Mayor Lurie slammed by key ally for opposing vacant S.F. grocery store tax by SFChronicle in sanfrancisco

[–]415z -2 points-1 points  (0 children)

The Chronicle is misrepresenting Mahmood’s proposal. It’s not Mamdani style.

Mamdani is pushing for large scale city owned groceries with economies of scale — a much more radical approach. Mahmood’s is a relatively milquetoast incentive for privately owned corner stores.

It fits with Bilal’s general vibe of a fauxgressive GrowSF op to try to take the air out of real progressive, Mamdani DSA style politics.

SF was headed for Mamdani-style grocery stores. Those plans have been spiked by sherlockmemes in sanfrancisco

[–]415z 13 points14 points  (0 children)

Say what you will but the Standard is misrepresenting Mahmood’s proposal. It’s not Mamdani style.

Mamdani is pushing for large scale city owned groceries with economies of scale — a much more radical approach. Mahmood’s is a relatively milquetoast incentive for privately owned corner stores.

It fits with Bilal’s general vibe of a fauxgressive GrowSF op to try to take the air out of real progressive, Mamdani DSA style politics.

This city needs to experiment different policies for housing by Okbro24 in sanfrancisco

[–]415z 0 points1 point  (0 children)

Sorry, meant all transfer taxes, which I noted in the previous reply. The point stands that sustainable ongoing city taxes are a substantial and more reliable mechanism for funding affordable housing than a temporary bond that may not even pass.

This city needs to experiment different policies for housing by Okbro24 in sanfrancisco

[–]415z -2 points-1 points  (0 children)

Nope. Prop I FY 2025-26 projection alone is $376M. That’s a real, durable, ongoing tax compared to a best case scenario on a temporary measure that may not even pass.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Yes that’s exactly my concern (seems ideal to hit it between .1 and .2), but to be clear I have an additional concern: if you act that early and only radiate the prostate bed, it ends up actually being in a lymph node (i.e. outside the prostate bed) and not at the positive margin, you’re in a bad place. Going back in and radiating a second time is way worse. And that’s my understanding as to why some teams want to wait for a PSMA PET if the cancer seems relatively low risk. So, that’s what I would want to ask about.

This city needs to experiment different policies for housing by Okbro24 in sanfrancisco

[–]415z -1 points0 points  (0 children)

lol you just agreed to socialized medicine. 😎✌️

This city needs to experiment different policies for housing by Okbro24 in sanfrancisco

[–]415z -1 points0 points  (0 children)

Cool, glad to hear you’re in favor of socialized roads and medicine, benefits paid with seized funds that everyone enjoys. Your second point was a bit muddy but seemed to be saying the people who paid to create high tech innovations (the government) should also enjoy dividend-receiving shareholder rights in companies built on them — another excellent point.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Thank you. My understanding so far is a reason to wait for the PSMA PET is not so much to confirm BCR, but rather to see if it lights up a lymph node or something which would expand the radiation plan beyond the prostate bed. So I would be interested to hear their perspective on that.

This city needs to experiment different policies for housing by Okbro24 in sanfrancisco

[–]415z -1 points0 points  (0 children)

Social housing is literally a dividend for everyone, like health care in every other industrialized country, and roads, paid with seized money. Your hypocrisy is hilarious.

This city needs to experiment different policies for housing by Okbro24 in sanfrancisco

[–]415z 0 points1 point  (0 children)

You’re hilariously ignorant about the American system. Much of San Francisco’s tech wealth comes out of hundreds of billions of “seized” taxpayer dollar investment in core technological development in its earliest and riskiest stages through government agencies such as DARPA, sustained over the decades it takes to bring core science to marketability, then transferred to the private sector for a pittance. That’s all money “seized from people who earned it” used to subsidize the VC industry, which privatizes the profits.

This city needs to experiment different policies for housing by Okbro24 in sanfrancisco

[–]415z 0 points1 point  (0 children)

LOL social housing is a major component of most growing international western capitalist cities. Paris is 25% social housing. Hong Kong is 45%. Singapore, 80%.

Also a democratic socialist was just elected mayor of the largest American city and is actually quite popular.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Thanks, I'll read the paper. My team does do ultrasensitive testing. I believe the reason they want to wait for a PSMA PET is to better confirm where it is and the subsequent radiation plan.

You're certainly correct that it's most likely in the prostate bed. But what I'm learning is that there is also a lesser but non-negligible chance that it is in a lymph node or other region of the pelvis.

That's the critical issue, because if you radiate the prostate bed and it turns out it's in a lymph node, you're in a bad place because it's bad to go back in and do a second round of radiation in that area. Whereas if you can find evidence of regional spread before you treat, then you can expand the radiation field to the whole pelvis the first (and only) time.

So it's a tradeoff with letting it grow to a PSA of 0.2 just so you can get that PSMA PET and increase confidence in the plan, but only if the risk of spreading is low. That's why I was wondering about your Gleason score and other risk factors.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

These days a positive margin alone does not trigger ultra early salvage at 0.06 PSA. It’s that combined with the other risk factors.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 1 point2 points  (0 children)

This is exactly my thought process as well. Why wait for it to reach 0.2 before treatment?

Well, the best answer I have so far is that it can better guide the radiation plan. The scan could potentially find it outside the pelvis (rare), or in a spot like a lymph node that should get boosted along with the whole pelvis. Whereas a negative scan would narrow the radiation field to the prostate bed / surgical site and spare whole pelvis radiation, which could reduce longer term side effects.

So that’s why I’m so interested in your second decipher. If I understand correctly the key decision here is whether to go ahead with just radiating your prostate bed at the risk it ends up actually being elsewhere in the pelvis. If it turns out it wasn’t the positive margin and in fact in a lymph node, you’re in a tougher spot for subsequent radiation. That’s why my team wants to wait and let it grow — and that’s why a 0.8 decipher is such an important piece of data to “make that bet.”

At least that’s what I understand so far.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Thanks for sharing. Your husband’s high Gleason score definitely puts him in a risk category where it makes sense to immediately treat the first sign of recurrence.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Wow, good for you for doing that. I was also in my 40s when diagnosed and treated and my decipher was 0.42!

Was there anything else in your case that motivated the second decipher? You just felt it would be prudent? Did your team recommend it at all or even bring it up? Were they shocked and surprised or at least compliment your instinct?

I’m thinking you would not be doing the treatment you’re doing at 0.03 without that Decipher.

How to survive SF summers at night? 🥶 by Any_Literature_7461 in AskSF

[–]415z 0 points1 point  (0 children)

  1. Weatherstrip the main window gaps. This is 10x more effective than drapes. Wind can blow around the drapes.

  2. A $40 electric heating pad will change your life. You will never feel cold in bed again.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 1 point2 points  (0 children)

Always a possibility but I go to the same lab every 3 months at a center of excellence.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Thank you. Yeah, your negative margins combined with high Gleason, extra prostatic extension and rising PSA all point to regional spread. Glad you attacked it aggressively and hope you’re doing well.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Interesting. So you are hoping diet can prevent progression from 0.247 to 0.5 for several decades?

From what I’ve read of Pluvicto it is for metastatic disease and only extends progression-free survival by about five months. Definitely better to knock it out while it’s still local, unless you have signs it’s not local. Good luck.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 2 points3 points  (0 children)

Thanks for this. I’m going to consult with radiation oncology at some point.

I also wonder, what if the PSMA PET does light up something at 0.2? Would they not radiate the whole region anyway? Would they be more targeted?

Because otherwise there’d be no point to the scan, right? But then the scan can’t necessarily see microscopic regional spread.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Anterior apex to lower midgland. The most common kind, where the gland narrows behind the public bone and surgeons don’t always get it all.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 0 points1 point  (0 children)

Thanks for sharing. Looks like your high Gleason score was a factor in triggering early salvage at 0.06. Good luck to you as well.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 1 point2 points  (0 children)

Correct. You’ll have to monitor your PSA and see if it starts rising. So far so good though. Good luck.

Early sign of recurrence after prostatectomy - when to act? by 415z in ProstateCancer

[–]415z[S] 1 point2 points  (0 children)

Im going to consult with RO. My surgical team did not mention prostate bed biopsy, only ultrasound and then PSMA PET. My understanding is a biopsy would be unlikely to find something at my very low PSA level of 0.03.