Ok, first of all...I don't know my PSA density and I had not heard about it before! But this is an interesting study (with all the limits of retrospective studies) about how PSA nadir and density can predict better outcomes of metastatic hormone sensitive prostate cancer.
It looks like PSA measurements after starting treatment can predict survival in patients with high-volume metastatic hormone-sensitive prostate cancer (mHSPC) receiving new hormonal therapies.
Researchers found that lower nadir PSA (≤ 0.2 ng/mL) and PSA-density (≤ 0.08 ng/mL²) after starting treatment are linked to better progression-free and overall survival rates. Additionally, the presence of visceral metastases, particularly in the liver, was associated with poorer outcomes. These findings suggest that monitoring these PSA markers can help doctors tailor treatment plans and improve patient care for those with high-risk mHSPC.
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Maxone73
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No, I have never been on enzalutamide or any ADT, and yes I was metastatic prior to diagnosis. I am most grateful for my ten year outcome, achieved by being out ahead of guidelines and what many think of as "SoC".
ah ok! I did not understand the correlation between what you said and the fact that there are (probably) predictors based on the early response to ADT + ARSi 😃
First, thank you for your detailed bio it helps everyone on this forum. Even though you were metastatic you never had a Gleason score higher than 7 according to your narrative. Do you think this is the primary reason for your success in fighting the beast for 10 years?
Hi Rolphs, kind of you, thank you! (I strive to be helpful - I am most grateful for the help I have received - especially the out of the box thinking). My final pathology after RP was 4 + 3, upgraded from original biopsy opinion 3+3 and 2nd and 3rd 3 + 4 opinions.
I believe the reason for my success to date is removing sufficient/(all) tumor burden before it spread outside of treatment fields and before there are just too many mets. I know of true G 6's that have died of this beast and I know some G 9's carrying on <0.010 after RP and salvage RT - no ADT.
My G 7 RP nadir was 0.50 - we accepted cancer remained. Over next 11 months, monthly testing, it steadily rose to 0.11 when I had salvage RT. That nadir was 0.075 - clearly we only got some and cancer was outside of prostate bed. Carried on with monthly testing, pondering STAMPEDE. Less than year later, back at 0.13, is when I had the nanoMRI I share about, plus additional imaging including PSMA, bone scans, etc. With nanoMIR identifying five suspicious pelvic mets and otherwise NED, I went for the salvage extended pelvic lymph node surgery. With six cancerous lymph nodes confirmed by biopsy at uPSA 0.13, and a post ePLND nadir of <0.010, we were left thinking we got most (all?) mets. I did not and still do not think in terms of being cured, and accept cancer cells of various names likely remain, expecially as I have seen uPSA rise through 0.1, 0.2 and into 0.03 range over past six plus years. IMO, as long as they float about and don't set up base camps, I am most grateful. If/when my (over the top to some) screening efforts identify one or more mets, we will take best effort, if possible, to reduce that tumor burden.
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Just hit the news stand
Abiraterone in Metastatic Hormone-Sensitive Prostate Cancer 
Advanced Metastatic Prostate Cancer Survivor
