Update of status. BCR

[MSTI]

Hi all, hoovering around 0.2 is ongoing for almost two years. Six years from RP.

MSK nomograms are not applicable for adjuvant RT cases.

Looking for more information on BCR, found something on the following link:

urologytimes.com/view/defin...

The only additional point that I would make is that sometimes in guys who had low-risk or intermediate-risk disease and had a modern-era radical prostatectomy [RP] with aggressive nerve sparing, bladder neck sparing, and urethra sparing, we see low levels of PSA that are not cancer-related. Therefore, I agree with Brian that in the high-risk patients, you can jump on a PSA recurrence quickly, but I would caution the oncologists in our audience tonight that you must look at the RP pathology. Moreover, if it was not so bad pathology, and if the guy has a PSA of 0.13, or even 0.2 [ng/mL] a couple of years out, I tend to follow those patients because there is this phenomenon of benign glands at the margin. We know from the Mayo Clinic’s series and our work at Duke [Cancer Center], that honestly, sometimes up to 30% of patients can have this in long-term follow-up, a little bit of PSA in the system that’s not cancer-related.

A couple of years out?

Does he mean that PSA is elevated right after surgery and hoover there for couple of years out?

(English is not my native language).

Any comment on numbers?

My comment: PSA likes winter.

PSA

07/16/20190.12

01/29/2020 0.20

06/15/2020 0.18

08/07/2020 0.16

10/05/2020 0.18

02/18/2021 0.23

04/13/2021 0.21 (CMIA, Abbott)

07/27/2021 0.20

09/14/2021 0.18 (CMIA, Abbott)

Roche ECLIA except where noted (the same labs in both cases)

Regards to all.

[Tall_Allen]

This is incorrect. Benign glands are NOT the source of PSA post-prostatectomy:

auajournals.org/doi/10.1097...

goldjournal.net/article/S00...

pubmed.ncbi.nlm.nih.gov/194...

It is always cancer-related.

But that doesn't mean that it will progress. If the leftover tissue is all GS6, it may never progress (55% of men active surveillance with GS6 never have progression). Or it might - you just have to watch it.

[MSTI in reply to Tall_Allen]

Thanks T_A. You are our encyclopedia. It would be interesting to know Judd W. Moul 's grounds for his point of view.

[Tall_Allen in reply to MSTI]

That's why I rely on peer-reviewed publications of actual data when I can. I've found that doctors (especially urosurgeons) are the greatest source of myths, after the Internet. They should know better.