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Good article on current options for managing early biochemical recurrance

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Posted 2/26/2013 5:56 PM (GMT 0)
David:

I was definitely impressed with your doctor.

Regarding answers to this thread, I still maintain that the CURRENT thinking seems to be combining HT with SRT in certain cases. That is a much more recent development. My SRT was in 2011. At that time, HT was just starting to be talked about as an adjunct to SRT.

For me, personally, it is a moot/academic point. But from my reading I keep getting the impression that the current standard practice is to combine HT with SRT, again under certain circumstances.

I might be wrong and clearly there is still some controversy. It is kind of like when to start HT. Most of the thinking seems to be sooner rather than later, but there are some that seem to advocate waiting. Now, waiting until what? I know some say wait until mets are present. But it appears others say do it if the PSADT hits a certain threshhold. Maybe others say wait until the raw PSA hits a certain target (I have heard "20" mentioned).

Mel

Posted 2/26/2013 6:59 PM (GMT 0)
Results from my SRT have been literally perfect -- 0.00 so far. However the statistics based on my personal PCa history also say that my probaility of long-term success are very low. So I've discussed next-steps, should they be needed, with my uro and RO. As, Mel mentions above, my uro says, absent any sign of mets, he would suggest waiting until a PSA of 10 to 20.

One thing I've been watching is the studies of C-11 Choline PET scan at Mayo under Dr. Kwon. This diagnostic approach has only recently been FDA approved, and I don't know if insurance companies or medicare are covering it yet. The thrust of Dr. Kwon's reports on this technique is that it has been successful in some patients of identifying specific loci of PCa (rather than widely scattered bone mets) that can be treated successfully with surgery or targeted radiation. However, the patient needs to have a minimum PSA of 2.0 before the technique has a chance of detecting anything.

So, speaking purely from conjecture right now, my thinking would be (in my own case) to look further into this or similar emerging diagnostic approach before agreeing to HT-- unless of course other tests clearly indicated widely-scattered mets.
Posted 2/26/2013 8:16 PM (GMT 0)
Bohemond,

Those SRT stats do look great...hoping for the same outcome for us if we go that route.
Jim's stats are close but not quite as good as yours were.

We have been in contact with Dr. Almeida in Phoenix to do the C11 acetate PET/CT clinical trial. Our PSA has to be .4 or above and the vampire appointment is March 5. It's been on the rise since we went intermittent.

Here's an interesting link I found on an Ustoo forum.
OB-Ron says its $3000 at Phoenix and $7000 at Mayo (also different imaging agent)

http://www.ob-ron.org/2012/05/tidbits-about-c11-acetate-petct-and.html

Jim and Marie
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