Admin Posted January 26, 2017 Share Posted January 26, 2017 Jim Marshall (not a doctor) said ... Paul can't post this from where he is now, so he asked me to post it for him. This article is a great summary of treatment options, but contains (in very large print) a true, but misleading statement about evidence of when to start ADT with rising PSA. One doctor advises: "Long-term continuous ADT should not be started until you have actual, visible metastases" because "There is no scientific proof showing a benefit to starting it just because you have a rising PSA." This last statement is misleading because it does not give the complete picture because: There is also no scientific proof showing there is NOT a benefit to starting it just because you have a rising PSA.[Jim, not a doctor] In the words of a recent key study: In summary, our study provides evidence on the when to start ADT question. In the absence of randomized trial results, our findings suggest that starting ADT at PSA relapse does not have a major impact on overall survival compared with deferred ADT initiation at disease progression. (Garcia-Albeniz, 2015) In other words, there is no clear evidence either way. So, one doctor may recommend early ADT, another later ADT. Your doctor's decision will be based on a number of factors about your situation, but the two factors that have been shown to have the greatest effect on your outlook are Gleason score and PSA doubling time (the time it takes your PSA to double). Higher Gleason score, and lower doubling time often indicate a more aggressive cancer, which may affect your doctor's advice to you. ... end Jim You can find the article here: https://www.pcf.org/c/when-treatment-stops-working-blame-resistance/ Link to comment Share on other sites More sharing options...
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