Good News

[Sebara]

My Professor advised me that I'm "biochemical in remission"Not sure what that means, any suggestions

[Tall_Allen]

It probably means your PSA is low and/or stable.

[Sebara in reply to Tall_Allen]

My PSA has been undetectable for 3 years

[6357axbz]

Are you metastatic, i.e., any distant metastases?

[Sebara in reply to 6357axbz]

Yes, in pelvis, sacrum hips, ileum and some in spine.Had radiation of sacrum and currently on eligard every 6 months and Enzalutamide 140mg every day.

[MateoBeach in reply to Sebara]

appears excellent, Sebara. However, I would suggest an Axumin or FDG PET and CAT scans to rule out progression of non-PSA producing variants. Just to be sure.

[Scout4answers]

Great news, sounds like you are responding well to therapies

[dadzone43]

Ask the professor what that means.

[slpdvmmd]

As I have said before I think those of us with the real deal, which it sounds like you have cannot be cured only managed. The two characteristics that define cancer are invasion and metastasis. Probably all true prostate cancer has disseminated i.e. metastasized by the time we are diagnosed. Prostate cancer as well as estrogen receptor positive breast cancer are the poster children for metastatic dormancy which can be decades. During these intervening decades we may die of other things before reawakening of these dormant essentially undetectable micrometastases awaken but we are not technically cured. This means we all need to be forever vigilant.

[NecessarilySo in reply to slpdvmmd]

"...we may die of other things before reawakening of these dormant essentially undetectable micrometastases awaken but we are not technically cure"

Does this mean the prostate cancer grows after we die? Gruesome thought.

[PSAed in reply to NecessarilySo]

the living dead- that's how i felt on Lupron.

[Purple-Bike in reply to slpdvmmd]

Right, forever vigilant. Doing all we can to keep it in remission.

[j-o-h-n]

For Sebara from Goggle.

ABSTRACT

Objective: We conducted a systematic review and meta-analysis to synthesize the evidence about predictors that may affect biochemical remission and recurrence after transsphenoidal surgery (TSS), radiosurgery (RS), and radiotherapy (RT) in Cushing disease.

Methods: We searched multiple databases through December 2014 including original controlled and uncontrolled studies that enrolled patients with Cushing disease who received TSS (first-line), RS, or RT. We extracted data independently, in duplicates. Outcomes of interest were biochemical remission and recurrence. A meta-analysis was conducted using the random-effects model to estimate event rates with 95% confidence intervals (CIs).

Results: First-line TSS was associated with high remission (76% [95% CI, 72 to 79%]) and low recurrence rates (10% [95% CI, 6 to 16%]). Remission after TSS was higher in patients with microadenomas or positive–adrenocorticotropic hormone tumor histology. RT was associated with a high remission rate (RS, 68% [95% CI, 61 to 77%]; RT, 66% [95% CI, 58 to 75%]) but also with a high recurrence rate (RS, 32% [95% CI, 16 to 60%]; RT, 26% [95% CI, 14 to 48%]). Remission after RS was higher at short-term follow-up (≤2 years) and with high-dose radiation, while recurrence was higher in women and with lower-dose radiation. Remission was after RT in adults who received TSS prior to RT, and with lower radiation doses. There was heterogeneity (nonstandardization) in the criteria and cutoff points used to define biochemical remission and recurrence.

Conclusion: First-line TSS is associated with high remission and low recurrence, while RS and RT are associated with reasonable remission rates but important recurrence rates. The current evidence warrants low confidence due to the noncomparative nature of the studies, high heterogeneity, and imprecision.

Abbreviations:

ACTH = adrenocorticotropic hormone

MRI = magnetic resonance imaging

RS = radiosurgery

RT = radiotherapy

SC = serum cortisol

TSS = transsphenoidal surgery

UFC = urinary free cortisol

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 05/15/2023 11:53 AM DST