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From: Alan Meyer on 24 Jul 2008 21:38 "Steve Jordan" <mycroftscj1(a)cox.net> wrote in message news:p82ik.7156$CY7.1793(a)newsfe06.iad... > ... > If I may be permitted a comment, I'll have to say that, as a Gleason 9 PCa > patient, I am disgusted when I see such patients subjected to > curative-intent surgery or other local txs. Such txs, as I learned and as > Jim is learning, are unlikely to succeed. > ... Well, maybe. Certainly Jim's odds of success were much lower than for a man with a lower PSA and/or lower Gleason score. But sometimes men with his PSA and Gleason do succeed with surgery. If I remember correctly, I.P. had a PSA in the 30's and a Gleason of 8 and has not yet had a recurrence several years after surgery. If I were told that I had a 25% chance of a cure, or maybe even a 10% chance of cure, by getting surgery or radiation, I might go for it. Maybe, as Len said, it's a "Hail Mary stab at a cure", but hey, sometimes one want to say the prayer and go for it. This is one of those cases where I think a good doctor will explain the odds and suggest that the patient should decide what to do - not pushing him one way or the other. Alan
From: Steve Jordan on 24 Jul 2008 22:57 On July 24, Alan Meyer wrote: Quoting me: >> If I may be permitted a comment, I'll have to say that, as a Gleason 9 PCa >> patient, I am disgusted when I see such patients subjected to >> curative-intent surgery or other local txs. Such txs, as I learned and as >> Jim is learning, are unlikely to succeed. Alan replied > > Well, maybe. > > Certainly Jim's odds of success were much lower than for a man with > a lower PSA and/or lower Gleason score. But sometimes men with > his PSA and Gleason do succeed with surgery. Indeed. Just as I wrote: Unlikely. Regards, Steve J Now pay attention; this is important: "We must tailor the treatment to the nature of the disease. We must listen to the biology." -- Stephen B. Strum, MD Medical Oncologist PCa Specialist
From: I.P. Freely on 25 Jul 2008 11:58 Alan Meyer wrote: > > If I remember correctly, I.P. had a PSA in the 30's and a Gleason > of 8 and has not yet had a recurrence several years after surgery. > > If I were told that I had a 25% chance of a cure, or maybe even a > 10% chance of cure, by getting surgery or radiation, I might go for > it. My PSA was something like 8.8, PSAV > 2.0, Gleason 4 + 4/8, seminal vesicle involvement, negative margins, RP Oct '04. My odds of recurrence (I've forgotten whether that was @ 5 or 10 years) were well over 0.5 (the coin toss threshold). Now that I'm still running about 0.020 at near 4 years, my uro says the coin toss is probably in my favor now, with long term survival odds maybe over 0.5. What we DO know by objective measurements is that I'm fitter than many athletes a third my age and can still play very hard many hours a day. And since even when/if my PC returns it should take another decade to finish me off, I'm WAY ahead if where's I'd be without prompt aggressive treatment. I.P.
From: Steve Kramer on 25 Jul 2008 15:16 "I.P. Freely" <fuhgheddaboutit(a)noway.nohow> wrote in message news:kLmik.3436$1N1.2509(a)newsfe07.iad... > Alan Meyer wrote: >> >> If I remember correctly, I.P. had a PSA in the 30's and a Gleason >> of 8 and has not yet had a recurrence several years after surgery. >> >> If I were told that I had a 25% chance of a cure, or maybe even a >> 10% chance of cure, by getting surgery or radiation, I might go for >> it. > > My PSA was something like 8.8, PSAV > 2.0, Gleason 4 + 4/8, seminal > vesicle involvement, negative margins, RP Oct '04. My odds of recurrence > (I've forgotten whether that was @ 5 or 10 years) were well over 0.5 (the > coin toss threshold). Now that I'm still running about 0.020 So now it's back down to 0.020. Lends credance to the theory that no one ought to be tested past 0.1 after surgery. -- PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 PSAD .056 years Lupron 07/03 (1 mo) 8/03 and every 4 months there after PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years Casodex added daily 07/06 PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08 Illegitimati non carborundum
From: Steve Jordan on 25 Jul 2008 15:36
On July 25, Steve K replied to IPF: (snip) > So now it's back down to 0.020. > > Lends credance to the theory that no one ought to be tested past 0.1 after > surgery. I'd restart the ancient argument on that point, but it would be, er, pointless. I've never seen any reason not to know what's below 0.1 ng/mL other than personal nervousness. Well, some people get nervous by reason of *not* having the facts. Regards, Steve J "What are the facts? Again and again and again -- what are the facts? Shun wishful thinking, ignore divine revelation, forget 'what the stars foretell,' avoid opinion, care not what the neighbors think, never mind the unguessable 'verdict of history' -- what are the facts, and to how many decimal places? You pilot always into an unknown future; facts are your single clue. Get the facts!" --Lazarus Long |