from Johns-Hopkins Pathology, Tesla 3 endo-MRI w/Spec, color doppler ultrasound, obtaining and confiming his correct PCa staging, and extensive research on T3 PCa. Hope this helps to answer your questions.

mrsjj said:

mrspjd
I am new here and like you have a husband with prostate cancer. I have been reading everyone comments and I am thankful that people share their experiences. I find your comments interesting above. You tell bdhilton that his question about your husband and prostate pathology is none of his business and then you ask ob66 today 101 questions about his treatments? I think this site is about sharing information?

mrsjj
I'm sorry your husband has PCa, and from one woman to another, welcome to the forum. With all due respect to your post, I've written over 90 posts, many with all the gory PCa details (including clinical pathology, tx choice, and more), and they are available for you to read, if you so chose, but it is apparent you have not. Perhaps you haven't yet figured out how to do a search or retrieve info on this discussion board or maybe you're unfamilar with what the "My CSN Space-about me/blog" actually is and that it is optional? Your post sounds so angry and hostile...all of us are angry about PCa and the way it has affected our loved ones and our lives. I see you have made only one post as of this date, but shared nothing in relation to your own personal situation other than your very apparent anger. Since you write that sharing info is what this site is about (and I agree), I'm looking forward to reading what it is that you'd like to share about your/your husband's situation with PCa?