Friday, June 13, 2008

An update to "Even Better Odds"

Earlier, I reported on research by Loeb, et al., on the efficacy of salvage radiation (see "Even Better Odds" below).

It turns out their research really didn't turn up improved odds for me like me--pos. margins and/or extracapsular extension.

I read a more detailed abstract of this on the AUA website. (I've also ordered a full text copy of the article for my own use).

On the AUA site (where they make poster sessions available for free) it says (all caps is my emphasis) "In patients with SM+/ECE, SVI, and LN+, the 7-year progression free survival rates WITH OBSERVATION were 62%, 32%, and 7%, respectively. AMONG THOSE WHO FAILED, 56%, 26%, and 0%, respectively, maintained an undetectable PSA for 5 years after salvage radiotherapy."

Okay. This means--using positive margin patients like me as an example--that 62% did not progress in 7 years of observation. Of the men that DID see their PSA rise during observation (like me), 56% seemed to have a good response to salvage radiation, at least out to 5 years.

So I'm back to post-salvage progression-free odds in the neighborhood of 55-60% again, like Stephenson's research indicates.

Thursday, June 5, 2008

The NEW Prostate Cancer Infolink

If you haven't seen this revamped site, drop everything and check it out right now. Tons of good information, and it's watched over and run by medical professionals. My friend John, (aka), is there. John is a real "go-to" guy for information on this disease.

Don't miss out on the social networking aspect of the site. If you want to talk about prostate cancer, it's the place to go.

Look for me (Galileo) there!

Survival Benefit

A preliminary, retrospective study shows that salvage radiation may offer a survival benefit in a subgroup of patients. Looking at two groups--those with PSA doubling times greater than or equal to 6 months, and those with doubling times less than 6 months, both groups did better with salvage radiotherapy than without--BUT--those with relatively fast doubling times had a more pronounced benefit.

Ten-year prostate cancer survival was substantially higher for men given salvage radiotherapy alone or with hormonal therapy than for those who received no salvage therapy (86%, 82%, and 62%, respectively, P<0.0001),>

Trock B, et al "Prostate cancer-specific survival in men with biochemical recurrence after radical prostatectomy: impact of salvage radiotherapy vs. observation" ASCO GU Meeting 2008.

Wednesday, June 4, 2008

Even Better Odds

Long-Term Rates of Undetectable PSA with Initial Observation and Delayed Salvage Radiotherapy after Radical Prostatectomy.

Loeb S, Roehl KA, Viprakasit DP, Catalona WJ.

Department of Urology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.

PubMed citation:

"The long-term rates of undetectable PSA associated with an SRT strategy were 83% and 50% for men with SM+/ECE and SVI, respectively. In the subset of 716 men who did not receive any hormonal therapy, the corresponding long-term rates of undetectable PSA were 91% and 75%, respectively."

91% long term rate of undetectable PSA. That's music to my ears, since I fall into that statistical group (positive margins, no hormonal treatment).