SRT @ .03???

There is a study that has been talked about alot here, pointing to the advantage/recommendation, that after surgery, if PSA rises to as low as .03, SRT should commence. I cannot find it using the search box.

So, just a question - was this recommendation for all post RALP situations or was it specifically for men with positive margins or some other less favorable pathology?

I am just curious, my mind is working overtime in anticipation of my next PSA test in 2 weeks. And it came up on another forum.

Thanks JFL, I'll look at the article.

Pratoman,

Before going SRT, I would figure in how fast or slow it took to get to 0.03. From everything I have read there isn't much difference in outcomes when getting SRT at 0.03 or the established 0.2 level. It could take years before hitting the 0.2 level. SRT therapy is rapidly advancing with newer methods and protocols which will reduce side effects and probably better outcomes.

I suppose there's no point in saying that anticipation causes anxiety and is toxic, and that there is no advantage in driving yourself crazy rather than in dealing with what is at it comes?

The commentary mentioned above applies to men with adverse pathology. Read the penultimate paragraph of the following to find your case:

Johns Hopkins: ultrasensitive PSA after surgery predicts biochemical relapse

- Allen

Where's the "Grand Study of All Studies" that averages all of the studies that's ever been done?

Load the averaged results into a central computer system. Every new study could be loaded as they become available.

Then all one would need to do is to type one's pathology and historical PSA's into a computer to know ones odds of clinical failure (metastasis) at any given amount of time in the future.

All urologists and patients would then be in agreement as to what ones odds are for anything.

It'd take the guess work out of how and when to treat anything at anytime with any treatment. . One would know all of the odds for any given decision at any given time.

At the touch of a few keystrokes.

Post Edited (island time) : 12/24/2015 5:15:25 PM (GMT-7)

I had SRT at .3 which was Johns Hopkins protocol (.2 twice in a row). Turned out to not work, but with my pathology, doing it earlier would not have made a difference IMHO. I'm now in the clear but who knows for how long? Fingers and toes crossed hoping for durable emission. 😬
Bob

JFL, it was always curious to me that none of the nomograms include in their input the volume number. I asked my surgeon about it and he said its not really a factor. Which was disappointing to me as my path was 5% involved by tumor.
From a laymans point of view it would seem that logic dictates low volume is a god thing. But the docs seem to say otherwise.

Goodluck to you, hope you finish your SRT uneventfully and thats the end of it for you.
And you as well, Bob, may you remain PC free forever

Post Edited (Pratoman) : 12/25/2015 8:23:32 AM (GMT-7)

Sheepguy, which tables are you referring to on the JH website. The Han tables, post op, and there is no input for volume

Prato , try this http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659365/

Prato, i understand your concern. I am at about 0.09and will have another psa next week. Psa went from 0.01 to 0.087 in 1 year after 18 months undetectable. I am trying to decide when to start adt and igrt.

Mel, maybe we should hold hands ! Lol

Seriously, don't know why, but there is something about the one year mark that heightens my anxiety just a bit. I know it's all in my head, but whatever.

Halbert, sorry i reminded you of the upcoming date. :-(
As usual, we are traveling the same path. Hopefully, we'll be continue on the same path together, the one we are on now, and it will lead to a lifetime of zeros for both of us!!!!!

At my 3 month post of visit, my Surgeons PA told me, that I'd be doing 3 month PSA for 2 years, then I'd go to 6 months for a year, or two (don't remember which), then one year.

However, at my 6 month visit, when i discussed it with the surgeon, he indicated that after one year of zeros, he would put me on a 6 month schedule for a year, then go to 1 year PSA. Honestly, i'm not sure i will ever go 1 year without PSA. Or at least not until i turn 75 or 80, God willing.

Intellectually, i know you are right, its highly likely neither of us have much to worry about. And thats confirmed by the nomograms. But still....... it's there. I'm sure you know what i mean. Even though, its not there as early in the cycle for you as for me.

When i was seeing a psych, in an effort to control my anxiety better, he asked me "what benefit do you get from worrying about test results before they come?" I didn't really have an answer, there obviously isn't a benefit. But i said, I dunno, maybe I'm trying to prepare myself for the worst, while hoping for the best. His response, was something i already knew, which was that you can't really prepare yourself for bad news, it won't feel any better if you mentally stress over it in advance.

OK, this is probably a different thread, so I'll stop now. And move on to enjoy the day.

Agree, hrp, psa anxiety is part of the game for most of us. It is what it is. Don't know why, but it calms me to post about it.
So thanks (to everyone) for indulging me.