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Scar, honest question.... where in the patient's body do you think the post-R0 resection PSA of 1.0 and subsequent rise to 2.0 is coming from? Where are the cells producing this PSA? Urologist did a hemi-prostatectomy? Pathologist missed a large involved margin? 2 consecutive lab errors?
Looking at the most recent Stephenson update, if you gave this guy XRT alone, he'd have a 10-year control rate of about 15% without factoring in a PSA DT of 1 month at all. I think that's pretty accurate, though I'd be slightly more pessimistic. Worth treating? Sure, I'd treat the guy if he wanted to be AGGRESSIVE. Worth calling it a big mistake to treat him with ADT alone? Not sure I'd go that far. He got both opinions. He went with the ADT.
Looking at the most recent Stephenson update, if you gave this guy XRT alone, he'd have a 10-year control rate of about 15% without factoring in a PSA DT of 1 month at all. I think that's pretty accurate, though I'd be slightly more pessimistic. Worth treating? Sure, I'd treat the guy if he wanted to be AGGRESSIVE. Worth calling it a big mistake to treat him with ADT alone? Not sure I'd go that far. He got both opinions. He went with the ADT.
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