Meyers' video on when to intiiate salvage radiation therapy -- and when not to.

Here's a new video from Dr. Meyers that has very helpful information for anyone who's had surgery and is now facing a slowly rising PSA and is wondering when to begin salvage radiation therapy.

His main point: if the PSA is not moving quickly it may not be a good idea to initiate SRT even if the PSA is slightly above 0.2! Here's why:

/askdrmyers.wordpress.com/2012/12/19/when-recurrent-pca-isnt-cancer/

Yeah, he's saying the PSA level vs time could level off over time, sometimes invalidating the double time. Hope he puts new batteries in that smoke alarm. Those chirps were annoying!

Furthermore, what I have learned (in my mind) is several key notes.   1. This is why John Hopkins considers recurrence as a PSA over 0.2   2. My PSA has been (undetectable) 0.1 for 19 months,     considering PSA doubling, I am already at 19 months.   3. So for me, if my PSA does rise, (although I will have concern), I will     be taking note if it pushes past 0.2, and not so much on doubling to     get there (19 months so far).   4.  Maybe the criteria for the Zero Club should be 0.2 and lower  

HD_Rider, Hey Buddy !

 

Glad to hear from you again.  I am busy outside during Spring/Summer/Fall; winter is too cold to be outside for long.  So it was PSA time and winter is here, so I am back to HW for a spell.

 

1. Haven’t had any PSA tests below one decimal point to the right, 0.1.  My Urologist is fine with it, and so am I. Many debates on how sensitive a test to use.  Two thoughts here, one it can cause more anxiety and two you see it coming. See what coming? Anxiety, PSA rise, or both.  As far as the standard goes, only stress and concern is standard.
2. With your positive margins and with a slow micro (hundredths) of a PSA rise I feel your concern.  However, even with positive margins the PCa could have been seriously damaged, and you have residual prostate tissue causing the PSA rise.  A PSA of 0.00001 going to 0.00002 is not doubling.  0.1 to 0.2 is doubling and how long it takes to get there, and if it goes past 0.2.  In my opinion and personally this is the rule that I am using if needed.
3. SRT should be not taken lightly and caution is in order.  SRT itself will bring about issues.  There’s allot of debate on when/if to get SRT.  My personal thoughts/opinion is to do nothing until it passes 0.2, and even then maybe not.  I have a big issue with any radiation passing through my body.
4. It’s just as easy to find proffessionals pro surgery, radiation, seeds, etc.., as there are opposed to any of them.  The truth is for younger men as us, there are no clear answers, and one is kidding themselves otherwise.  We were thrown into  a sea of choices, and must make an educated decision the best that we can.  
5. I am not prejudice for any choice or decision any man makes battling this horrid beast.  Even the best minds in the business are questioned amongst their peers

         

          As always PCa brother, do your homework, listen to all advice, and then take a stand.

http://urology.jhu.edu/newsletter/prostate_cancer829.php

http://wiki.medpedia.com/Clinical:Rising_PSA_in_Nonmetastatic_Prostate_Cancer#Definition_of_Primary_PSA_Recurrence

Well said, purgatory, as one of those rushed (by me, not the doctors) gleason 6, 2 core guys, this disease is not one size fits all, everything needs to be considered before doing anything...........

dj, i hate to hear that. and from talking to me, you know i am not against SRT when needed and justified. i think my oncologist makes a sound point, i hope you can dodge that bullet for as long as you and your doctor feels it safe.

the more i hang around our twisted world of PC, the more i believe there is a lot of overtreatment going on, both with primary and secondary treatments. i am very much for screening and diagnosis, but feel that even with a pc dx, jumping the gun with treatments is not needed for many. i am all for whatever treatments are needed and proven to be needed, wouldn't want to limit anyone with a legitmate need, because PC can still be a dangerous thing and a killer.

i have suggested this idea many times before, and still not sure how to work out the details, but if the systems somehow could be in place, where a man couldn't just demand or be talked into immediate primary treatments when his stats don't justify it. it could be an effective way of slowing down these rash decisions and expensive treatments. if it were up to the insurance companies, they would be in favor of men not being treated period, for obvious reasons. while i am a big defender of most doctors, surgeons, ro's etc, if they have a vested interest in a patient being treated, it would be hard for such a professional not to be biased toward immediate treatment.

that's why i love having an oncologist who is neither a surgeon or a RO, nor does he have direct ties to either service. wish i had seen one first before i ever did anything, especially since my primary treatment (surgery) and secondary treatment (radiaton) failed so rapidly.

just something to think about.

david