Blood Test Parameters

[TFBUNDY]

Hi all. I am trying to come up with a definitive long term list of parameters for monitoring Prostate Cancer. My GP is hopeless, and the urologists only check PSA. My CRP is high, testosterone normal, ALP normal, what else must I check to monitor prostate cancer to give early indications that things might be going badly... Or going well...? I need long term data and trends. Also indicate the benefit of the tests you suggest so that I can show the medics the value of the monitoring program. Cheers...

[Tall_Allen]

Unfortunately, you chose a treatment (HIFU) for which there are no known biomarkers for progression. It is even unclear how to use PSA as a marker of biochemical progression. The best you can do is regard yourself as if you are on active surveillance and have to have periodic mpMRI-targeted biopsies.

[TFBUNDY in reply to Tall_Allen]

Hi, and thanks. I am on the INDEX study with follow-up mpMRIs and the horrible biopsies. I want a set of data so if there is any evidence of progression I spot it early..... No suggestions?

[Tall_Allen in reply to TFBUNDY]

It's not something anyone can suggest. PSA recurrence of nadir+2 was set based on experience with thousands of men who had radiation. It replaced 3 consecutive rises which was found to overestimate recurrence. They were more likely to have a clinical recurrence if PSA reached nadir+2. There is a Stuttgart definition of nadir+1.2 and rising for HIFU that has been proposed, but the data are not very robust. That is one of the consequences of being a guinea pig (I was too) in that not all the bugs have been worked out yet.

[RonnyBaby]

I had complete 'blood panels' done every 3 months to monitor my immune system and anemia that was caused by ADT.

That lasted (and some is still tested every 3 months with my PSA) until my blood work came back 'normal' in the key areas of interest.

I used my GP to schedule / setup the testing and monitoring.

Those tests are typically not part of the SOC and the MO / RO types don't routinely order them.

IF you need to pay extra lab fees, it is money well spent, IMO.

It also establishes some baselines for future reference(s).

[TFBUNDY in reply to RonnyBaby]

Yeah... But what parameters to measure? What's useful information? What are cancer drivers I should monitor like inflammatory markers. Testosterone? I'm not on ADT and will probably refuse when the time comes. Estradiol? SHBG? Free T? Erythrocyte settling rate? Albumin? Vit D? Mg, Zn or wtf? I need to take a list and the reasoning to my medics and get it sorted. Historical data I don't have is useless..... Cheers

[RonnyBaby in reply to TFBUNDY]

I'm sticking to my guns on this one - I mentioned complete 'blood panels' - everything red and white - THAT helps monitor your immune system and your state of health or anemia.

Supplementation (medicinal mushrooms, deep immunity tonics, daily multi-vitamin + zinc / iron / vitamin D (daily minimums)) is highly recommended to rebuild or maintain it.

IF you aren't on ADT and totally 'off treatment', then your blood work SHOULD come back as 'normal', unless something else is amiss.

The 'mainstream' PCa markers like PSA et. all, are a different issue that I monitor as well but this is one key point to consider.

You can test and establish a baseline for several important candidates that will ring a bell - when they say - it would have been advantageous IF we knew that - where we started from - might be a diagnostic tool .....

[TFBUNDY in reply to RonnyBaby]

One of the major omissions for me is zinc. I must eat zinc I must eat zinc.... I need to change my teeth for hacksaw blades....

[RonnyBaby in reply to TFBUNDY]

You are quite right about zinc - it is one of the keys to the so called white killer 'T' cells.

The problem with zinc is that you don't want to overdo it - that could be a big mistake.

[TFBUNDY in reply to RonnyBaby]

I'll galvanise myself into action....

[j-o-h-n]

Get a new G.P. (unless she's your wife)...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/17/2020 4:57 PM DST

[TFBUNDY in reply to j-o-h-n]

I'm in London. Tricky to find a stable practice because we are overwhelmed by immigrants on both sides of the desk. I should know because my wife is one ... The GP practice is more or less closed in case anyone sick turns up. You couldn't make it up....

[j-o-h-n]

Sorry to hear that....You have two choices to pick from.... The short straw or the other half of the short straw.... (the new normal)..............

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/17/2020 5:55 PM DST