Low PSI but advance cancer

Has anyone had re-current cancer with a low PSI (under 1) but an agressive tumor.

PSI 34  at age 47 Gleason 4.5+4.5=9 in 2005

Prostate removal 2005

Hormone Therapy since

3.5" tumor found 4/2010

Chemotherapy treatment (not working, tumor still growing)

To start Radiation Therapy 8/2010

The tumor was found by my general practitioner not my Oncologist.

Some PC, the real nasty aggressive stuff, can mutate to the point it no longer resembles normal prostate tissue and it stops producing any PSA...

Fairwind is right; Walsh writes about this in his book; Catalano has a little on this in the FAQ's on the website. Catalano encourages annual DRE's as well as PSA tests, since these nasty ones often show up first as small lumps in the prostate bed and are palpable.

You can have your pathology slides (now in storage)re-reviewed by experts like Bostwick or Oppenheimer whom do ploidy analysis on the pathology samples(3 types of dna structures possible, it does make some differences) and are familar with PCa variants (24 known now). If you have ultra low psa and chemo and other drugs are ineffective, it is worrisome. You should hire a specialist onco-doc like these types: Dr.Sartor, Myers, Scholz, Lam, Volgelzang, Leibowitz and there are some other reknown types. They have seen variants and all scenarios, you might respond to alternative drugs, they should know: estrogenics like DES, Leukine, Thalidomide (combo maybe), Abiraterone is in clinical trials, and other options, something may have value to use. I would not wait to long on looking at alot of choices that exist.  (www.hrpca.org  see treatments-drug protocols)

 The radiation being likely to handle the tumor??  How was it detected and what else do you know on this????

Ploidy info:  www.prweb.com/Releases/2007/10/prweb564967.htm

If you want to read about variants I can get you a link (not certain you have a variant), only a few are more worrisome situations and it is more rare of course to find one with such. Start studying is my words of wisdom. You need expertise at this level.

Post Edited (zufus) : 8/25/2010 12:50:57 PM (GMT-6)

Yes we have heard of docs like Dr. Strum whom has mentioned such and why he and Dr. Epstein disagreed on the value of ploidy testing and Strum recommends Bostwick and Oppeheimer and a German guy that is fabulous he says(for ploidy useage). Says it can make a difference to some onco docs and Dr. Strum analyzises way more overall factors than most docs and used to post on P2P (free advice on PCa cases, usually those whom failed treatments somewhere else, they have archives) , also oncos like probably Myers, Scholz and some others would find this probably useful, as to what drug therapies may have more value for a patient or possible duration or necessary combos to add a boost to them.

In the future this information will be more valueable. Not only DNA ploidy but PCa variants might be identified that were missed by average pathologist. (I contend that happens...no proof). Some of these variants do not respond well to hormone therapies, e.g.  'small cell' PCa.

Variants (old list of 18, 24 exist now):

www.webpathology.com/case.asp?case=23     (fyi stuff)

Hey I am not entending to burst anyones bladder with scary stuff, just be aware of how complex this stuff might get. The variants are rarer to occur.

Post Edited (zufus) : 8/25/2010 1:48:04 PM (GMT-6)

Thanks all, I have a lot to learn. Zufus, I would like to learn more about variants. A link would be helpful. Info on these specialists would also be helpful. Where do they practice?
STeveC

The variants (18-this is the old list, link for 24 types???)
www.webpathology.com/case.asp?case=23  (years ago posted at Bostwick labs website)
www.prostate-help.org  (has a section therein dealing with about 5 variants w/info)

You can google any of those oncology docs and find info and where they are at. Dr. Scholz is in California Marina Del Ray (fyi).
Dr. Scholz www.prostateoncology.com  
Dr. Leibowitz www.docotorleibowitz.org  
Dr. Strum www.pcri.org  (retired now, info still abounds, has great book The Primer)
Dr. Myers  www.prostatepointers.org/cmyers

Dr. Labrie  "                      "            "/labrie   

Dr. Barken "                      "            "/barken

Maybe try this with after the slash any doctors name, pointers know most familar names

Pathology guys (websites): www.bostwicklaboratories.com  (Bostwick)
www.prostatelab.com  (Oppenheimer)

Makes the Twilight Zone seem like non-fiction in comparison  (LOL). I have humor, so hope it is addicting for curing the blues.

Post Edited (zufus) : 8/26/2010 10:37:06 AM (GMT-6)