Friday, September 28, 2007

LESS THAN 0.1 !

This is the best possible news. (Note: I had earlier blogged that it was 0.1, but the nurse had misspoken on the phone.)

Before surgery: 4.8 (but really, 9.6 because I was on a medication that artificially lowered it)
3 months after surgery: less than 0.1 (or "undetectable" on the standard assay)
6 months after surgery: 0.2
10 months post surgery: 0.6
Day before radiation started (about 11 months post-surgery): 0.7
IMRT for 8 weeks
3 months post-radiation: 0.1
4.5 months post-radiation: 0.1
and now, 6 months post radiation: < 0.1

I'm clearly in the "complete responders" group Andrew Stephenson has reported on. His study shows 49% of those who got a complete response within 9 months were free from disease progression 6 years later. That may not sound great to you (50-50 odds) but overall rates of success in salvage radiotherapy in the long run are not nearly that high. My odds in the short run are excellent.

3 comments:

gam said...

Thanks for you personal info. I am waiting for results of my CT and bone scan. PSA now is .3, never went to undectable. I suppose salvage radiation or homones may be next. I will watch your progress and good luck

Replicant said...

gam,

Good luck. From your WebMD posting it sounds like you're on top of this. A radiation oncologist would probably want to see more than one PSA result before doing IMRT salvage (assuming the scans are okay).


I would advise you, as a layperson who has done extensive reading on the subject, that if your next PSA rises, an there is no sign of systemic cancer, AND you decide to try salvage radiation, that you do NOT DELAY further at that point. The studies are clear--the lower your PSA when you start salvage radiation, the greater the odds that it will have a durable effect (and potentially a cure). Ideally, according to Stephenson, this should be at 0.5 or below, but I don't see this as realistic for most men. You would want to try to get started before it got to 1.0.

If you live in southern California, or if you have the means to pack up and live there for 8 weeks, you might want to consider proton radiation at Loma Linda. From all accounts, patients have fewer side effects.

I had set up an appt. with Loma Linda, but in the end I realized that for family and financial reasons I needed to have salvage done closer to home.

As you can see, I had some mild side effects but they have diminished greatly.

If your PSA rises again, I hope that you will consult with a radiation oncologist AND a medical oncologist (I did) to chart out your best path forward.

Don't despair. Even if you're having a recurrence (and you might not be--maybe you'll stay at 0.3!) it's not a death sentence.

Anonymous said...

I HAD A PSA OF LESS THAN 0.1 THREE MONTHS AFTER CRYO SURGERY,AND I AM REAL HAPPY ABOUT THAT