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When is HT needed

User
Posted 07 Mar 2019 at 18:26

I am 6 years post RP and 3 years post RT with a low but rising PSA and otherwise feeling very well. My PSA was 0.06 in September 18 and 0.14 today – my oncologist was not concerned and said that scans would not reveal anything at this stage, and he would rather keep all the treatment tools in the box until they are needed. Fair enough, but when I asked him when he would recommend HT he said he would wait until it my PSA was around 10.



Based on my limited knowledge, a PSA of 10 would indicate quite an active/advancing decease and whilst I am not in the habit of questioning medical advice, I would welcome any thoughts about the ‘right’ time for intervening with HT.

User
Posted 07 Mar 2019 at 21:55
Hi Andrew,

As I understand it, the reason that many oncologists prefer to delay the start of HT in such circumstances is because every HT drug has a limited period of time for which it will work, hence the desire is to administer the drug at the time that it will have the greatest benefit. If the drug is given too early in the progression of the cancer, there is not much for it to do, and then once the disease has become more advanced, the opportunity to use that drug has gone.

Hope that’s of some help,

Chris
User
Posted 07 Mar 2019 at 22:44
For recurrence post RP / RT / HT a wait until PSA reaches 10 seems to be common across regions although some oncologists wait until it hits 20. We recently saw the specialist re my dad’s recurrence and he said that rather than fixate at the actual numbers, he would prefer to watch the doubling time.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Mar 2019 at 09:57

Doubling time is much better way to look at PSA post-treatment; looking at PSA as if it's a newly-diagnosed PCa doesn't work. The rate of climb is always more important than the actual level.

.
-- Andrew --
"I intend to live forever, or die trying" - Groucho Marx
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User
Posted 07 Mar 2019 at 21:55
Hi Andrew,

As I understand it, the reason that many oncologists prefer to delay the start of HT in such circumstances is because every HT drug has a limited period of time for which it will work, hence the desire is to administer the drug at the time that it will have the greatest benefit. If the drug is given too early in the progression of the cancer, there is not much for it to do, and then once the disease has become more advanced, the opportunity to use that drug has gone.

Hope that’s of some help,

Chris
User
Posted 07 Mar 2019 at 22:44
For recurrence post RP / RT / HT a wait until PSA reaches 10 seems to be common across regions although some oncologists wait until it hits 20. We recently saw the specialist re my dad’s recurrence and he said that rather than fixate at the actual numbers, he would prefer to watch the doubling time.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Mar 2019 at 09:57

Doubling time is much better way to look at PSA post-treatment; looking at PSA as if it's a newly-diagnosed PCa doesn't work. The rate of climb is always more important than the actual level.

.
-- Andrew --
"I intend to live forever, or die trying" - Groucho Marx
User
Posted 08 Mar 2019 at 23:34
Hi Andrew, very similar stats to me. I had RP and RT 6 years ago. PSA was 0.08 in Nov and 0.12 in Feb. Roughly the same advise from my medic

Be good to hear how things progress for you but hope it’s a really slow progression

Bri
 
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