Sometime during the last week or so, I received an e-mail blast from Prostate Cancer Foundation – these usually sit in my inbox until I have a little extra time, or need something less intense to occupy my mind. When I opened it, I read a story that rang a couple of bells. The featured patient, Stephen Eisenmann, has metastatic prostate cancer …. sadly that’s not unusual for many of your reading this note. What distinguished Steve is that, like around 5% of PCa patients, he does not make PSA!
This is an issue that has been on my radar for many years ….. since around 2008 when I first came across this phenomenon through supporting a friend who had recently had an RP and showed minimal post-surgical readings that barely changed but trended upwards – I continue to dialog with this gent 11 years later. Most of you depend on the inadequate PSA marker to monitor your disease ….. so think of the difficulties when that is ineffective; when your PSA creeps, no inches up from, non-measurable to 0.130 over 11 years. For much of that time there are no advanced scanning techniques … that you don’t qualify for anyway even if you did have a tumor mass that produced no PSA.
Then there’s another issue as to whether you even want to get an ultra sensitive PSA – some of you may remember Dr. Moyad addressed this in an UsTOO newsletter back in 2017- check his column on Page 3 ….. he wrote about Jack and was speaking about our same friend!
And finally, the doctor to whom Jonathan Simons referred Eisenmann is very well known to AnCan …. and one of our favorite GU med oncs, Dana Rathkopf at MSKCC. It’s good to see that there are now a few trials for men in the ultra-low PSA category, and we are in the process of connecting Jack with Dr. R. Ironically for AnCan, CDK12 now appears to be actionable – it was not back in 2015 when our dear friend Dominic Marrese, GRHS, ws found to harbor this mutation.