"A higher NLR was associated with a poorer OS {overall survival} for CRPC patients who received ABI or ENZ. The NLR was positively correlated with prostate cancer progression."
"The median NLR was 2.90, and a receiver operating characteristics analysis suggested a candidate cut-off point of 3.02."
"Inflammatory cytokine markers, including the neutrophil-to-lymphocyte ratio (NLR), monocyte-lymphocyte ratio, and platelet-to-lymphocyte ratio, play important roles as prognostic markers in several solid malignancies, including prostate cancer."
Its a challenge to get Serum Albumin above 4.0. Mine used to 3.5 -3.7. I started drinking whey protein (30mg) pure protein drink every day and its creeping up but stays 3.8-4.0. If anyone knows how to take Albumin higher than 4, please chip in .
In the absence of infection/inflamation, inadequate protein is the only thing I can think of. Your basic diet does lack pre-formed protein & given that you use a wealth of polyphenols, protein looked to be the issue. & yet you have had a limited response.
The issue of albumin <4.0 is that, for most men, it does mean inflammation. If your other inflammation markers are all good, I wouldn't be terribly concerned.
Patrick...Thank you for keep reminding our fellow members that Inflammation DOES play a significant part not only in initiation but also propagation of prostate cancer.
It is clear to me that a very low NLR, PLR and high LMR can provide good idea how our treatment is working and what is most likely going to be our prognosis.
BTW..my readings from this week are NLR 1.1, PLR 67 and LMR 4.0, CRP 0.3, LDH 122 )
Herbs, spices and vegetables esp. turmeric, Ginger, Onion, Garlic etc. keep inflammation down and indirectly curtail speed of growth of cancer cells.
A rule of thumb is that NLR should be less than 3, LMR should be more than 3....and PLR should be less than 100. And to top the anti inflammatory pizza.....CRP should be less than 1 and LDH should be less than 150.
If some one has these numbers right. .along with very low PSA and BALP...he can sleep peacefully as most likely his treatment is working well.
Patrick, thanks again for your valuable contribution to our knowledge about connection of inflammation and prostate cancer.
LDH (lactate dehydrogenase) monitoring can give us an idea if prostate cancer cells are changing from androgen sensitive cells to neuroendocrine cells. Although LDH trending upwards continuously can indicate treatment induced neuroendocrine change ,it is not a definite measure.
However, if LDH is monitored along with Chromogranin A and Neuron Enolase test ,it can provide pretty good estimate of NE transformation. Add add osteolytic bone lesions to this triple test and you can be almost certain of Neuro-Endocrine PCa.
I think NLR is meaningless right after radiation because lymphocyte count is artificially low, driving up the ratio.. My lymphocytes fell from about 1100 to 250 right after IMRT, then recover to 500 six months later. I think a steady/stable lymphocyte count is needed for this ratio to be valid.
I think your right, whereas I am not sure I am wanting to go down this rabbit hole and I am not castrate resistant yet, but my CRP is <.2 and Albumin is 4.4 but my NLR/TLC ratio or some other one with lymphocytes was way off. If others feel they have a handle on all these bio-markers and ways to address changing/improving them consider me impressed but I remain skeptical. If there was something to it why isn't it part of SOC? Hold the conspiracy theories please. I do recognize the need to reduce inflammation and will continue to study that but it's clear that I can spend a lot of time doing it and barely scratch the surface. Practical info seems to be lacking in my initial searches but there's plenty of recipe books.
Is this NLR something that gets measured during routine annual physical labwork or does it require a special request to have it done? Would a GP order this or is this something only a urologist or oncologist would order?
I am cautious on this topic as an immunologist and clinician. I am more interested in the absolute levels of these cells (lymphocytes and nueutrophils as well as the other other blood cellular components). Also there is a wide variance in the numbers of these cells in normal people; my neutrophils are typically low compared to the population mean but there is no evidence that I am a 'low inflammation man'. In addition, many of us have been through many different treatments (ADT, chemo, Lu177, EBRT to bone marrow etc) almost all of which throw these values around.
Agree that other comorbid conditions can mess up the meaning of NLR,PLR and LMR. Even a UTI can increase neutrophils and bump up the NLR. So we need to first rule out such other conditions for ratios to give good estimates.
But absolute numbers separately do not give current status and prognostic info about PCa...its the Ratios which give that information.
In almost all related research about inflammatory markers and estimates of treatment effectiveness and prognosis, Ratios (NLR,PLR,LMR) are used. No research uses pure WBC subtype numbers except perhaps number of Monocytes which are proxy for number of macrophages/phagocytes and NK cells.
We agree to disagree. I find leukocyte ratios in the context of knowing absolute numbers most useful. Incidentally NK cells are a sub-class of lymphocytes not monocytes.
You just need numbers of Absolute Neutrophil count, Absolute platelet count , Absolute Lymphocyte count and Absolute Monocyte Count from your CBC test results.
Here are the formulae:
NLR = Abs Neutrophils Divided By Absolute Lymphocytes.( normal <3)
PLR= Abs Platelets Divided By Absolute Lymphocytes (normal <100)
LMR = Abs Lymphocytes Divided By Absolute Monocytes (normal >3)
These numbers change but they give idea about situation at that time when the blood test was done.
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Bone metastasis good news: OsteoDex got to phase 3 at last
High NLR post RP. Is this indicative of recurrence or survival rates?
No More Orgovyx, Continuing with Abiraterone and Prednisone
It is already happening
