What marker is useful if PSA is not?

[GranPaSmurf]

Adaptive Therapy uses as a biomarker PSA doubled or halved to decide when to resume or hold treatment.

At dx, my PSA was only 2.14, with Gleason 8 and bone mets.

Without PSA, what biomarker would give these benchmarks?

[Tall_Allen]

radiographic progression, bone alkaline phosphatase.

[CantChoose]

ncbi.nlm.nih.gov/pmc/articl...

[FCoffey in reply to CantChoose]

That article is a good review of the present state of the art. Thank you.

Unfortunately, I didn't see anything that would serve as a biomarker for guiding treatment decisions in cases of advanced prostate cancer. Pretty much all the tests are to determine if cancer is present, whether to biopsy, etc. All the men in this group are far past that stage.

[GranPaSmurf in reply to FCoffey]

Good point. Alk Phos is an enzyme found in the cells of the skeletal system and in the liver - to a lesser extent in the heart and other cells. If you had frequent data points, it might make sense for adjusting treatment.

As TallAllen pointed out, watching the tumor growth or receding by X-ray would probably be simplist. MRI would be more accurate if you need more resolution. Of these visualizations, Ultrasound would probably provide more bang-for-the-buck.

An inexpensive blood test is needed.

[FCoffey in reply to GranPaSmurf]

With such low PSA and bone mets, it is possible the Circulating Tumor Cells would give a reading. Not certain, but possible. If you do get a baseline reading you could try tracking that as a blood test biomarker.

Good luck!

[CantChoose in reply to FCoffey]

If you really want to know, I can ask my husband (he works with lab directors). But I don't think there is one that would be clinically available. Hubby is part of a biomarker study for this reason.

[GranPaSmurf]

Thanks men. And the article is very informative. Saved and filled.

[Hidden]

Good question. My PSA at diagnosis was 2.7. Good to see the answers provided here.

[immunity1]

Radiography. PSMA PET and NRI better than CT scan better than ultrasound. Of course their price is inverse! =Rob.

[GranPaSmurf in reply to immunity1]

All you need to know is 'more' or 'less', right?

[immunity1]

And where! The more sensitive tests eg PSMA PET, (MRI) can tell you if you have visceral mets that may need to be treated differently to your bone mets.