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Guihan's interesting case - part 2


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Continued from "Who would be interested in a case like mine?"

You can see that here:


Jim, the reason I consider a 3-month PSA blood test perodicity sufficient lies in my low levels. In a worst-case senario, let's assume one of my PSA results came back at the usual <0.01, but that my PSA was actually just about to exceed that level. If we give it the value 0.01, and apply my worst-recorded PSA doubling time of 66 days, my PSA blood test 84 days later would still measure only 0.025. Accordingly, on my revised treatment plan, my first indication of ADT failure would be a PSA reading in the range 0.1 to 0,25. An extra blood test would then be ordered 28 days later, by which time my PSA would still be less than 0.034. I will also be monitoring my testosterone levels by then, and this should provide additional useful clues.

Tony, your question on Zoladex is a good one. On the other hand, I don't know what Zoladex options already exist, and this is something I want to discuss with my GP. I am also curious about how my past Zoladex treatment (which began in September, 2007) has affected my testosterone production. I feel sure my GP will have something to say about that.

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You aware that the level of PSA is not as important as the doubling time?

What matters is how fast your PSA (and presumably your cancer) is growing, best represented as doubling time.

At least one man still alive in our group has had PSA readings in the thousands, and at last report was at 32 ng/ml.

Others I have met have lived in double digits for years.

But the slow growth (low doubling time) meant their cancer was not growing fast.

A doubling time less than 12 months represents a fast growing cancer.

A doubling time less than 3 months represents a very fast growing, potentially lethal cancer.

According to Anthony D’Amico and colleagues, when the PSA doubling time (the time it takes for the PSA number to double) is less than 3 months following radical prostatectomy or radiation, the patient has a 20 times increased chance of dying from prostate cancer within 6-10 years.

Ross et al. reported "A PSADT of 3 months or greater was associated with a longer TTP on ADT than for a PSADT of less than 3 months (median 33 months vs 12 months, respectively" [jm: TTP=time to progression].

So, when I asked you if you had considered asking your doctor about more frequent testing, I was thinking you and your doctor may wish to limit the time your cancer had to grow with a high doubling time.


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