Studies re: PSA > 0.5% after RT

[quietcorner]

Can anyone interpret the gist of these studies? Correct me if I am wrong (and I sure hope to be) but from what I am gleaning, it seems that for those who have RT and a concurrent round of ADT:

1) Researchers and studies are showing that waiting 18 months to reach a post RT nadir isn't necessary to determine the future outlook of PCa, and

2) A PSA test given immediately and/or 3 months after a full round of RT with results showing > 0.5% is indicative of what the future may hold for intermediate (unfavorable) and high-risk folks, and

3) Doctors should consider discussing this with those patients > 0.5% PSA to get a head-start/circumvent the unfavorable outlook, ie, consider ADT while still in the early days, post RT.

So, if the above holds true, why do doctors wait a full 18 months for PSA to reach nadir level, if earlier tests indicate a pro-active stance is better?

renalandurologynews.com/new...

renalandurologynews.com/new...

renalandurologynews.com/new...

dailynews.ascopubs.org/do/p...

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

[SimMartin]

think this is another interesting if small study - ncbi.nlm.nih.gov/pmc/articl...

[maley2711]

I agree generally..trials are now underway. However, I don't believe this proves that a PSA nadir of 0.1 at 18 months post-RT is not a good sign also. We certainly don't want to begin overtreating men either???

[quietcorner in reply to maley2711]

Agreed, we don't. The point of the studies - if I'm interpreting them correctly - is that it is better to get a head start and go with the immediate post-tx PSA score, or the 3-month PSA score, to begin proactive measures. Letting the full 18 months elapse to judge nadir PSA is a waste of time, literally, when early indicators are just as accurate. At least, that's how I'm reading it.

[maley2711 in reply to quietcorner]

You may be right, but researchers doing trials to confirm what you believe is obvious? I wold need to read more research in more detail....uninterested in more treatments that may have been unnneeeded???

[quietcorner in reply to maley2711]

What did you think after reading through the reports and findings (llinks above?)

[maley2711 in reply to quietcorner]

I think I looked at all of them, aand pretty much agree with their general conclusions....if I remember correctly, these findings warrant additional trials to test the hypothesis generated by the findings in thes reports. As I said, could lead some men to undergoing unneeded treatment .....or might not.....that would be/is the purpose of additional randomized trials I believe. I twould be up to you if you wanted to risk the possibility of unneeded treatment.......some men may be fine without, but extremely low nadir is not reached that quickly in their cases?

[turkeyjoe1]

I was Dx 10/21 with Gleason 9 PSA 106. PSMA didn't show any Mets or LN involvement. 30 day firmagon shot. PSA 1.47 6 month lupron shot given PSA .47. Started IMRT 44 treatments. 3 months after IMRT PSA .01. Continuing lupron only. No abi 7 months later PSA .01. Stopped lupron and ADT 19 months of treatment. Waiting for T to recover to see where it goes.

[quietcorner in reply to turkeyjoe1]

sent you pm

[turkeyjoe1 in reply to quietcorner]

I don't know how to get it.

[quietcorner in reply to turkeyjoe1]

upper right hand corner, Chats, with a paper airplane icon.

[turkeyjoe1 in reply to quietcorner]

Got it

[Mgtd]

We must be twins. I was researching to see if PSA could help spot a positive or negative trend early after treatment and had the same thoughts as you expressed.

I am now coming up on 9 months post radiation and 6 months post Lupron. I get PSA every three months before seeing the RO and then three months latter the MO. So far my PSA has been unmeasured. Last RO visit she was pleased with this and extended my visit schedule to 6 months instead of 3 months.

MO visit and blood work coming up in late April. Curious to see what she has to say.

As you can see they alternate so I was getting PSA and a doctor visit with either the RO or MO every 6 months.

Overall I take it to be a positive trend based on the PSA but realize the other foot can fall at any time. Kind of a crap shot; only time will really tell.

I had 25 IMRT treatments and also had my pelvic area treated at the same time. The RO recommended this to stop microscopic cancer cells. I gathered this is not really SOP but based on my age - almost 80 and her experience she thought this was prudent. Sounded good to me. Looks like it maybe working so far.

No side effects as a result.