Treatment search

Your good health: a consistently low PSA after treatment is a good sign

But it is only after years that we can be sure of the aggressiveness of your cancer.

Dear Dr. Roach: I’m 68 and I have prostate cancer. I had PSAs, an MRI and a biopsy. My Gleason score was a maximum of 7. No genetic testing if I remember correctly. My urologist told me I had “upper moderate” cancer and could have my prostate removed or radiation therapy. I underwent three months of radiotherapy from September to November 2020. I have done three PSA tests since radiotherapy. All have been very low and, according to my doc, good.

I don’t specifically recall my doctor referring to my rather slow cancer or more aggressive cancer. How can I determine this for my situation?

TP

Certain factors can help predict whether prostate cancer will be aggressive. The most useful of these are the size of the tumor (and whether lymph nodes are involved); PSA level and Gleason score; and the molecular characteristics of the tumor. The last comes from DNA testing of the tumor. Since I don’t know the height and you haven’t had any molecular tests, the best information I can give is that you have a Gleason score of 7 and apparently no positive lymph nodes or distant disease. That would put you, as your urologist said, in an intermediate risk group. Without having the details of the pathology report, I can only give a rough estimate, but the best estimate is that between 65% and 83% of men like you would continue to be prostate cancer free five years after diagnosis. .

However, there are some additional good findings since your treatment, in particular that your PSA levels remain low. It is only after years that we will be able to be sure of the aggressiveness of your cancer, but from what you tell me, your prognosis is rather good. Your urologist has all the information to give you the best estimate and should give you more information if you tell them you want it.

Dear Dr. Roach: Are vibrating machines safe? It wasn’t until I bought one used that I went online to find out more about them. I have read that they can cause brain damage and possibly permanent neurological damage. My machine now sits in the garage while I learn what its fate should be. If it is dangerous, it must be destroyed and not passed on to another unwitting buyer.

E

The whole body vibration machine theory makes sense – your body tries to stabilize you against the vibrations, which makes the muscles stronger with less perceived effort. Understanding the science on them, however, takes some judgment.

Some studies show increased strength in users (compared to before use) and improved weight loss (in conjunction with dietary changes). In the studies I read, I did not find any reports of significant adverse effects. The length of follow-up in these studies is short enough that there may indeed be adverse effects that may only appear after prolonged use.

Some of these devices exceed recommended levels for occupational exposure even after one minute. I found expert opinion that there may be neurological damage caused by whole body vibrations, but no hard evidence to support this claim.

Based on the large body of evidence on the beneficial effects of traditional exercise and the relatively short duration of reviewing the effects of a whole body vibration device, I would still recommend regular exercise over the device. However, I haven’t found much evidence of damage from these devices.

Dr Roach regrets that he cannot respond to individual letters, but will incorporate them into the column whenever possible. Readers can email questions to [email protected]