Bill, I haven't had RT and I don't know what degree of
"undetectability" you should have post-SRT but I'm not sure you should
be worrying just yet. But FWIW when to start HT is a subject of debate
in PCa circles. The traditional and majority view is that there is no
rush, that you can wait until clinical symptoms, some relatively high
PSA, a rapid PSADT, etc. I have seen 2 med-oncs for my recurrence and
both were solidly in this camp. E.g. the one I saw Mon. at Dana Farber
said he wouldn't start until PSA 6 or so. The other view says that you
just should never let cancer grow, and should hit it as soon as a
recurrence is identified.

Bill Denton
RP 2/12/02
PSA 1.6
Memphis

Some big names in this field say we should wait until we have symptoms
before beginning ADT (aka HT) even without pre-existing other problems.
Other big  names disagree. Your "other problems" are, indeed, high
probability and high impact targets of ADT. That would make me lean
towards the "wait until symptomatic" camp, or at the very least try ADT
tentatively 28 days at a time, watching for and treating against SEs
very aggressively.

I.P.

2005 to 2007,  .06 to .07, that looks pretty flat.

At 62, I'd worry more about the heart disease and diabetes.

Wait a long time before trying HT because it *might* exacerbate both
heart disease and diabetes.    While on Lupron, my 130 fasting blood
sugar rose to 300 and my normal triglycerides went to 800.

-kh

Bill,

Your PSA is suddelnly erradic after 1½ years.  I am not an expert, but I
believe some here would say that might be expected.  If you take your last
three readings, it would average 0.053.  That is very good.  Right now, I
think your oncologist would be extremely happy with your readings of the
last two years.

To determine whether there is failure, you would have to have a rise of
three consecutive readings and by some percentage (which I keep forgetting).
But, I'd say that if your next quarter's reading is .09 and the one after
that is .13, start worrying then.  That'll be November.

Looking at just the last three readings, the
doubling time between the:

- 2nd and 3rd last readings, i.e. between
 11/2006 and 01/2007, is 189 days and

- the last two readings, i.e. between
 01/2007 and 04/2007, is 185 days

so the two doubling times are nearly identical.
That is suggestive of a consistent pattern.
This contrasts significantly with the steady level
of 0.06 which persisted until 08/2006.

On the other hand, what is particularly strange is
how the 11/2006 and 01/2007 readings were actually
lower than prior readings and how the variability increased.

Do you know
- if all these readings were done at the same lab
- if they were all done using the same assay
- what the lowest level that the assay is capable of
 detecting?
- what the sensitivity of the assay is?
- specifically which assay was used?

I wonder if there was some change?  Could it
be that the lowest reading that is reliable is
0.06 and the lab used 0.06 to represent anything
lower than 0.06 while a different technician or
change in methodology at the lab or a different
lab or different assay resulted in giving
the number rather than 0.06 starting in 11/2006 ?

If there are any changes then this needs to be
taken into account; or, if it has been consistently done
then I would try to get additional readings to determine
if there is continued progression at a doubling time of
around 185 days or whether this is just random variation.

---
The Palpable Prostate
http://palpable-prostate.blogspot.com