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Any other methods Better than PSA to monitor prostate cancer?
I've attached my PSA scores since they started saving in EPIC in 2000. While you can seen a marked increase around 2017, my Family Medicine Dr. said it was age related and well within the norms. Having read other's numbers, you could make a case that my numbers have always been low. We decided on an MRI in 2022 just for 'sh*** and grins' so to speak. I couldn't accept the PI-RADS 5 result and followed up with a confirming MRI shortly thereafter. My faith in PSA, as a solid indicator of PCa, was badly shaken.
My TPUS revealed G: 4+3=7 in one core with some risk factors and I began a tri-modal treatment plan (Orgovyx 4 months; Cyberknife Boost and VMAT). The later treatment is currently underway, 5/25 completed.
I continue to query Drs. and other sources about how to monitor progress and determine if any cancer will be remaining after the conclusion of my treatments. The only answer that I'm hearing is that
we'll be monitoring my PSA. You've probably guessed my question by now. I have very little faith in PSA and wish that I discovered my cancer years earlier. Has anyone heard of other methods to know the state of our PCas, hopefully zero, post treatment? I'm thinking I might have to buy a Ouija Board;-) Kindly advise.
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Indeed other doctors pretty much say the same thing.
One slightly divergent opinion is liquid biopsy may find smaller prostate cancer cells. But then there seems to be no treatment that can destroy such low level. And given it is unlikely to cause any trouble, even if there is a treatment, is it worth it, giving consideration to QoL, etc.
Dont mind me. I am just another layman trying to make sense of the whole thing.
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1 ReactionRich:
My understanding is that PSA after RP that rises above .2 is indicative of BCR and the "sweet spot" for salvage radiation treatment is .2 - .4/.5
My initial postop PSA was .19 and I was referred to Radiation Oncology for salvage radiation including 4 mos short term ADT.
My PSMA PET scan post op was clear for cancer.
In my case, the thought was that PCa cells remained in the prostate bed/floor and possibly the pelvic lymph nodes, resulting in whole pelvic radiation (WPRT), including PLNs.
See SPPORT trial.
I am not a physician and my treatment was at Johns Hopkins.
Best wishes on being and continuing cancer free.
@wellness100: This is exactly the type of info I was looking for, like @msciulli comment to "check out Dr. Kwon’s (Mayo doctor) videos. I believe they are on YouTube and the Prostate Cancer Research Institute. He is a big believer in scans to monitor post treatment cancer." It is intuitively obvious that scanning should be a part of PCa analysis, post treatment, and PSMA PET scans are a good, albeit limited, first step.
I think we are all 'layman' on the MCC and free to say what we believe without any institutional bias. I am fortunate to have a friend who is a retired urologist and we can talk under strict 'cone of silence' as he's well known to all my current Drs.
@rcockerell Best wishes and good news on PSMA/PET! Did you have a decipher grid run, I'm wondering if the would have been a good prognosticator?
Well, it seems the scientist have developed a medicine that both finds the cancer cell and kills it at the same time. They might even have FDA approval to go on trial. Even though that may still take years, to be clinically available. There is als sketchy info as to how sensitive, the success rate etc. Still, it is another revolution. Like it is a scan and cure at the same time.