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Biochemically Recurrent Prostate Cancer After Local Therapy

Don Oberlin is coming up to the five year mark of his diagnosis. he has kept a detailed blog which you can access from his story and has spent a good deal of his time investigating his options and how best to track what is happening to him after an apprent failure of his proton beam therapy choice.

He sent me a link to an interesting article about what is often termed BCF (biochemical failure)or BCR (biochemical recurrence. The article is entitled Management of Biochemically Recurrent Prostate Cancer After Local Therapy: Evolving Standards of Care and New Directions .

I think the key message is this:

Although patients may be concerned about their rising PSA levels, physicians attempting to address patient anxiety must inform them that BCR is not typically associated with imminent death from disease, and that the natural history of biochemical progression may be prolonged. Misinterpretation of the significance of early changes in PSA may cause patients to receive androgen deprivation therapy (ADT) prematurely, especially in settings where the disease is unlikely to impact survival.

Thank you Don.

All the best
Terry in Australia

Re: Biochemically Recurrent Prostate Cancer After Local Therapy

You are always helpful Terry and always gracious. Thanks again!

Re: Biochemically Recurrent Prostate Cancer After Local Therapy

Terry:
I don't disagree with what you regard as the key message in the subject article, but I do want to share with you (and others) the theme that especially captured my attention:
"The ultimate goal in treating patients with BCR prostate cancer is to identify a safe and effective nonhormonal therapy that is able to delay metastasis and death without the need for pharmacologic castration."
I also hope to discover a solution that will preserve my quality of life without jeopordizing my longevity. Its a tall order, my research effort continues and I remain optimistic.
Regards Don O.

Re: Biochemically Recurrent Prostate Cancer After Local Therapy

Don,

Thanks for your post on BRCP, which said in part:

"The ultimate goal in treating patients with BCR prostate cancer is to identify a safe and effective nonhormonal therapy that is able to delay metastasis and death without the need for pharmacologic castration."

I agree. The goal cited and your personal research are both tall orders, somewhat on the order of searching for the Holy Grail.

Jack from Jersey

Re: Biochemically Recurrent Prostate Cancer After Local Therapy

Amen Jack Amen.

Re: Biochemically Recurrent Prostate Cancer After Local Therapy

Don, I certainly appreciate the opportunity to read your blog which is detailed but never unnecessarily so. You keep on track and follow the most important line of inquiry. For that I'd say you are doing a good service for many others.

Going forward, I did not see a clear message from your doctors as to the tradeoffs with starting ADT at various PSA levels. Clearly putting it off gives your good quality of life a longer run in the meantime. But is the longer term quality of life or length of life not as good? I would imagine that there is plenty of discussion by professionals on this topic.

Re: Biochemically Recurrent Prostate Cancer After Local Therapy

BillG:
I appreciate your kind words and thought provoking observations concerning the iniation of ADP.
Please believe me; I am no expert. There appears to be two camps in the medical community regarding the iniation of ADP. One camp believes the sooner you begin treatment the better. "Why wait," they ask, "your cancer will only continue to progress unless we intervene." The other camp believes your quality of life is adversely affected the minute you begin ADP. Both points of view have merit. What each of us decides depends on our specific circumstances and our personal values.
Having read my journal you have been exposed to some of my personal perspective. My current quality of life is highly satisfactory bordering on excellent. My goal is to preserve this status for as long as possible. If I jepordize my longevity with my decisions toward this end so be it! I have had a good,long, satisfying run(age 77).

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