[Hopespringpcsg] FW: [PPML] PSA doubling time for castrate-resistant prostate cancer

[Glen Tolhurst]

Hi all:
See below for an interesting article & link from a US blog.
Thx.
Glen


Subject: [PPML] PSA doubling time for castrate-resistant prostate cancer

An often question in support groups from men whose PSA starts to rise again while on ADT is at what point should I really worry about metastases?

Often ultimately at some point while on any of the drugs for Androgen Deprivation Therapy (ADT, "hormone treatment") the PSA starts to rise again as the cancer develops other sources of stimulation than testosterone.

If the rise in PSA is gradual and imaging shows no signs of metastasis often some doctors delay immediate advanced treatment in order to delay the side effects of chemotherapy or other advanced treatments.

Other doctors may advise immediately to move to advanced treatments feeling that 'the sooner the better to fight metastases'.

A natural question from men facing this issue is at what point in the PSA rise when ADT has failed is there serious risk of metastases?

One approach is to monitor the PSA Doubling Time (PSADT).  Here is an excerpt from a recent article by Dr. Charles Ryan:

*"As one might imagine, the prognosis of patients without metastasis is highly variable. Also, because this is “PSA Only” disease we really have only one parameter to follow, so the prediction of outcome in such patients can only really be done through PSA kinetics. In a pivotal study years ago that explored the use of zoledronic acid in preventing metastatic spread (it didn’t) Matthew Smith of Massachusetts General Hospital Cancer Center described a curious phenomenon related to PSADT (PSA doubling time) and development of mets: a severe inflection point at around 9 months. A PSADT
> 9 months was associated with a low risk of metastatic disease, whereas
the risk shot up asymptotically as with progressively faster PSADT. Since this is, by definition, “PSA only” disease, it is absolutely critical to know the patients PSA doubling time, as this is the principal disease-defining characteristic."*
*
From: www.urotoday.com/conference-highlights/asco-gu-2018/asco-gu-2018-press/101639-non-metastatic-crpc-the-five-essentials-charles-ryan.html
<http://www.urotoday.com/conference-highlights/asco-gu-2018/asco-gu-2018-press/101639-non-metastatic-crpc-the-five-essentials-charles-ryan.html>*

The Best to You and Yours!

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