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PSADT

Timlong
Posts: 42
Joined: Nov 2011

A brief history of my buddy Tim:

Dx 3 years ago at 53 with PCa. Psa 22. Gleason 9.(4+5) 12/12 cores Positive 70-90 percent. Tumor represented 70 percent of gland with SVI, EPE and PNI.

Surgery removed prostate, vesicles, nerves and 12 nodes. PT3BNO Margins Positive

Post Surgery....June 2012....PSA .03

Aug 2012.....                      PSA .07

AUG to DEC 2012 post imrt   PSA .01

JUNE 2013....                      PSA .2

Nov 2013.....                       PSA .5

Jan 2014....                        PSA .5

May 2014...                        PSA .7      PSADT 5.5 months

June- Aug 2014.....              PSA .01    3 months of Casodex

Oct 2014...                         PSA .1

Dec 2014....                        PSA .3      PSADT 1.3 months

Feb 2014....                        Pending   

 

Using the last 3 readings, one of which is a Casodex effect , is the PSADT considered accurate?

His doc at Fox Chase has indicated he can wait until a PSA of 2.0 to go on Casodex again indicating that the outcome does not change.

This cancer seems very aggressive to me and I think allowing a tumor(s) to grow until 2.0 is not in his best intrest however, I'm not the Doc.

If I've mapped this out correctley I think this next Psa will be .6 to .7 but we will see very soon.

Please review this data above. I would welcome your opinions.

 

Jeff

 

 

 

 

 

 

VascodaGama's picture
VascodaGama
Posts: 3087
Joined: Nov 2010

Jeff

The PSADT is not so important in your friend's present therapy, and the increasing PSA is still low enough to alter any decision. In any case  the Casodex alone may not be enough to control the type of aggressive cancer of your friend. I would recommend him to discuss with his doctor about possibilities of increasing the androgens blockade adding a LHRH agonist (Lupron) or antagonist (Firmagon).

The intermitent modality in hormonal treatments shows to be benefitial to some patients. It extends the period of HT before it fails and permits to have a period free from the symptoms from the side effects.

 In my case of HT, with only the agonist Eligard, I have done the intermitent protocol (IADT) regulated by the PSA level, which markers/conditions are:

Stop of taking drugs when: PSA=<0.05 is maitained during one year

Restart taking drugs when: PSA=2.5 ng/ml is reached

Your friends doctor seems to be using a similar threshold.

Best

VG

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