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SRT seems to have failed so what next?

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User
Posted 09 Apr 2019 at 10:18

https://onlinelibrary.wiley.com/doi/full/10.1111/bju.13926


The paper above sums it up.

Edited by member 09 Apr 2019 at 10:19  | Reason: Not specified

User
Posted 09 Apr 2019 at 10:47
I’m not sure that tells us anything we didn’t know. Earlier bcr and aggressive pathology is still a marker for high risk and vice versa. As there are multiple parameters I think it is a bit too loose to say most BCRs don’t kill you. Some of us are at the high risk end and I guess we are more sensitive to individual cases. Happy to be proved wrong!!
User
Posted 09 Apr 2019 at 11:01

Originally Posted by: Online Community Member
Christophe, you need to clarify your ultrasensitive results with your lab. Are they to 3 decimal places or 2? I would expect s "bang on" 0.02 to be written as 0.020 if it's an USPA assay.


If the third place is rounded you need to know if they are rounding up or down.  


 


Some hospitals offer PSA to 1 decimal place, others offer ultrasensitive testing to 2 decimal places. A very small number offer usPSA to 3 decimal places. Mathematical rounding is always done upwards for 4 or below and upwards for 5 or above. 


Since the previous results were <0.01 and this one was 0.02, it seems safe to assume that Christophe's hospital offers usPSA to 2 decimal places. A result of 0.02 could have been a true reading of 0.015 but at these levels it could simply have been that he had a big poo that morning, or that the test was taken at a different time of day to the previous ones - it certainly isn't 'classic small positive margins' ... if the result had been 0.1 rising to 0.2 prior to salvage treatment then yes, but small positive margins is a misnomer post-RT! 


 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 09 Apr 2019 at 11:58

Originally Posted by: Online Community Member


Originally Posted by: Online Community Member
Christophe, you need to clarify your ultrasensitive results with your lab. Are they to 3 decimal places or 2? I would expect s "bang on" 0.02 to be written as 0.020 if it's an USPA assay.


If the third place is rounded you need to know if they are rounding up or down.  


 


Some hospitals offer PSA to 1 decimal place, others offer ultrasensitive testing to 2 decimal places. A very small number offer usPSA to 3 decimal places. Mathematical rounding is always done upwards for 4 or below and upwards for 5 or above. 


Since the previous results were <0.01 and this one was 0.02, it seems safe to assume that Christophe's hospital offers usPSA to 2 decimal places. A result of 0.02 could have been a true reading of 0.015 but at these levels it could simply have been that he had a big poo that morning, or that the test was taken at a different time of day to the previous ones - it certainly isn't 'classic small positive margins' ... if the result had been 0.1 rising to 0.2 prior to salvage treatment then yes, but small positive margins is a misnomer post-RT! 


 



I was talking about post RP, so we know some cancer was left and that is why he had the ART. 

User
Posted 09 Apr 2019 at 13:34
Ah I see, although at 0.06 - 0.03 - 0.06 it wasn't showing classic signs of any cancer having been left behind anyway - I suspect the A/SRT was more due to the positive margin than anything else.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 09 Apr 2019 at 21:18

Thanks to all for your comments. A wealth of knowledge on here which is appreciated

 
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