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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
@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
Replies to "@topf A lot of them do - that’s why 30% of SRT to the prostate bed..."
@heavyphil Yes, when no radiation has yet been used, waiting to radiate recurrent cancer only when first visible on PET scans will certainly allow cancer to spread more easily and greatly decrease the chance of a cure (NED after 5 years). I doubt that we will see other oncologists agreeing with Dr. Kwon's approach on this.
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@heavyphil
Dr. Kwon might’ve picked up that idea about waiting for metastasis to show up from Dr. Mark Scholz. He promoted the same thing in the PCRI conferences. Claims it works much better and he just keeps track of the people to see if they have Metastasis show up.