Connect
← Return to My PSA climbed 02, .04, .07 .15 .21 had a RP 2 yrs ago PSMA negative ?
Discussion
My PSA climbed 02, .04, .07 .15 .21 had a RP 2 yrs ago PSMA negative ?
Prostate Cancer | Last Active: Feb 24 9:59am | Replies (45)Comment receiving replies
@brianjarvis What Meant is that if SRT to the prostate bed has bcrfs rates of 80%+ in nomograms, how can it be that 2/3 of patients treated have cancer outside the prostate bed?
Replies to "@brianjarvis What Meant is that if SRT to the prostate bed has bcrfs rates of 80%+..."
@topf For each of those cases where salvage radiation treatment had been administered to the prostate bed, had it already been confirmed that’s where the recurrence was? It’s important to know that when interpreting the data.
@topf A lot of them do - that’s why 30% of SRT to the prostate bed only fails. You need to treat the pelvic lymph nodes as well.
Dr Kwon has a somewhat different approach than most: he wants to SEE cancer on scans before he treats.
IMHO, by the time you ‘see’ the 8-10 million cells that form an actual tumor, or mass, how many microscopic clumps are floating around elsewhere??
I think he’ll probably have to put together some kind of study where one group of men are given SRT to the bed and nodes, and another is treated only when metastases are visible on PET scans. Survival rates could then be compared.
Following the Estradiol argument made by Dr Wasserman, you want to keep the absolute number of circulating PCa cells low; both for metastasis and castrate resistance. I cannot see how waiting for visible tumors accomplishes either goal.
Phil
Connect
@topf
Dear Topf,
There are so many new "suggestions" and theories that IMHO it is best to stick with "old and proven" methods. That "new way of thinking" is too scary for my comfort since if there IS recurrence in a prostate bed and one misses that PSA 0.2 level (or lower for aggressive cancer) than one risks distant metastatic cancer developing !!!
I do not understand Kwan at all. Yes- if cancer already is metastatic (in other parts of a body) than irradiating pelvic area makes no sense but if it IS there than it is great advantage to eradicate is while it is still "there" and at PSA level 0.2 or lower !