Interpreting PSA Results

User

Posted 24 Oct 2021 at 23:44

All of those things are available in the UK, Jules, except proton beam therapy which currently isn't approved on the NHS as a primary treatment for prostate cancer because the results weren't very good (although it performs much better as a salvage treatment). I can't see anything about a new treatment that targets the prostate and mets at the same time?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 25 Oct 2021 at 02:14

Originally Posted by: Online Community Member

I don't want to divert the thread away from its original purpose so I'll keep this brief. Here's a couple of references:

targeted radiotherapy

external beam therapy

Jules

As regards the claims for External Beam as 'cure' - we dont use this term in the UK but 'in remission'. Regardless, the claims for success are well in excess for figures I have seen reported in trials. Furthermore, whilst there are obviously cases where EBRT (IMRT or IGRT) will be the best option for some individuals, to generalise and say it is superior to Brachytherapy (Low or High Dose) long term needs evidence to support it, because the contrary is what I have read. In some cases Brachytherapy and EBRT are used as part of a treatment plan. This study of trials shows how the major treatments compare for three stages of the disease. You will find trials are segmented into an elipse for each treatment. You will need to work your way round the site. https://www.prostatecancerfree.org/compare-prostate-cancer-treatments/

Edited by member 25 Oct 2021 at 02:19 | Reason: Not specified

Barry

User

Posted 25 Oct 2021 at 05:03

Originally Posted by: Online Community Member

I can't see anything about a new treatment that targets the prostate and mets at the same time?

Lyn, as I understand it, that is exactly what the treatment here is doing, targeting the mets in the sessions of RT that are dealing with the prostate.

Jules

User

Posted 25 Oct 2021 at 07:30

Having been told a number of times that I don't know what I'm talking about, I rather regret having said anything about this treatment. The only thing I'll add, is that it's being carried out by two large regional hospitals here, several thousand men have received it and there is no reason to believe that the outstanding results might be contrived.

If the figures are wrong, it would amount to medical fraud by a highly respected oncologist ... I find that unlikely.

Edited by member 25 Oct 2021 at 09:44 | Reason: Not specified

User

Posted 25 Oct 2021 at 09:49

Originally Posted by: Online Community Member

I can't see anything about a new treatment that targets the prostate and mets at the same time?

Lyn, as I understand it, that is exactly what the treatment here is doing, targeting the mets in the sessions of RT that are dealing with the prostate.

Jules

Jules, I have just read the links you posted and the first thing that leaps out is it refers to "Men with localised prostate cancer". That is clearly not the same as treating mets that have spread through the body. There is a major difference between "Advanced PCa" and "locally advanced PCa".

Good luck to everyone coping with the insidious big C

User

Posted 25 Oct 2021 at 10:26

Agreed. Sorry if there's a misunderstanding here. I'm only referring to treatment of lymph glands in the vicinity of the prostate and certainly not in the chest or elsewhere well away from the prostate.

Jules

User

Posted 25 Oct 2021 at 11:02

I don't think any of us were saying that you didn't know what you were talking about; Australia does sometimes seem ahead of the UK in terms of treatment and it would have been exciting if they had developed some new treatment protocol.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 Oct 2021 at 04:00

Originally Posted by: Online Community Member

Ah okay - that makes sense. Yes, treating lymph nodes close to the prostate at the same as the prostate is possible, they can do that with radiotherapy and / or by removing them during prostatectomy. It doesn't always work because sometimes the cancer has also moved unseen to far flung lymph nodes and that doesn't become apparent until further down the line, but it works often enough to be worth trying.
I don't think any of us were saying that you didn't know what you were talking about; Australia does sometimes seem ahead of the UK in terms of treatment and it would have been exciting if they had developed some new treatment protocol.

Thanks Lyn. I suspect that the RT they're using here is not so much a radical new development as a refinement of existing techniques and equipment that's allowing more precise locating and targeting of cancer, particularly where Lymph nodes are concerned. The results certainly indicate some progress.

Jules

User

Posted 26 Oct 2021 at 04:29

Originally Posted by: Online Community Member

If the figures are wrong, it would amount to medical fraud by a highly respected oncologist ... I find that unlikely.

What I am suggesting is the terminology is misleading here and on some other sites too. From the links you gave there is a stand alone paragraph without any qualification or clarification stating :-

"Men with localised prostate cancer who are treated with external-beam radiation therapy have a cure rate of 95.5% for intermediate-risk prostate cancer and 91.3% for high-risk prostate cancer."

To me, and I beleave most people, this implies that for these two stages of PCa, if you have EBRT you are cured, to the respective percentages of cases, with no need for further treatment. However, this is a paste from the Internationally renowned John Hopkins :- "Recurrence Even if your cancer was treated with an initial primary therapy (surgery or radiation), there is always a possibility that the cancer will reoccur. About 20 percent to-30 percent of men will relapse (have the cancer detected by a PSA blood test) after the five-year mark, following the initial therapy. The likelihood of recurrence depends on the extent and aggressiveness of the cancer."

Some other sites quote up to 40% recurrence. As well as the cancer grade and type the amount of radiation and number of fractions will make a difference. So, the very high success numbers quoted originally are more likely to be for control over a certain time frame rather than cure, which I believe should be complete eradication without time limit.

Edited by moderator 07 Dec 2022 at 11:18 | Reason: Not specified

Barry

User

Posted 26 Oct 2021 at 10:38

Barry, I quite agree with you about the terminology. I would prefer to have been able to link to a scientific paper on the work rather than what is more like press release material.

As far as the treatment goes there's no assumption that after you've had RT you walk out to never return. I'm on Zoladex, in theory for three years and no member of the team who treated me ever used the word "cure".

On my first appointment post EBRT treatment I was told that my cancer, prostate and lymph glands had been "totally obliterated". I don't know if this is an unusual claim but at least it's a good start.

Time will tell of course.

Jules

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