CTC

672 hours of indecisiveness

Advanced Prostate Cancer, CTC, dasatinib, David Emerson -

Two good updates from our appointment with Dr. V. this morning….
First, since we didn’t have to go to the lab, we were in and out of the office in under 90 minutes!
Not that I’m looking for drive thru Oncology services, but this was nice! It gave Mary and I time to share a celebratory cup of coffee and then an early lunch at the Blue Koi.

Second, and most importantly were the results of last weeks tests:
Blood:
PSA – 101.46
This is up, but only two points.
CTC – Circulating Tumor Cells: 0
This is the third consecutive time since April that the CTC measure was 0

Alkaline Phosphates: 55
Still well within the normal range of 29-110
Testosterone: 10 <
Cholesterol – 155
This is back down from 210 approximately 90 days ago – not sure why it was so high previously
All other blood markers were normal.
Scans/X-rays
Bone scan was stable with no new areas notated
C/T Scan – The only thing notated was a lymph node in my lower right abdominal area which was slightly larger this month than last. Dr. V was convinced that at this time, it was nothing to worry about.
Once we decided we were relatively comfortable with my current condition and that we would maintain the current treatment, we discussed potential future treatments. Dr. V mentioned an upcoming trial that we may want to consider, SPRYCEL® (dasatinib). We are going to do some research on it to determine if it is a viable option. When the time comes that we are ready to begin a new treatment, we will also confer with Dr. L in Houston regarding other potential clinical trials for us.

Dr. V. also mentioned Provenge as a potential treatment in the future. Of course it is pending approval by the FDA, so it is once again a matter of time. Another example of why we must continue to try to manage the cancer by maximizing the time we can gain from each treatment.

So there you have it, as in the past it’s really hard to get excited, although we were relieved that all of the tests, with the exception of the stubborn PSA, were stable. We have a reprieve for another 4 weeks, 28 days or 672 hours!

Summer time, summer time, sum-sum-summer time!

alkaline phosphate, CTC, David Emerson, hrpca, PSA -

On Monday we met with Dr. V for my monthly appointment.

PSA = 39.75

This is up slightly from four weeks ago (36.16) but not significantly.
He reviewed the letter from Dr. L at MD Anderson and we discussed the recommendations at length. He is in agreement with the recommendations and he ordered the two new tests. We will use a combination of these three tests two determine when we make our next move.

I already have total alkaline phosphates measured each month as part of a standard CBC Blood panel but the first new test will break it down further. Here are some details from my friend Howard at hrpca.org:
Alkaline Phosphatase, serum Bone-specific alkaline phosphatase (BAP.) When alkaline phosphatase is measured, it is actually the sum of the bone-specific and liver-specific components (isoenzymes.) BAP can indicate excess osteoblastic cell activity which may indicate bone metastases. Metra Systems, Inc., says that Bone Alkaline Phosphatase is an osteoblast membrane-bound molecule which is involved in bone formation. Levels of this enzyme are thought to be indicative of the activity of osteoblasts.

Another description of AlkPhos is that it is an enzyme that is found on the surface of osteoblasts(the cells that build bone) and as such is used as a serum marker of increased osteoblast activity. Since bone is being added at prostate cancer bone metastases, an increased alkaline phosphatase can mean increased bone met formation. A recent paper by MR Smith et al in Urology discussed BAP and NTx in their role as predictors of skeletal complications in HRPC patients (MR Smith, et al, Urology 70: 315-319, 2007.) Their conclusion was that elevated baseline levels of BAP are associated with a greater risk of adverse skeletal outcomes – events such as shorter time to radiotherapy or shorter time to first pathologic fracture. NTx was also found to be of value in monitoring patients on bisphosphonates.

The second new test will measure the amount of CTC’s or Circulating Tumor Cells. Recent studies suggest that for men with advanced disease, measuring whether the number of cancer cells circulating (CTC) in the blood stream is rising or falling may be a more accurate method for determining response than PSA. CTC’s are found in many cancers but are most common in prostate cancer.

So we ran both tests in order to establish a baseline and I will have the tests repeated in three months along with an updated bone scan and MRI. So unless my PSA goes crazy or I develop pain somewhere, no foreseen changes for the next three months.

Not sure if you caught that, three months, as in July!!!

Woo-hoo!!!