Patrick C. Walsh Quotes.
11. "of Urology, evaluated nearly five thousand patients from nine hospitals who had received external-beam radiation therapy alone and had been followed for an average of six years. This study, too, looked at how well the ASTRO criteria and other definitions could predict actual clinical failure (the development of distant metastases or the return of cancer in the irradiated prostate). Despite its stellar acronym, the ASTRO definition did not prove to be outstandingly superior; in fact, the researchers found, some of the alternate definitions of biochemical success or failure were slightly better. The Phoenix Definition In 2005, another panel of radiation"
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Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
12. "oncologists met to discuss a replacement for the ASTRO definition. They decided to define treatment failure as a PSA level that has risen 2 ng/ml higher than a man’s PSA nadir (the lowest level it reached following treatment). This definition has been correlated more accurately with long-term results in all patients, and it takes into account such factors as hormonal therapy and the PSA bounce. Failure is now considered to occur when the PSA level reaches the nadir + 2 value. This is called the Phoenix definition. Still, it takes time to determine this value, so this equation should not be used to gauge the success of treatment in men with less than two years’ worth of PSA tests after radiation therapy. Furthermore, the consensus panel that developed this definition cautions,"
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Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
13. "Physicians should use individualized approaches to managing young patients with slowly rising PSA levels who initially achieved a very low nadir and who might be a candidate for salvage local therapies (see below). The Phoenix definition is the new standard measure of the success of radiation therapy. And even this isn’t the one-size-fits-all, perfect definition of biochemical failure for all men who have undergone radiation. Nor is there a single best approach if a man’s cancer does return after radiation (see What Happens If My PSA Goes Up After Radiation Treatment? below). The good news is that the longer a man’s PSA remains stably low after radiation, the less likely he is to have a return of cancer down the road. Some men wonder whether any healthy"
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Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
14. "need to have a prostate biopsy to confirm that the cancer recurrence is local; you will also need a bone scan and CT scan or MRI of the abdomen and pelvis to rule out the possibility that cancer has spread to distant sites. The guidelines above (see What Should I Do If My PSA Comes Back After Surgery?) may one day be adapted for men who have failed radiation treatment, but the overriding principles can be useful here in identifying the likelihood of metastases. If you have a high Gleason score (8 or greater), or if the PSA level begins to rise early after radiation therapy, or if the PSA level has a rapid doubling time, it is more likely that you have metastases than a local recurrence, and in this case, you should seek systemic therapy (see chapter 13)."
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Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
16. "The purpose of radiation treatment is to disable the prostate, to stop cancer there from continuing to grow. Because the prostate is the source of PSA, if PSA continues to be made and its level begins to rise, there are two possibilities. Either the cancer has reactivated locally, within the prostate or surrounding tissue, or a distant metastasis—a tiny bit of cancer that probably escaped the prostate before treatment began—has started causing trouble."
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Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
17. "that the radiation alone has not killed the cancer, this should be clear long before your PSA level reaches that point. However, it’s worth repeating that the consensus panel that developed the Phoenix definition (nadir + 2) advises, Physicians should use individualized approaches to managing young patients with slowly rising PSA levels who initially achieved a very low nadir and who might be a candidate for salvage local therapies. If your PSA level continues to rise, what should you do? To determine whether you are a candidate for surgery after radiation, you will need to have a prostate biopsy to confirm that the cancer recurrence is local; you will also need a bone scan and CT scan or MRI of the abdomen and pelvis to rule out the possibility that cancer has spread to distant sites. The guidelines above (see What Should I Do If My PSA Comes Back After Surgery?) may one day be adapted for men who have failed radiation treatment, but the"
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Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer
18. "overriding principles can be useful here in identifying the likelihood of metastases. If you have a high Gleason score (8 or greater), or if the PSA level begins to rise early after radiation therapy, or if the PSA level has a rapid doubling time, it is more likely that you have metastases than a local recurrence, and in this case, you should seek systemic therapy (see chapter 13)."
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Patrick C. Walsh, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer