PSA uptick to detectable

Thanks for your thoughts, ddyss!
I’m inclined to do both ADT & SRT. Let’s nuke the sucker. That was the advice I got from Dr. Ko on Guam, and it seems right to me. As he said, there’s a decent chance of a cure still, but if we hold back fugeddaboutit. Still, I’m gonna listen to what Drs. Abramowitz and Biagioli have to say. I’m interested in what their protocols will be and the facilities they offer. Also, I’d kinda like to get a PSA from a non-Siemens machine in Florida, just for ships & giggles. I’m not jonesing for ADT, mind you, but you gotta do what you gotta do.
Surgery was a piece of cake compared to this, mentally/emotionally, for me at least. Whether I do SRT in Guam or Florida, it means 2 months away from home and from my wife (she may be able to join me for a couple of weeks), and that really hurts.

Hey SP...want me to take notes for you on Monday? Know that Abramowitz is very aggressive regarding ADT. Pressing him on why should be enlightening. I agree that surgery was much more straightforward than this ADT/SRT journey. I still believe much of current ADT standard of care is fog sculpture. The Hugh clinical trial due to be completed in 2020 holds much promise, but even those results won’t be published until about 2022.

Good Morning Saipan, its interesting that the doc told you the same thing my mayo team told me with my post op path report which you and I almost the same t3a and t3b that without lupron there was 0 chance of a cure almost to the point where why do radiation and all the SE's that go with it if your not gonna do Lupron which Mayo really really likes. One of our new guys here at hope lodge asked about a different ADT drug and they said no to the one he wanted. Lupron is their drug of choice because it works has been working for many many years and you know when the no. 1 hospital again this year for urology recommends that's good enough for me. I look at it like I do when training people on equipment and doing safety work take every precaution you can to reduce as many risks as you can because it greatly increases your chance of getting the job done and doing it safely. Our chances of a cure are already not the best so why not do everything we can to help improve those odds. Of course this is JMHO.

Larry

Hello everyone I'm new here and still figuring this but and have a couple of questions on the thread's comments.

What is the no "HT Zone reachout mentions" ?

and

fiddlecanoe said...

"I believe that it is a very good sign that your PSA went to undeectable"

What is the significance of Saipan having reached undeectable even though it appears to have rose from that point ?

Thanks and good like Saipan.

I understand “no HT zone” to mean recurrence that can successfully be treated by radiation therapy alone, without the addition of hormone (androgen deprivation) therapy. I.e, you can get a cure without having to suffer through HT.
Statistically, those whose PSA became undetectable before RP failed have better odds that SRT will succeed than those whose post-RP PSA never became undetectable. But in my case it’s a weak indicator because (1) I didn’t stay undetectable very long and (2) my PSA test was sensitive only to .05 no/mL. Had my lab used a more sensitive test, I could be confident my PSA had truly dropped through the floor. As is, my actual nadir may only have been something like 0.47 — well above the 0.03 level that is coming to be accepted as an indicator post-RP that some PCa cells are still chugging along.
I should add that the short doubling time from <0.05 to 0.09 is reason to suspect I never really dropped super low.