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With regional lymph node metastasis what is the progression?
Prostate Cancer | Last Active: Jul 14 7:30pm | Replies (22)Comment receiving replies
I have a difficult time responding to your comment, "why are you so concerned?" Where does that question come from? Does it come from some concern for me? I really can't tell from the chat.
After the first treatment failure I have been interested in developing a narative of the disease progression. This helps me wrap my head around the situation, and allows me to make informed decisions on how I want to live my life. Not in ignorance and fear, but with curiosity and courage.
The surgical removal of the prostate did not halt the cancer because it was more aggressive than what the biopsy suggested. Within a few months the PSA "quickly" rose to 0.15, and the doctor and I decided to do SRT. This is in line with the current research. The radiation treated the whole prostate bed, and any cancer there was eliminated, and so when the cancer did return it was probably in the regional lymph nodes. The doctor agreed with this analysis.
This is where the progression is today: oligometastatic lymph node Prostate cancer. I am interested in knowing what underlies the kinematics of the PSA now. The PSA is undetactable for 35 months, at 24 months they said I was clean. Now it has been level at 0.028 for 12 months. I certainly like that. There isn't much of the cancer and it isn't activing aggressively.
This is probably what is called micrometastatic Prostate cancer, which refers to the presence of cancer cells in other parts of the body that are too small to be detected by standard imaging techniques. These cells may have spread from the primary prostate tumor but haven't yet grown large enough to be seen on scans. The patients PSA levels may be quite low. The presence of micrometastatic disease can affect treatment decisions and prognosis.
Minimal residual disease is that not detected by conventional imaging studies and clinically the patient remains disease free. However, with time these dormant cells will awaken and disease progression occurs, resulting in clinically and radiological detectable metastatic disease.
So my quess is the next rise in PSA will tell me a lot about the cancer.
Replies to "I have a difficult time responding to your comment, "why are you so concerned?" Where does..."
I agree with Jeff that the rise in PSA is really minimal. I was diagnosed last fall with Gleason 7, N1M0 (iliac lymph nodes). I’m in my 7th month. Of Orgovyx and had 44 weekday radiation treatments during February to April. PSA last fall was 6.4, in May 0.01. Tested again 7/24.
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Who told you the cancer is probably in the lymph nodes? I’ve had it for 15 years had Surgery then salvage radiation, No lymph node involvement. I have attended advanced prostate cancer meetings Weekly for the last four years. I have never heard of somebody being told by their doctor that when their PSA went from .02 to .03 that it was probably in the lymph nodes. That seems ludicrous, Is there some proof to that? The fact is that it goes to the bone much more frequently than it goes to the lymph nodes. You usually only see lymph node involvement early on before treatment.
Your PSA rose .01 over 6 months. PSA go up and down. A doctor will consider treating a cancer case when the PSA starts doubling at a fast rate. Your PSA has not doubled at all, Rising .01 over 6 months is not considered doubling. It appears you are in remission.
At this point, it is much ado about nothing.