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Cancer: Prostate Message Board

Cancer: Prostate Board Index

[COLOR="DarkGreen"]Hi again Linda,

I'll insert some comments in green in an excerpt of your response, and this time I'll put my glasses on, and thinking cap too! Sorry I missed that 0.[U]0[/U]16. Should have realized that was inconsistent with the <0.1, and it makes a heck of a difference. Congratulations to your cousin for this preliminary but major success, and to Dr. Menon too! :D :jester: :cool: [/COLOR][QUOTE=Linda070770;4053164]...

[COLOR="darkgreen"]It's reassuring to hear that a doctor of Dr. Menon's caliber is using the ultrasensitive tests to look for recurrence. [/COLOR]

The ultrasensitive PSA score was 0.016. You mentioned that 0.16 is probably a valid indicator of a recurrence, but it was 0.016 so it was still under 0.1.

[COLOR="darkgreen"]In fact, it's under 0.02, which is a level with rather good odds against a recurrence. At least at the moment, it appears that your cousin is [U]not[/U] having a recurrence! [/COLOR]

Do you recommend that he has both of these tests every three months?

[COLOR="darkgreen"]No, the conventional PSA test is superfluous, though having the ultrasensitive test every three months makes good sense. There are two reasons I can think of why Dr. Menon may with to keep getting that additional result. First, it could be that he wants to make statements in his research papers about all patients of a certain type being tracked with a certain kind of PSA test. In other words, it could give him some crystal clear comparability with research he's involved with that extends to the time before there were ultrasensitive tests. The second reason is to help demonstrate to his less enlightened colleagues that ultrasensitive tests give much earlier indications whether there is a recurrence, giving far earlier peace of mind or far earlier warning.[/COLOR]

That's what he's planning on doing.

[COLOR="darkgreen"]Unless Dr. Menon needs the results, there is no reason to get a conventional test as well, until and if your cousin's PSA score rises to the point where it is giving useful information. With a test version sensitive to <0.1, that point would be a PSA of .1 or higher, since the ultrasensitive PSA is needed for clarity below .1.[/COLOR]

Would more frequent testing be beneficial if he opts to wait on the radiation?

[COLOR="darkgreen"]My savvy layman's view is that more frequent tests would not add much at this point, expect perhaps anxiety while waiting for the results. Three months seems about right for now to observe any rise in the score. (There have been some key times in my own treatment when my doctor and I were tracking results every one or two months. For quite a while now, I've been getting labs every two months; that's mainly because my triple blockade therapy has failures that tend to have one cluster around the ten to eleven year point, where I am now. If I can get my score down to <0.01 for a third time, we will be relaxing the PSA schedule to every three or four months.)[/COLOR]

Should he inform his doctor that he wants the test that is sensitive to <0.04?

[COLOR="darkgreen"]No, his test is already more sensitive than that, which is excellent. I'm sorry my misreading your earlier post prompted me to make that misleading comment. [/COLOR]

He has done a bone density, which was negative, thank God.

[COLOR="darkgreen"]That would mean that he does not have osteopenia, which is a milder form of osteoporosis. However, the DEXA scan that was probably used for his BMD scan can be fooled by arthritis or calcification of blood vessels in the areas being scanned; it will then report a healthy density when the density is actually decreased. If you cousin got a qCT (quantitative CT) scan, then his result is reliable. Still, it's good that he got the DEXA scan and the good result.[/COLOR]

Remember that although it was a very agressive cancer, gleason 9, it had not spread to his lymph nodes or seminal vesicles.

[COLOR="darkgreen"]Your cousin is in that group that clearly should have a curative attempt made, as he did. You don't want to mess around with aggressive cancer, giving it a chance to do its thing. [/COLOR]

He has incorporated a healthy lifestyle change that includes a proper diet, excercise and supplements. He is taking IP6 Inositol vitamins daily.

[COLOR="darkgreen"]Someday I'll have to look into Inositol. I know that some health conscious folks are enthusiastic about it, and if you go to and search for " prostate cancer AND inositol ", you will get 91 hits. Most of the research is animal or lab research using prostate cancer cell lines, and there have not been clinical trials.[/COLOR]

He has reduced his red meat intake significantly, and this is a man who loves red meat.

[COLOR="darkgreen"]Personally, I think that is important. In fact, I've eliminated red meat and pork. Unfortunately, the research is not compelling yet, but it is strong enough to persuade me to take this harmless step. But it is sometimes hard to take a pass on some great beef and pork menus. It's not just the saturated fat in the meat. Unwise ways of cooking it can enhance cancer influencing effects. But perhaps most important, red meat and pork are big sources of arachidonic acid, and that supports the growth of prostate cancer.[/COLOR]

He is also starting an exercise routine.

[COLOR="darkgreen"]That's great. He should be sure to include strength exercises, though aerobic, balance and flexibility exercises are also worthwhile for us as prostate cancer patients.[/COLOR]

Here's something new that we recently discovered. A couple of physician friends have informed him that the side effects of radiation are worse than he thinks because the radiation could increase his chances of cancer in other areas such as the bladder and the rectum. I have done research on radiation side effects but that one never came up. I know that the bladder and rectum would be affected by the radiation because targeting the healthy cells there produces side effects such as incontinence, urination burning, bowel problems and rectum bleeding

[COLOR="darkgreen"]Mostly acute effects that resolve pretty quickly, with some preventive measures or countermeasures to help with longer-lasting or potentially permanent late effects. Also, these side effects are not certain; it's an odds thing, and an odds thing with the degree of severity also. These days, such effects are usually pretty mild when the radiation team is competent.[/COLOR]

but we did not know that there was a risk of developing cancer there through radiation. Did you know that?

[COLOR="darkgreen"]That's called secondary radiation. It does exist, but the odds appear to be very, very low. I'll bet that neither of the physician friends was a radiation specialist. [/COLOR]

So far, the doctors that he's talked to have suggested that he waits on the radiation until if or when the cancer comes back, and to deal with it at that time. That's what he is leaning on right now but we are still scared and want to make the right decision because we don't want it to have spread to his testicles and bones by the time we catch it.

[COLOR="darkgreen"]The testicles are are rare target for prostate cancer spread. Prostate cancer is very different from testicular cancer. With the aid of the ultrasensitive tests, he should have an excellent view of whether the cancer is still there, and if so, if it is aggressive. If needed, he will have plenty of advance warning and will be able to hit the cancer while it is still very small.

There is one possible hitch. Normally, though not so hot before diagnosis, after diagnosis the PSA is an outstanding way of tracking what the cancer is doing. The exception is with some Gleason score 8 to 10 cancers. Some of them do not produce much PSA, though many do, and it would be a rare cancer that would not produce enough to be picked up with an ultrasensitive test. There are at least four other markers that can do a better job for monitoring the cancer for these patients. The markers are known as PAP, CEA, NEA, and CGA. The Primer describes them, and I'll be glad to provide detail if you wish. If I were in your cousin's shoes, I would want to get my baseline levels of these markers with a simple blood draw; he probably will not need that data, but it will be useful if he does need it.[/COLOR]

Jim, God bless you for helping other people that are confused and looking for an answer. A person never knows how crucial it is to seek help from others until they are in this type of situation and desperately seeking a cure. This experience has taught us to share our knowledge and experience with any one out there that needs help.

Thanks again!

[COLOR="darkgreen"]You're welccome! One of the reasons I'm glad to help others is that I myself got some vital help from the Internet patient groups (particularly from the wife of one patient. That makes you want to "pay it forward."

Take care,

Jim :wave:[/COLOR][/QUOTE]

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