I like this part, "1,395 patients enrolled in a prospective phase III study of intermittent vs continuous ADT in metastatic hormone-sensitive prostate cancer, a nadir PSA level < 0.2 ng/mL after 6 to 8 months of ADT was associated with a median overall survival (OS) of 75 months".
This is interesting reading for those who are considering early chemo treatment. It shows a far greater median survival rate.
Thanks for the article. I have read other articles about the relationship between PSA nadir and time to nadir being predictors of overall survival. Interesting that PSA at time of diagnosis is not a factor in overall survival.
• in reply to
One of my oncologists, world renowned Maha Hussain, MD told me that my high psa at time of diagnosis, (850) no longer factored in due to my nadir of 0.06. I focus on improving scans and low (<.1) psa. A 75 month Median survival time tells me that half of us will live much longer. Also, with emerging treatments we will more than likely make the 75 month mark obsolete.
I noticed in your profile that you are less than a year into treatment. It took me over a year to reach my nadir. Your .2 will probably go much lower. Let's compare psa's in ten years,shall we?
• in reply to
I like the idea of comparing PSAs in 10 years.
I'm really happy with how low my PSA is. If I can get under .2, that's a really good sign. But I'm also a little nervous about how fast it has gone down: from 400 to .2 in 4 months. That's really fast. Hopefully it doesn't just bounce back up again but keeps going down and I have a long time to nadir. I'm nervous about it and keeping my fingers crossed. I still have another Taxotere cycle to go after the one I just started (after the .2 PSA) so hoping the PSA gets pushed down even more. Let's hope for the best for both of us.
Have you hit your nadir and if so how far out was it? I'd be interested to see what your PSA numbers have been over the 7 years if you wound't mind sharing them.
I'd also like to see your numbers and dates so far if you wouldn't mind sharing them.
• in reply to
Ok, something like this
3/1/2015 850
4/1/2015 400
Started chemo along with Casodex and Lupron progressively fell to 0.5 after the 6th chemo course.
4/1/2016 nadir at 0.06
10/1/2016 up to 0.1
stayed at 0.1 until 4 months ago. Rose to 0.7 , month later up to 1.8. At 1.8 stopped Casodex. Rose to 2.0 the next month. Following month down to .5. Last month down to less than 0.1. So, I'm at 2.5 years and back to undetectable. As you can see it took me a year to reach my nadir. I hit a bump 4 months ago, stopped Casodex, right back to my nadir after 2.5 + years of treatment. I have planned ahead and applied for Provenge approval, (approved). When the favorable Casodex withdrawal ends and my psa rises three consecutive times, I will jump on the Provenge bandwagon. As you can see, I'm just getting started treatment wise. And to think some pseudo-intellectual oncologist told me I had two years to live when I was first diagnosed. Now they are telling me That based on my "numbers" and time it took to reach them, I have many years left. Final notes, it took two years for my lymph nodes to return to normal size. I had 3 bone mets which are still slightly visible. I continue to run 4,5 miles every other day, lifting on days I don't run. 100% vegan, no sugar, booze or drugs. 66 years young and plan on hanging around until they turn stage 4 prostate cancer into a chronic illness, not a deadly one.
• in reply to
Great response to ADT + chemo. I'm hoping for something similar. So far it's looking good. One day at time.
My Psa at dx was 148, GS 10, stage M1 widespread metastatic disease to bone and LN, originally they thought lungs were involved, My PSA nadir was3, I am 11 years out, guess just lucky. What surprised me was the talk of benefit in local therapy to patients with widepread mets, I always thought that was the case. Horst Zinche at mayo showed 25 years ago the benefit of removing cancerous Lymph nodes during RP, before that they just closed you up, in fact I think that happens a lot still.
Have a great day, Gregg I hope you are feeling better today!
Thanks Dan59, I'm feeling a lot better today. If things continue to improve, this will be one of the better cycles.
For your diagnosis, the fact you are 11 years out is amazing! Very impressive recovery. You've destroyed all the statistical models when it comes to predicted OS. Hope to follow in your footsteps.
Live Long and Prosper Gregg! Cancer statistics are confusing for people who do not know statistics, often they sound more grim than they are, as Mark Twain indentified 3 levels of Lies each one worse than the Previous " Lies , Damned Lies. and Statistics."
Thank you Nameless for this post and yes we will make this 75 month survival rate obselete. I had my 6th and last chemo yesterday but prior to that I met with my onc and said my PSA had maintained at 0.1 since after my 4th chemo. He said you cannot get any lower than that. I will continue to have my shots of xgeva every 6 weeks and Lupron every 3 months. I am praying that nothing changes for a long time. My onc said if my PSA starts doubling, he will start me up again on casodex. Greg, we have identical numbers so if you would like to compare numbers in the future, please text me at 856-278-6631 or anyone from this group. I'm from the Philadelphia area ( the king of cheesesteaks). I stopped eating them and I eat mainly veggies, grilled chicken and fish. Dan, Lourdes France was beautiful. Our hotel overlooked the Pyrenees Mtn. I said a prayer to everyone. Our next major trip will be Portugal to see Our Lady of Fatima. God bless us all.
Great response for you so far. Would love to compare numbers, mine are updated in my profile for anyone who wants to see them. What was your PSA at the beginning of treatment?
On March 3, 2017, my PSA was 415 at diagnosis. On March 16th, I immediately started on casodex. 7 days later, my PSA dropped to 210. I had my first Lupron shot and 1st chemo on March 30th and PSA dropped to 6. Its been dropping from each treatment. Thank God. I hope the best for everyone.
Thanks. Your PSA numbers and dates are almost identical to mine. I started on Casodex and then Lupron about a week or 2 after you did. My first drop after one month was from 400 to 12, then .6 a month later. Let's hope for the best going forward.
I'm doing my last chemo 2 weeks from today, already starting to celebrate. Only one more, the last one.
I wonder about strategies of getting there. Our current oncologist said he would be happy to keep up the current regiment until it " stops working" ( PSA rise). However, Our Dr. Scholz consult said switch meds if the PSA stops decreasing. He said the goal is not to suppress the cancer but rather to extinguish it.
I found the answer: it's the first treatment received. So I guess it doesn't apply to guys like me who've had multiple treatments. My nadir after RP was .1. After SRT it was <.1, and after RT to lymph nodes was <.1. But I've never had more than two mets and am I believe still responding to my third session of ADT. I'll know in a few days.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Management of the Metastases in Oligometastatic Prostate Cancer 
Time to PSA Nadir is related to progression-free-survival
