High NLR post RP. Is this indicative of recurrence or survival rates?

[piousheart]

Hello,

This community has been extremely helpful in educating us about PCa. And the information and guidance we got from here had helped us help our father (65yrs) decide to get RP done.

His surgery was successfully done on 7/15 and now he is in recovery phase. His post surgery reports indicated no spread to lymphs. Due to the conditions during his surgery, DJ Stents were required. It is now time for us to get those removed and the Dr. asked us to get CBC (Complete Blood Count) done. The NLR (Neutrophils to Lymphocytes Ratio) is 7.5 post RP and it was 2.2 pre RP (reference range is <3.3).

Is the high NLR post surgery any indication of biochemical recurrence or survival rates?

Thanks for your input.

[Tall_Allen]

No. It's just an indicator of systemic inflammation. Only PSA is an indicator of biochemical recurrence.

It may be a mistake to use information you read about on an advanced PC forum to inform decisions about localized prostate cancer. You may get more relevant info on this site:

healthunlocked.com/prostate...

[piousheart in reply to Tall_Allen]

Thank you for informing me about the other group. I'll definitely seek information there as well.

[Tall_Allen in reply to piousheart]

The biomarkers and concerns of men with metastases are very different from those with localized PC. Please remember that when you accept the "information and guidance" on this forum. Knowing what applies to your case and what doesn't is very important when assessing information. Also, people on these forums post a lot of studies that should not be used to inform treatment decisions, perhaps because they don't understand how to evaluate research. There is lots of misinformation. Be careful.

[piousheart in reply to Tall_Allen]

I'll keep that in mind, thank you for cautioning me. This is the most valuable advice especially when it comes to health.

Given we are still learning and will continue to for a long time this is the right advice. We are definitely seeking medical advice in conjunction but that takes time and is very limited because of our location and current circumstances (pandemic) so trying to find some answers through people who've experienced this as well or have ample knowledge to share.

[Tall_Allen in reply to piousheart]

Two really excellent sorces of info are these:

nccn.org/patients/guideline...

res.cloudinary.com/pcf/imag...

[pjoshea13]

The NLR is indicative of subclinical inflammation. It is indicative of poorer survival if not addressed.

See:

Inflammation. [1] Neutrophil-to-Lymphocyte Ratio [NLR]

healthunlocked.com/advanced...

&

Inflammation. [4] How to Change the Numbers

healthunlocked.com/advanced...

-Patrick

[piousheart in reply to pjoshea13]

Thanks a lot, Patrik. I was just reading all your great posts on NLR, they are extremely useful. I truly appreciate how much effort and research would have gone into making these posts for everyone's benefit.

[Hidden]

There is a difference in biochemical recurrence for low vs. high NLR, but I don't think the differece is that significant.

It is a marker of inflamation so it may go down over time.

Here's an article:

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

[piousheart in reply to Hidden]

Thank you, this is very helpful.

[Hidden in reply to piousheart]

The main thing to keep in mind is that his long-term prognosis is very good and that's much more important than small differences between low and high NLR. It's hard sometimes to keep things in perspective and we can lose sight of the big picture when we drill down on the less significant aspects of this disease.

[piousheart in reply to Hidden]

How true! Very are extremely thankful that the reports show he is tumor free post RP. Now just trying to ensure there is nothing else that we are ignoring if we can treat it in time.

[LearnAll]

Patrick is totally right about connection of systemic inflammation and initiation and progression of prostate cancer.

We have to treat PCa with comprehensive treatment which includes keeping general health good, keeping immune system regulated ,control of co-morbid conditions such as diabetes, high BP etc., physical fitness exercises and of course keeping systemic inflammation as low as possible.

The markers and ratios of systemic inflammation such as NLR, PLR, LMR and CRP etc help us to keep low inflammation by certain foods, supplements and other complementary stuff.

SOC alone is not enough...beware of only SOC peddlers.

[Hidden]

My experience is different. Three months prior to RP it was an all time high; 4.4. Four months post RP it was like 10 to 20 years ago: 2.5. So, I thought, a cause of inflammation was terminated and that made me happy for the time. But, following this, my monthly tests have shown a variance spanning from 2.3 to 4.3. Conclusion; It is more complicated than a strong link to PCa. Check additional reasons that may have augmaunted your father's stage of inflammation.

[piousheart in reply to Hidden]

Thank you for sharing your experience. We will need to do more investigation looks like

[MateoBeach]

Inflammation is a necessary part of healing, such as after his surgery, as well as part of the normal immune processes of fighting infection, etc. So short term inflammation in this setting does not carry any adverse implications as does chronic sustained inflammation. Check it again in a few months. May he live long, be well, love well and be free of unnecessary worry.

[piousheart in reply to MateoBeach]

Thank you so much for your kind words. We are all hoping and praying for him and all of you

[monte1111 in reply to MateoBeach]

I always worry that I'm worrying too much.

[treedown in reply to monte1111]

Me too, what's a worry ratio measurement I can keep and eye on?

[monte1111 in reply to treedown]

There are many. The distance in feet between you and the grizzly bear, divided by how many feet the grizzly is gaining per minute, multiplied by how fast you can run in miles per hour, by the square root of how pissed the grizzly is, equals how screwed you are if the grizzly knows math.

[treedown in reply to monte1111]

Thanks I have only one issue, what if the grizzly falls amply in love with me, I have a way with animals. Now I need a new ratio for the success of a relationship with a bear.