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Any other methods Better than PSA to monitor prostate cancer?

Prostate Cancer | Last Active: Dec 12, 2023 | Replies (35)
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@seasuite

Thanks @trusam1
No question about following PSA levels post radiation and ADT. I am a big fan of preventative medicine, testing and avoiding drugs. Prior to starting Orgovyx (4 months) and Flomax, my systems had been free of any pharmaceuticals for many years, unless you count grape byproducts.

I had consulted a couple well published ROs on how to best monitor post treatment biochemical recurrence and actually found the comment from @wrothrock more insightful. He mentioned the differentiation in reliability of pre and post treatment PSA reading as a metric for recurrence. I'm planning to review the link that he kindly provided for the PCRI. However, what I am still missing is research and reports that provide an in depth verification of what is likely the most important question that all of us have: do I still have any remaining cancer? There are some reports to be found questioning PSA reliability, post treatment, such as the UCLA study: https://www.uclahealth.org/news/psa-levels-after-treatment-may-not-be-reliable-predictor.

As someone nearing the end of treatments, my investigation continues.

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Replies to "Thanks @trusam1 No question about following PSA levels post radiation and ADT. I am a big..."
wrothrock | @wrothrock | Dec 9, 2023

I believe this speaks directly to your questions: https://www.youtube.com/watch?v=e1y_HR1WPN4&ab_channel=ProstateCancerResearchInstitute

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trusam1 | @trusam1 | Dec 11, 2023

@seasuite
If the question is: "do I still have any remaining cancer?", there is no way to get 100% assurance there is no cancer remaining after any treatment. PSA is more sensitive to that possibility than anything else I'm aware of, but it won't provide a definitive yes/no answer to that question. And it can be confusing after radiation and ADT, because if the PSA is rising over time, there *may* be some remaining normally functioning prostate cells after the treatment, OR there may be some multiplying cancer cells producing the antigen. Or both.

As to the UCLA study you linked, I don't think it should be read as an indictment of using PSA post-treatment to follow disease progression. The authors' conclusion reads: "the results of the study indicates that it (biochemical recurrence) should not be the main focus or primary measure in future clinical trials for localized prostate cancer."

What they are suggesting is not that doctors shouldn't use PSA to follow and make clinical decisions for their prostate cancer patients. Rather, they are saying that studies about the efficacy of any treatment (in regards to things like disease-free survival, metastases, etc) should not use PSA as a surrogate endpoint for how successful the treatment is.

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