PSA: “How low should it go“ ?

[Vasili]

My last measured test level PSA 0.007ng/ml And radiotherapy still works and can further reduce PSA. Now I take an eligard which also lowers the PSA. I have an idea to start taking Casodex 150 for a double blockade. My goal is to lower uPSA further and reach a level of uPSA <0.003 where the cancer appears to disappear, as stated in a study by John Hopkins Medicine -

PSA: “How low should it go“ ?

- “If your PSA level is less than 0.003 ng / ml, you could be sure that all your cancer has been removed. On the other hand, if your PSA level is greater than 0.003 ng / ml, you might choose to be monitored more closely for PSA recurrence in the immediate years ”

Although this refers to after surgery, not after radiation, I think it essentially reflects the presence or absence of cancer cells. So by analogy. I hope with double blockade and the effect of radiation, to reach uPSA <0.003 in the hope that this will be the treatment for my lymph nodes. This has not been proven, but there is no other treatment. Could this be true?

[LearnAll]

If you have intact ,full prostate...any PSA 0.2 or less is considered very good and is called undetectable.

But if your prostate has been removed by surgery or burnt by radiation..then, PSA is coming from cancer cells only because there are no normal prostate cells to add PSA. So lower is better. I do not know what is best level in these cases.

Not just PSA, you need to monitor other well established biomarkers such as ALP, LDH, prolactin and Hb.

Remember: in human body, there are only TWO sources of PSA...(1) Normal prostate cells

(2) Prostate Cancer Cells. NO other cell is capable of producing PSA.

[Tall_Allen]

You are confusing PSA with cancer - they are not the same thing. Can you explain what your situation is? You are posting on an advanced prostate cancer site, so I assume you have had detected metastases - how many and where are they? Have you had any treatment, other than Eligard? What do you mean by "And radiotherapy still works?" Have you had radiotherapy? If so, what have you irradiated - prostate? matastases?

If you are metastatic, it is great that Eligard works so well. You may consider adding Zytiga or Xtandi. Lowering uPSA still further is not the goal - extending survival is.

[LearnAll in reply to Tall_Allen]

If PSA does not indicate cancer....3.5 billion men on Earth walking with PSA less than 4 will be having cancer. But they don't. PSA is a measure of cancer.... If it was not so..Big pharma researchers will not spends billions to find cancer drugs which lower PSA. Why entire Onco Industrial complex uses PSA as a parameter for all their research studies ?

In a small number of PCa pts..PSA may not be accurate biomarker . For majority, It is.

That's why I say ..measure all well established markers such as ALP, Hb, Serum Calcium, LDH to get a better picture.

[Tall_Allen in reply to LearnAll]

Read what I wrote, not what you imagined I mean. PSA is a biomarker for cancer (in most cases), but is not cancer. It is entirely possible to lower the biomarker to undetectable levels without getting rid of the cancer (as with metastasis-directed therapy). PSA only leaks out into the serum when metastastases have grown large enough to develop their own leaky blood supply. Cancer survives as micrometastases that don't put out PSA. That's why men taking abiraterone, enzalutamide, apalutamide, and docetaxel lived longer even when Lupron already lowered PSA to undetectable levels.

[LearnAll in reply to Tall_Allen]

A small number of cancer cells are present in every human beings body but they are eliminated and or neuralized by immune system by phagocytes, macrophages and natural killer cells.

That is why the advice to cancer patients should be improve their general health and boost their immune system to do its job of keeping cancer cells to the very minimum.

The wrong way is to keep pushing for more and more toxic meds...causing further destruction of overall health and immune system and creating more illnesses like Diabetes, High BP etc.

The role of plant based, antioxidant, anti inflammatory diet, regular physical exercise etc are minimized by onco-industrial complex and all the emphasis is placed on more and more toxic treatments.

They start with faulty assumption that all prostate cancers are very aggressive which is incorrect. Most Pca's are not aggressive...some are. But Oh well..they have to scare men so they keep buying very expensive, highly toxic meds out of fear.

What was keeping your cancer in check before you were diagnosed...was it your immune system or was it your Abiraterones and Lutamides ?

[Tall_Allen in reply to LearnAll]

Maintaining good overall health is certainly very important in preventing cancer. After cancer is diagnosed, only those "toxic meds," (and toxic treatments, like radiation) as you call them, give us any chance of controlling the cancer. You are being ingenuous when you suppose that the situation remains the same after cancer is diagnosed as before. It is very important to maintain good health (exercise, diet and lifestyle), but those "toxic meds" are what is proven to increase survival. In fact, people who rely on alternative therapies die over twice as fast as those who take those "toxic meds."

Vasili has already been diagnosed with metastatic PC, so how are your comments at all helpful to him?

[LearnAll in reply to Tall_Allen]

I am not against medical treatment. You know that from our prior debates.

I am insisting that the medical treatments should be used judiciously and not irrationally. My mantra is "Comprehensive Treatment" which includes all modalities such as diet, herbs ,spices, supplements, exercise, relaxation therapies, prayer AND logical and needed medical treatment. I do not take extreme position because mostly truth is in the middle. I emphasize again : Judicious ,rational Use of Medical treatment.

[Tall_Allen in reply to LearnAll]

I'm glad to hear it. What you wrote, however, was "The wrong way is to keep pushing for more and more toxic meds..."

I don't recall any "debates," I don't read your posts unless you respond to me directly, as you've done here. It is too time consuming to correct all the misinformation I've seen posted on this forum (I'm not saying by you).

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If the world was flat , we’d like the Psa to go right over the edge never to return .