Why psa tests after being told treatment cured

[Darryl]

Someone (previously treated for prostate cancer) asks you, “Why does my doctor do PSA tests on me after he told me I am cured?”

What is your response?

[Tall_Allen]

Doctor should tell you there is no evidence of disease. To me, "cured" is a term that should only be used by patients (like myself). I do annual PSAs to congratulate myself.

[Steve507 in reply to Tall_Allen]

Huh

[Hidden in reply to Tall_Allen]

Thank God ! That you are cured. Check me if I am wrong.? You were not stage #4 , or were you? Stage #4 = no known cure by mankind.

[Tall_Allen in reply to Hidden]

I had low risk PCa. I think that N1M0 can be cured, and T4NxM0 can be cured even though they are Stage IV PCa.

[noahware]

My (cynical) response is: your doctor tells you, "you ARE cured" because that is his business model. A more honest response is, "with any luck, you HOPEFULLY are cured... we should know in about ten years."

But he tests PSA because he knows that within the group of men treated "with intent to cure" there are three subgroups: men who got cure, men who didn't truly ever even need cure (and therefore may be termed as "cured" but really aren't), and men who are NOT cured who will eventually progress (with a rising PSA).

If I wasn't worried about how he might handle it, I might also tell him what urologist Anthony Horan wrote in his books: your prostate cancer very likely seeded itself to your bones long before it was a clinically detectable cancer, and whether those seeds either stay dormant or take hold and grow into metastases is very possibly beyond the control of either you or your cure-promising RO or surgeon.

(Since MOs promise treatment rather than cure, they have the luxury of being more honest without compromising any "intent-to-cure" business model.)

[noahware]

Perfect answer! (As in, "even better than mine," LOL.)

[Hidden]

Was this person treated for stage#4 ? If not there is a chance of a cure for him. If so, the doc is sugar coating it for some reason? I think the Doctor is being cautious . Why not? If I’m told that I’m cured from #4 pc there is no way that I’m not checking my PSA often .

[dac500]

Two years after brachytherapy, my RO told me your cancer is cured. I immediately shot back "You mean in remission?" A year later my cancer came back and now I have metastatic prostate cancer.

[E2-Guy in reply to dac500]

I describe mine as 'temporarily sleeping'.

[Boywonder56 in reply to dac500]

And in the words of frank zappa ....whom i might add died from pc....is " the crux of the biscuit" but instead of an apostrophe....those who think they are cured ...its cured with an *......i believe that lurpon et al ...should be known from now on as " rip van winkle " treatments ...cuz at best we put crmpc to sleep....hopefully for long time...bw

[Hidden]

My response is “Our knowledge is incomplete. After 5 years chances are you are cured but checking your psa on a regular basis, even after years, is a safety measure to compensate for our incomplete knowledge.”

[Hidden in reply to Hidden]

thoughtful response

[Danish-patient]

Many doctors sadly have poor communications skills. But any patient that has had cancer - even if “cured” - will have that fear for the rest of their life, that the disease might attack again, out of the blue. So I think they should feel comfort in knowing that a close eye is being kept on the PSA status.

[Cooolone]

There is no known "cure" for cancer!

Otherwise, well... We'd all be "CURED!"

Lol

[rscic]

Prostate Cancer can come back rarely as much as 20 or more years later (similar to Breast Cancer). IMO Doc should tell you (at most) you are likely cured but PSA tests need to continue for the rest of your life in case a few cancer cells escaped the Prostate.

[pjoshea13]

If "cured" actually meant "cured", why are there 4,526 PubMed hits for <prostate "biochemical recurrence">?

-Patrick

[Hidden in reply to pjoshea13]

Micro-metastasis.

[Hidden]

I believe the better term to use is "durable remission".

As far as I know, recurrance is always a possibility even if only a remote possibility. Why would you need to keep checking your PSA if you are "cured"?

[Bcgkelly]

My surgeon told me “we don’t talk of a cure with the aggressive prostate cancer that you have”. When PSA is under .05 he describes it as no current evidence of disease. He didn’t sugar coat it and made it clear it would probably come back and it did. It appears it’s an ongoing fight but I’ve had two years since radiotherapy and PSA test is next week which will give me an idea how long more before the next treatments.

[Explorer08]

There is no cure for prostate cancer. What we hope for is durable remission.

[Hidden in reply to Explorer08]

Baylor College of Medicine now uses the term, “rarely cured”. Who knows, maybe it’s in deference to me being a guinea pig with them in 2004...... stat positive.

GD

[Hidden]

As my friend Charles says: "We are just kicking the flaming can down the road"

[j-o-h-n]

The doctor is late on last month's mortgage payment.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 05/17/2021 9:25 PM DST

[elvismlv123]

A radiologist told me he could cure me. I never went back.There is no cure for prostate cancer.That means he is guessing with a positive attitude.

[elvismlv123]

explain bcr/ty

[Hidden]

I have been no evidence since 2008. Extra words from my researcher MO, “I can find no cancer in your body.” In 2010, he said, “I know that you are a realist, but you are cured.” Proved by stopping Lupron and then adding Low dose of T when it did not come back in 2011. I have been undetectable since. I have quarterly blood work. I could go to semi testing, but elect quarterly. Good luck.

GD

[elvismlv123]

danke

[elvismlv123 in reply to elvismlv123]

A rise in the blood level of PSA (prostate-specific antigen) in prostate cancer patients after treatment with surgery or radiation. Biochemical relapse may occur in patients who do not have symptoms. It may mean that the cancer has come back. Also called biochemical recurrence and PSA failure.( In case Im not the only one who doesnt know this.)

[Tall_Allen]

Darryl, you may be interested in this patient survey of expectations for a cure in metastatic men. Doctors who try to impart an optimistic attitude may be fostering unrealistic expectations. Doctors are only human and bad news is difficult to deliver. Or, patients may not be hearing what their doctors are telling them. A lot can be miscommunicated when emotions are filtering such fraught communications.

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

[Darryl Partner in reply to Tall_Allen]

Thanks