PSA
in [Prostate Cancer]
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From: Ken on 17 Feb 2005 16:45 PSA saved my life... and maybe not. Nine years ago, after I ignored a slowly-rising PSA for several years, it hit 6.0, and my doctor insisted I get a biopsy. It was positive, and I had the surgery a couple months later. Pathology reported malignant tumors at the capsule wall. My PSA stayed below 1.0 for a few years. That's the good news. Five years later, my PSA was 4.0. I got a 90-day shot of Lupron and 90-day supply of Casodex. A month later, my PSA was 0.3, but the side effects were so debilitating, I stopped the Casodex after 30 days. About 18 months ago, my PSA was back up to 7 something. I went to Dana-Farber for a consult, because I had read in an US-TOO newsletter that they were doing a Celebrex trial to lower PSA. I couldn't get into the study because of my prior medications. They recommended hormone therapy again. My PSA rose to 9.9, and my doctor agreed to put me on Celebrex, since I had arthritis anyway. Also, I started taking green tea and a lot of supplements. A few months later, I went to M.D. Anderson as a last-resort consult. They recommended the same thing as everyone else, the dreaded hormone therapy. While I was there, I got a PSA test. A week later, they faxed me the results... 6.3. A few days later, I met with my urologist who said 6.3 was too far from 9.9 to be believable. He scheduled me for radiation to help reduce gynaecomastia from the hormone therapy I would be starting. A month later, I was in the radiologist's office, and I brought up that strange 6.3 PSA. He agreed with my urologist that it couldn't be right. I told him that since I was at the hospital, it wouldn't hurt to get one last PSA before giving up. He agreed, and rescheduled the radiation. When I got home and played back my messages, I heard him yell, "IT'S FIVE POINT ONE THREE!!!" So... my PSA went from 9.9 in April to 5.13 in July. The ONLY medication I was taking was Celebrex, and a lot of supplements! Now, seven months later, it's up again, leveling at 8.8 to 9.3. Because of the serious potential risks of Celebrex, I stopped it a couple days ago. Since I started the Celebrex and supplements at about the same time, we don't really know if it had any affect. After a month without Celebrex, we'll see what the next PSA looks like. Meanwhile... over the past five years, I have had three bone scans (most recently, last week), two CT scans, an MRI and five or six chest X-rays. No cancer has EVER been detected, and I feel fine. Is the PSA the be-all and end-all of cancer detetection? If the PSA continues to hold at 9, or slowly climbs, is it worth the horrors of hormone therapy if it's the only indicator?
From: ron on 17 Feb 2005 18:10 Ken wrote...snip... > So... my PSA went from 9.9 in April to 5.13 in July. The ONLY > medication I was taking was Celebrex, and a lot of supplements! Any hormonal supplements or Propecia for hair regrowth? > Meanwhile... over the past five years, I have had three bone scans > (most recently, last week), two CT scans, an MRI and five or six chest > X-rays. No cancer has EVER been detected, and I feel fine. Is the PSA > the be-all and end-all of cancer detetection? If the PSA continues to > hold at 9, or slowly climbs, is it worth the horrors of hormone therapy > if it's the only indicator? These tests don't typically show "hot-spots" until the PSA is up in the double-digit range. It sounds long you have a lot of post-surgery PSA data. If you drop out the points affected by hormone therapy, can you calculate a PSA doubling time? Was the MRI endorectal? If so, was any residual prostate noticed? How old are you and what was your clinical / pathological staging? ....best wishes and good health, Ron
From: Stephen Jordan on 17 Feb 2005 19:47 On February 17, Ken wrote, in pertinent part: > > .............................................................. Because > of the serious potential risks of Celebrex, I stopped it a couple days > ago. Since I started the Celebrex and supplements at about the same > time, we don't really know if it had any affect. After a month without > Celebrex, we'll see what the next PSA looks like. > The Celebrex risk, if it really exists and is not an artifact of statistical flimflam, begins at very high doses, >400 mg. There is "no apparent effect with doses equal to or less than 200 mg." See: http://www.reuters.com/newsArticle.jhtml?type=topNews&storyID=7661734 Let's not fall victim to the Chicken Little Syndrome. Regards, Steve J
From: Ken on 21 Feb 2005 16:07 ron wrote: > Any hormonal supplements or Propecia for hair regrowth? Nope. So far, so good in the hair department. > If you drop out the points affected by hormone therapy, can you > calculate a PSA doubling time? How do I determine which readings were affected? My PSA after Lupron+Casodex was 0.3, on 4/29/02. On 1/17/03 it was 5.2 and climbed to a high of 9.9 by 4/12/04. Then it dropped down to 5.17 on 7/6/04 and has stayed between 8.3 and 9.2 (8.8 most recently) since 9/2/04. > Was the MRI endorectal? If so, was any residual prostate noticed? No. They said no prostate was visible, but the "prostate bed" is there. > How old are you and what was your clinical / pathological staging? I was 62 two months ago. When I had the surgery, almost exactly nine years ago, my PSA was 12 and a Gleason 7. I haven't seen any recent data about Celebrex relative to cancer. Have you? Here's the intro of the article that got me interested: "April 24, 2003 Researchers at the University of Texas M.D. Anderson Cancer Center have, for the first time, identified the molecular pathway by which a commonly prescribed arthritis medication inhibits the growth of cancer. Before this study, scientists had linked use of celecoxib capsules (commonly known as Celebrex) to prevention of cancer, but the way in which the medication acted in cancer cells was unknown. Now, investigators have found that celecoxib capsules stop a key transcription factor known as Sp1 from turning on multiple genes in cancer cells known to be associated with cancer growth. One of those genes triggers production of vascular endothelial growth factor (VEGF), the predominant angiogenic factor that leads blood vessels to grow to feed tumors. The findings were published in the Proceedings for the 2003 Annual Meeting of the American Association for Cancer Research. "Our results provide a novel molecular mechanism for the antitumor activity of celecoxib," said Keping Xie, MD, PhD, assistant professor in the department of gastrointestinal medical oncology. Xie added that although the study was conducted in models of pancreatic cancer, the results likely describe how celecoxib interferes with development of a number of common cancers that all involve the Sp1/VEGF pathway."
From: ron on 21 Feb 2005 17:47
Ken wrote: > ron wrote: > > > Any hormonal supplements or Propecia for hair regrowth? > > Nope. So far, so good in the hair department. So that's not affecting the PSA > > > If you drop out the points affected by hormone therapy, can you > > calculate a PSA doubling time? > > How do I determine which readings were affected? > My PSA after Lupron+Casodex was 0.3, on 4/29/02. On 1/17/03 it was 5.2 > and climbed to a high of 9.9 by 4/12/04. Then it dropped down to 5.17 > on 7/6/04 and has stayed between 8.3 and 9.2 (8.8 most recently) since > 9/2/04. Over this relatively short time it might be hard to determine when the HT stopped affecting the PSA. It seems to be moving around a lot making doubling time calculation problematical. > > Was the MRI endorectal? If so, was any residual prostate noticed? > > No. They said no prostate was visible, but the "prostate bed" is there. > > > How old are you and what was your clinical / pathological staging? > > I was 62 two months ago. When I had the surgery, almost exactly nine > years ago, my PSA was 12 and a Gleason 7. > So with your stats and relatively young age you can't just "wait it out." > I haven't seen any recent data about Celebrex relative to cancer. Have > you? Here's the intro of the article that got me interested: For men who have systemic disease and practice intermittent hormonal therapy, it seems to slow the PSA rise when they come off of hormone therapy. Have you had your PAP (Prostatic Acid Phosphatase) measured to see if the disease is systemic? If it is then hormones and / or mild chemo are the only mainstream treatments that I am aware of. Maybe it's time to start working with a prostate cancer oncologist...Best wishes and good health, Ron > "April 24, 2003 > Researchers at the University of Texas M.D. Anderson Cancer Center > have, for the first time, identified the molecular pathway by which a > commonly prescribed arthritis medication inhibits the growth of cancer. > > > Before this study, scientists had linked use of celecoxib capsules > (commonly known as Celebrex) to prevention of cancer, but the way in > which the medication acted in cancer cells was unknown. > > Now, investigators have found that celecoxib capsules stop a key > transcription factor known as Sp1 from turning on multiple genes in > cancer cells known to be associated with cancer growth. One of those > genes triggers production of vascular endothelial growth factor (VEGF), > the predominant angiogenic factor that leads blood vessels to grow to > feed tumors. > > The findings were published in the Proceedings for the 2003 Annual > Meeting of the American Association for Cancer Research. > > "Our results provide a novel molecular mechanism for the antitumor > activity of celecoxib," said Keping Xie, MD, PhD, assistant professor > in the department of gastrointestinal medical oncology. > > Xie added that although the study was conducted in models of pancreatic > cancer, the results likely describe how celecoxib interferes with > development of a number of common cancers that all involve the Sp1/VEGF > pathway." |