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Reading one of the updates this morning something struck me, yet again. Here's the part.
QUOTE: His post-surgery PSA was 0.1 margins were clean, no extra capsular invasion, clear seminal vesicles, negative lymph nodes. Perfect results.
But none the less this persons PSA has increased through Radiation and Hormone Treatment. Just how does that happen? It seems by the time PCa is found it's often already systemic. I'd like to hear your thoughts on it.
Look the real truth mentioned by Dr. Barken and Dr. Strum and others is that 'micro mets' can go undetectable, maybe for years. Some surgery patients can have BCR even 10 yrs. out because of such. No scan is accurate enough, the best scan Combidex is unavailable currently, next best is USPIO in Sand Lakes Florida. Still these are not even good enough.
You can have miss biopsies that harbor PNI, higher Gleason scores or even perhaps a different PCa, 24+ types seem to be known now. Docs, don't like give what I would call total disclosure...doesn't sell as well perhaps. No guarantees in PCa, many generalites also many exceptions, exclusions, strange things, etc.
Also, in surgery which if any lymphnodes sampled, how is that determined....likely it is s.w.a.g. estimate, some docs don't sample at all. You can have clear margins, clear everything...it is no guarantee...how many will mention the non-guarantee up front???? This is what I see happening in PCa. Perhaps I am incorrect, we hope.
Thanks Bob I agree. It seems by the time PCa is detected it's often escaped but they just can't detect it, that's my simplified version. You see it often, no escape but the person has PSA failure, so the truth is it had escaped.
I agree, Bob, with what you wrote. Through PNI, cancer cells can freely migrate to just about anywhere, and not only cause micro mets, but even as one of my doctors has said, create micro clusters. The best surgery and/or RT aren't going to prevent this happening. My own case is evidence of this, with a decent surgical pathology, yet recurance post surgery of 9 months, and recurance post SRT also in 9 months. The cancer was long out of the barn in my opinion.
Aloha,
At the time of treatment I knew nothing about eventual spread of PCa to other parts of the body. I knew my own situation was hi risk, and I agreed with my uro that radiation (EBRT) was the only choice I had. I now feel that perhaps that choice was better than I realized because the treatment MAY have targeted those little fellows outside the prostate that only pelvic cavity treatment (EBRT) would/could knock down. For how long remains to be seen.
Life is still difficult but perhaps life will be longer.
Joe
