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PSADT Changes w Time

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Posted 12/13/2014 7:00 AM (GMT 0)
Does PSADT after RP biochemical recurrence
decrease [get shorter / worse] with time ?

I am trying to calculate how long I can wait
before starting HT. I am hoping my PSADT remains level
at 8.7 months. But I fear it will shorten with time.

======================
2014 3 April open RP
Pathology; ECE+ LN- SV- Vasc - 152gms
Neg Margins, PNI + , half nerve taken one side
GS upgraded to 4+4 Grading pT3aN0MX
ED , Incont down to 1pad/day in 5 months
3July14 3mo Post OP PSA 0.224
4August14 4mo Post OP PSA 0.247
3October14 6mo Post OP PSA 0.29
PSADT 8.7 mo w MSKCC Nomogram

Post Edited (pablocito) : 12/13/2014 1:53:14 AM (GMT-7)

Posted 12/13/2014 4:18 PM (GMT 0)
The only calculation, I have is from JohnT. He said it takes 40 doublings for cancer to kill you. I find that comforting, true or not, as an older gentlemen. Well I am one or the other maybe not both. I always liked that term, fitting or not. I don't think cancer acts in a fissionable way, myself. Ps Believe that calculation was with out any treatment. left to itself, that is!
Posted 12/13/2014 4:28 PM (GMT 0)
In my case both, but only an insignificant rise in PSADT. You may be past the ideal "trigger" already. I'd say you can wait indefinitely, but why would you want too? QOL I'm guessing. Delaying HT side effects speeds up possible mets side effects in my estimation. I don't think it would be normal for a PSADT to level out or increase without some form of treatment. Just my thoughts, best of luck!

Cheers, Doug
Posted 12/13/2014 4:47 PM (GMT 0)
pablocito

I'd question the accuracy of the MSK tool with such small changes over such a short time period. But, that said, with a PSA of .29 in October -- 6 months after open RP, it does look like you are headed for further treatment, and as a Gleason 8 that probably does mean HT. Your medical situation is outside of my personal experience, but if your care to-date has been with a urologist, you might also do well by getting a consult with a medical oncologist who specializes in PCa.

Jim
Posted 12/13/2014 5:06 PM (GMT 0)
Yes, the doubling time can accelerate sometimes. It varies.
You did not mention Salvage Radiation.
Something to consider.
Good luck.
Posted 12/13/2014 6:07 PM (GMT 0)

logoslidat said...
The only calculation, I have is from JohnT. He said it takes 40 doublings for cancer to kill you


I believe this 40 number assumes one is starting from an undetectable PSA level of 0.01. But if the beginning number is say .3, the number of doublings to metastasis or death would be much less. And if PSADT slowly gets smaller, survival time is even less.
Posted 12/13/2014 10:42 PM (GMT 0)
Im not sure, Id be more comfortable saying it would start from official bcr of .2 +. Doubling times are not accurate at the low levels you refer to imo and with every urologist oncologist I've talked to an that was 3 plus a couple of run of the mill local urologists, nononcological , if you will. If the doubling truly [email protected] the survival time would increase think about it, a bit. Whats the concern, your psa is steady at .03give or take a molecule. I may not have all the info, but Id say relax, life your life. My first ultra sensitive taken in march of this year was .07. Im done with psa tests unless I be come symptomatic, then I' consider treatment, consider, be the operative word. Be advise I had negative margins, prostate contained. Any cancer would be systemic. Gotta die of something. We all pass "out of time" at the "same time" any way. Ill give the devil his silly pound of flesh, poor ting, the devil, yeh? He has amazing grit tho, which could explain his attraction. Check out Miltons Paradise Lost, tho be prepared for 5 or 6 readings before you are found. Im on my 4th. What, me worry?? I love your name, especially during this Christmas season. It reminds me of a query… tiny riddle, should be easy to solve…. don't over think about it , or better yet, at all
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