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PSA "undetectible" for amost a year
Prostate Cancer | Last Active: 6 hours ago | Replies (38)Comment receiving replies
@jeffmarc It kind of feels like you're rushing to respond to things and not actually reading what people write. You wrote this alarmist reply to @johnfinch but his PSA is way below 0.2 -- he says it's 0.041 now, which is 5x lower than that threshold.
Also, that link you shared in your reply does not say all of those things you say it does. Do you have a correct link to a source for this claim:
"≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
"? I don't disagree with the sentiment but I cannot find that quote or those exact numbers in any source.
You share a lot of great info here but you've been missing and misunderstanding a fair bit of what people are writing lately, hope everything is ok on your end.
Replies to "@jeffmarc It kind of feels like you're rushing to respond to things and not actually reading..."
@notpetecrowarmstrong
The article does discuss the higher risk based on the PSA in this section.
Elevated risk of all-cause mortality was significant for all PSA cutpoints above 0.25 ng/mL through 0.50 ng/mL. At the 0.50 ng/mL cutpoint, the adjusted hazard ratio was 1.61 (95% CI = 1.21–2.14, P = .001).
Recommendation for ADT in higher risk cases is discussed in a lot of other places. I captured this information from an article that referenced the link I included. The only thing missing seems to be the recommendation for ADT above .5 which other articles like the one mentioned below recommend ADT when PSA level before SRT was ≥0.7. I know there are articles that discuss the .5 recommendation for ADT but it’s been a long time since I captured that information.
ADT combined with SRT appears to improve OS in patients with a PSA level before SRT of ≥0.7 ng/mL. In patients without persistent PSA after prostatectomy and PSA levels of <0.7 ng/mL, ADT should not routinely be used, but may be considered in patients with additional risk factors such as Gleason Score ≥8 and negative surgical margins.
Discussed here
https://pmc.ncbi.nlm.nih.gov/articles/PMC12170276/
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@notpetecrowarmstrong
You are correct. I misread .041 as .41.
At least he has the recommendations for when he should start worrying about this PSA rising.