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Using PSA to determine prognosis

November 17, 2009
  • By Harvard Prostate Knowledge

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July 13, 2018

There is a difference between the grade Gleason score ! Just so people understand my boyfriend was Diagnosed stage for prostate cancer lymph nodes and was in bio Chemically in remission for two years now he’s taking a turn for a bio chemical reoccurrence which means as a PSA rises so does the cancer to rule out all odds doctors must do testing bone densities and other scans to see if there’s any visible evidenceOf the cancer spreading two other organs of the body or in the same regional area because he is not a candidate for salvage radiation we wait and see what doctors will put together as far as treatment goals every one is different this cancer is a very symple or complicated cancer because there is 3 types drs will tell you oh well your osa went up a bit because you just had sex Exercised no no no it’s the cancer that’s making it rise !!! D.R. don’t know and the Patients Live in limbo smh if they don’t know how we supposed to know ??? I think everyone deserves to know the truth!!! Blessings to all that have been touched by cancer 🙌

June 8, 2018

June 9,2018
Roger. 75years
Had a RP 2012 at Mass General. The sutures let go and i almost bled to death. Was told cancer was contained,no follow up needed. Forward to feb 18 2018 Psa came in at-3.2,june 18-6.1 Started on Eligard, testosterone suppression treatment today. DR. said the cancer was aggressive and the prognosis is most likely 4 years.
Goes to prove medicine’s got a long way to go. They is no cure, only management and God.

Mike fink
April 30, 2018

Get2nd opinion. Some people are given 4 mos live 5 years or more.

Donald K. Duncan
April 9, 2018

I am 92 years old. Had radical prostatectomy at age 66 when PSA was 5.3 and Gleason 8. Have taken hormones (Casodex, etc.) for past 10 years. Recently PSA went from 0.9 to 2.5. Also have very frothy urine. Doctor suggests Lupron. Is it really necessary?

March 10, 2018

psa 42.8 sorry

March 10, 2018

I just recently went to doctor with my fiance. His psa is 24.8. Exam found a nodule and a biopsy is being preformed Friday. The
doctor told us it was Cancer and stage 4. I am at a lose, how
can he possibly tell us this without a biopsy. Any thoughts,
advice can be used now. I am begging Fiance to get a new doctor.
I also worried about this doctor performing biopsy since he told
us he had a patient die from ignoring symptoms after procedure
was done. I know any procedure comes with risks. Scared beyond
belief right now. Thanks in advance

March 7, 2018

Very good Silverback female. I am going to fight my prostate cancer naturally…not risking what others did( ie: prostate removal, chemo. radiation etc..) but what I will be doing is a risky too…. God is in control. No worries!!!!

Silverbacked Female
March 1, 2018

My husband is doing a fruit diet and herbs.
His PSA doubled and he is into the mid 40’#s now —age is 69
Takes a long time to detox so it’s long haul, but he is not symptomatic tho the almost killing procedure of biopsy has showed some mild +signs and MRI last year showed some capsule involvement. He feels fine, and raw fruit has been a big adjustment. Cancer is just dis-eased cells so the body wants to fix it if you give it the right power of high energy fruit and the protection of well grown herbs in the right type and amounts. Dr. Morse of Port Charlotte can support this type of detox. Not for the weak of mind, and we are thinking a lifestyle change forever will be required with diet regardless. Stop eating proteins like meat and dairy goop and plugging up the lymphatic system with grains. The north american diet is killing us and drugs are snuffing symptoms but not looking at the cure. Chemo is acidic and that is killer to your cells- all your cells! Pain is a sign of acidosis. So all your arthritis, lupus, etc. Of course Coca Cola can eat you away too even faster. Don’t get me going on the side effects of diet soda. But look into Dr. Morse if you can handle it, take it slowly, and wear the cloak to wellville. Or don’t, I don’t care if you do or not. We all must find our path and our spirit to reach the higher enlightenment. Our medicine of today will never do this-and that is truth enuf for us to keep on keeping on. Best to all going along this road, see you in the next. Take what you need and leave the rest behind. Trust that you will hear and see what you need when you are ready. Stop thinking so much and just observe. It is so easy to get caught up in the ego. There is unfortunately huge ego in medicine. Try to keep it simple and understandable. Recall your roots! Power On.

Anthony J. Hewitt
February 25, 2018

I am amazed atthe relative youth of many of those writing in. I am
85 suffered a heart attack at age 37. I take Asprin one tablet daily I show none of the six signs of the prostate with PSA 10. I
have what was considered to be Arthritis, but does not cause me any
difficulty. I believe that considering all the side effects of the
various treatments. I should perhaps leave well enough alone. What
neither parent suffered fro m any cancer. What do you think?Anthony

February 17, 2018

Diagnosed 11 months ago with Gleason 3+4, stage 2. PSA was 19. I have had an enlarged prostate my entire adult life, I am 69. Tried HiFu, cryosurgery, they won’t do because of enlarged size at .97volumne. I’ve been on hormone therapy, casodex, proscar to help shrink. Cancer is in one lobe. Just had PSA test, dropped to 2.3, not sure how to take that. I can not get a clear answer, cause my Urologist just wants to do surgery. Thinking about watching a little longer and retest. Any thoughts?

December 28, 2017

I’m 52 years old.I did get relief by taking a herbal medicine called Diuretic and Anti-inflammatory Pill . Maybe it can relieve your symptoms too.

Gordon Cole
December 28, 2017

I am 76 yrs old with a PSA of 4.30. I had radiation therapy 10 years ago and PSA results since then have averaged about 2.0 with a low of 0.8 and a high of 3.0. My last test was 2 yrs ago at 2.16. What’s my prognosis?

Deb Rouis
December 14, 2017

Did you know that you have a post from Dr. Ronald E. Wheeler with contact information who was arrested this year for practicing without a license in Sarasota, Florida?

richard C
November 6, 2017

I am 67 years old and during my annual physical my PSA was .05. My MD performed a DRE which he advised was normal. My father died of prostrate cancer in 2012, so I have a family history and I am concerned. During my prior annual physical in 2016 my PSA was .03. Should I be alarmed at the rise in PSA. Should I have further testing?

charlie meyers
November 3, 2017

i was dx with prostrate cancer 2008 Gleason 5 or 6 the total score was like 10?. went thru the radiation and it was contain a yr ago with zytiga and predinsone never more then 4-5 then they took me off and was just taking casodex. will this yr psa went to 11.8 and three months later 11.5. a doctor at cancer nw in my town thought my cancer was localize in the lymph nodes in the groin area. so again was radiated for 31 days and got my results. now my psa is 26.67 2 months after the radiation. they are going ahead of cat scan and bone scan. i know if its metasis hopefully there is drugs out there. my doctor thinks i should be on lupron shots for ever even though the last score was 8

Marnie G
October 30, 2017

My husband had high risk prostrate cancer diagnosed less than 2 years ago, had robotic removal and then had radiation for thirty three days. His PSA has been rising going from 0.07 to 0.12 in less than three months and now is 0.41 three months on. Guess we’re wondering what happens now. When should hormone treatment start? What scans should he have etc. In addition to the rising PSA he’s also had a year of urinary bleeding from radiation cystitis and regular admission to emergency for retention from clots. He’s had recent heart surgery for a device to allow him to go off blood thinners and have six weeks of daily hyperbaric treatment which will hopefully address the blood loss (daily with any movement) and now this PSA scare is something else again!

July 24, 2017

My friend has stage 4 prostate cancer lymph nodes lower back next to the spine 43 treatments of radiation to the regional area plus trelstar hdt shot Dr says his cancer is at bay are you could say readmission biochemical and undetectable PSA his last PSA was 0.02 this month 0.01.. no more sites for him no more treatments no more nothing nuclear bone scan MRI X-ray CT scan PET scan nothing now we wait six months what are we waiting for and what is going to happen he is age 54 diagnosed in States for September 2014 can you please help answer this missed questions by doctors I get no concrete answers as a care aide thank you

Greg Spirou
May 20, 2017

May 20th 2017
I had prostatectomy 12 months ago at the age of 62. PSA before operation was 15 with a Gleason score of 8. After surgery my PSA for the most part was stable at .02 (during the first 11 months). The next reading it went up to .03 and then came back down to .02.
Two weeks ago i had another blood test and this time it was .25 (3 weeks before it was .02) I spoke to my GP assuming this was a mistake so i had another within 2 days of the .25 reading and this was worst, .3
How can PSA go up so quickly at such short period of time. Has anyone heard of this before? Please help i am panicking.

November 1, 2017

we are asking ourselves the same question my husband’s PSA was it 26.3
And then 10 days later he got another blood test and now it’s 41.2
I am not sure if we should be freaking out either
Is this normal he is on a clinical trial and since he’s been on it it went from a 12 to a 41 and two months

February 4, 2017

My father (68) was diagnosed with prostate cancer 11 years ago. He went thru 38 treatments of radiation and 27 months of therapy. Last spring (he is now (79) we were told the cancer had metastasized to his ribs. He went thru more therapy and we were told the cancer was undetectable. We continued treatment, but his psa continues to climb even tho in treatment. Has anyone had an experience like this? Can you share with me how much time he has. The doctors aren’t saying.

simon shrestha
September 14, 2016

My Dad
A cancer patient, passed away after 4 year battling with prostate cancer at the age of 75. He was lucky man. I consider him as luck man as he should not bear to see any other pain in this world where we born to die. He was treated with radical prostatectomy, hormone therapy and chemo. But not radiation. As there are different stages and different types of prostate cancer a Dr should give treatment as per above mentioned stages and types. Since cancer itself is very aggressive decease, it’s treatment also should be aggressive. We shall not left room to treat it as in the case of my Dad. He was not treated with radiation. he has 10 Gleason score, HRPC, 22 PSA and stage 3c. None of the medicine stop his cancer for more than 2 month. Including chemo like Taxotere, Fytoside and carboplatin, CAMPTO and other such as Elligard, Zytiga, Honvan, cancer caught him in the middle of his journey.
During treatment with chemo his PSA was down to 0.2 but still has cancer all over his body seems like cancer cell adopt to live with chemo and feeding on it instead of dying. At the end he seems to have small cell A. Carcinoma which is the most rare type of cancer probably 2%. I suggest to all to use all type of treatment till it is possible. Do not wait and take chance.

God bless to all cancer patient and his family.

thank you.

dave howell
August 16, 2016

Age 58 Had prostrate removed in January. All well except 1 of 9 lymph nodes had a 1mm of cancer. 2 psa’s undectable. Some doctotors say I’m possible cured. I am skeptical. No radiation or hormone. Any thoughts PLEASE My doctor says 50% 50% chance it wont return

August 14, 2016

Dear Sir,
I am 62, I was operated 2 years ago with radical robotic protatectomy, with a PSA 5,17, Gleason 3+4=7, 2Tc.
I didn’t have any therapy untill now.
I feel good, with a normal style of life.
My PSA level was in the last 2 years from: 0.003,0.011,0.018,0.019,0.030,0.030,0.045,untill 0.066 checked every 3 month.
I had every year CT control with nothing found.
Is this still in a normal range or should I worry because is slowly increased?
Please let me know some information, because I am from Romania with not good experienced doctors in this field.
Many thanks,
Zoltan Darabont

joe bowen
August 1, 2016

I’m now 79 & have moderate bph, urinate 3 or four times in the morning usually & maybe 6 to 7 times ea 24 hrs.
& my bph score is usually .7 it .8 but not higher.

Is it advisable to buy a sol palmetto product to take daily or is there a suggestion?

Joe G Bowen

Hardy Wright
July 2, 2016

I’m a 65-year-old, and I have prostate cancer; I live in Colorado; I got my original biopsy when my PSA jumped from 4.7 to 6.9, in the span of two months.

After conferring with my urologist, I began the Rick Simpson protocol for programmed cell death in cancer. It requires ingesting 60mg of THC over 90 days.

At the 70 day point, I had my PSA tested. It came back 4.0. We’ll be testing again in 30 days.

I have experienced a few side effects; my arthritic elbows, thumbs, and hands, don’t hurt. The depression that has wracked me for 5 years is gone; I’m not stoned. I barely feel the meds.

Rick Simpson protocol is a viable, mix-it-up-in-your-sink cancer cure. It’s cured 5000 people; it’s curing me.

For more information go to

Ralph Severs
May 30, 2016

I am 77 years old with PSA level of 9 ( R 97.2) and a Gleason score of 3+4. Rectal exam did not find any bumps or hard areas. I had biopsy with cancer in 5 of 12 samples. My Doctor recommended radiation for 8 weeks . I am not sure if I should take radiation due to fact that I have arachnoiditis which cause sever pain.

gordon tate
April 1, 2016

At age 55 my psa went to38 from 2 at age 53. my gleason was 4&3 I immediately had a biopsy with cancer in 4 of 12 samples. I was put on various hormones for 18 months after which the psa dropped to 1.5. Then it was radiation followed by radioactive iodine12 pellets(77 pellets due to my small prostate). I thought I was a goner but it has been seven years with a psa of .02 I read where pomegranate juice at 6 ounces daily can reduce the double time a lot. I also exercise vigorously and eat a very healthy diet except for red wine. I also take vit. d because I live on the wet west coast. A positive can due wonders and keep your sense of humour if you have one,if not get one.

Joe Douglas
March 2, 2016

I am 75 years old fit and still working I was diagnosed with a recurrence of prostate cancer after 10 years clear after brachytherapy. I ad a MRI of my pelvic area and a pet scan and there was no sign of cancer spread outside the capsule and the prostate margins around the capsule clearly defined. Only my PSA has increased to 30.4 over an 8 month period( 10 years ago it dropped to 1.4 after brachytherapy)I suffer on and off with prostatitis and although tested nothing shows infection wise but I have all the discomfort with it. I am booked in for a 68Ga-PSMA scan which is supposed to show up if there is cancer spread and is supposed to be a more precise diagnostic scan. Any advice on where to from here or comments on treatments available would be welcomed. Joe

patricia frenette
February 25, 2016

On chemical castration procedure after PSA slowly rose to 20.
Would this person be in fragile health, physically/otherwise?
Thank you. pf

Thom Knott
January 19, 2016

I was 47 and my PSA was over 4 and the decision was to watch and wait, within 12 months it had double. I had a gleason of 4+3 with PSA just over 8 and I chose external beam radiation and was monitored with again a PSA doubling oin 12 months from over 2 to mid 4 and we were prepared to do something more aggressive such and was at the time considering salvage surgery. Then a miracle occurred, PSA was sliding down over four quarterly tests to 2.02. Unfortunately, in the last 3 months it has again doubled. I have just turned 51 and I don’t think that I have made good choices by choosing radiation over surgery with no backup other than hormone surgery to slow it down. I have good years ahead of me but I worry that they may be to few, my mental disposition is good but the reality is that I am likely to die from this disease. I wish I had someway to know what to expect so that I could plan accordingly, I don’t want to work myself to the grave. Good luck to you all. Thom

January 8, 2016

I’m 64 had RP 11-17-15, PSA was 9.9, Gleason 3+4, 4+4 after surgery. Had just left Stage 2 into beginning of Stage 3. Everything was clear. Altho capsule broken. Now 0.1 Going to first app in Feb to dIscuss options. Eliminated red meat, eating mostly fruits and veggies with few exceptions. Chicken occassionly etc. More walking altho 2 yrs ago injured lower back, which slows me a bit. Still have ED and wear pads at night. Feel well over all. Can anyone chime in on likely future? Radiation scares me have heard mostly likely to trigger bladder or rectal cancer later, adds to ED problems etc. Horomone acceptable but hear can mess with your brain, little for me to spare there. Thanks in advance.

J W Ziervogel
December 26, 2015

After robotic prostatectomy my psa was at 3 weeks post-op 48,6 weeks post-op 17.Later it dropped to 1.2 then 3months later rise till 7.4.Eventially it dropped to 5.4.Because no cancer was find in the dissected prostate,I still refuse radiotherapy.
My urologist suspect that the medial lob of my prostate was left behind during surgery due to the fact that it had grown into the bladder wall.

Ronald E. Wheeler, M.D.
December 13, 2015

I am a HIFU treating expert and I have been for almost 10 years, having treated with both technologies.
HIFU (High Intensity Focused Ultrasound) has been around for more than 26 years in Europe and Japan (primarily). HIFU has been approved by the FDA on November 9, 2015 for ablation of prostate tissue. In my experience, I believe HIFU is the best treatment when an aggressive prostate cancer is diagnosed with a Gleason Score of 4+3=7, 4+4=8, 4+5=9, 5+4=9 or 5+5=10 regardless of PSA value. This article from Harvard points out accurately that aggressive prostate cancer fails commonly regardless of treatment. This is true as the literature states recurrence with Gleason Scores of 8-10 is associated with failure up to 85% within 5 years so we should be looking at something other than radical prostatectomy or radiation therapy for cure. With any prostate cancer while survival is important and commonly achieved regardless of treatment, we need to be talking about cure. Cure and survival are two totally different concepts. I have had incredible success in dealing with high grade prostate cancer using HIFU* (with an asterisk) and welcome men with their wives to call us regarding consideration for cure. During the process of collating our data for publication, we have found an extraordinarily high cure rate for this aggressive class of cancer that arguably makes up 35-40% of all prostate cancer. I did say cure rate based on a nadir of less than 0.13 (PSA level) at more than 2.5 years. Of interest is our intellectual property that allows us to improve our outcome data in this very significant patient group. For best results with HIFU* (with an asterisk), we prefer a PSA of 8.5 ng/ml or less. If this factor is present, regardless of Gleason score, we have 100% of patients cured at 2.5 years. While we are continuing our research we encourage folks with interest to view our website ( or call us to set up a no obligation conference call. While we plan to continue this research we are heartened by the fact that patients are not failing within a year which is very common with radical prostatectomy with or without radiation. I believe we are on to something that will change medicine dramatically but only time will tell. I also encourage physicians with patients at high risk to give us a call toll free at 877-766-8400.
Respectfully submitted: Ronald E. Wheeler, M.D. Medical Director

November 20, 2015

My husband was diagnosed in 2013 at age 41 with Gleason 8, tertiary 5. He had a radical prostatectomy thinking it was all contained. 6 weeks after surgery his PSA was 5. It had left his prostate, gone into his seminal vesicle and invaded 3 lymph nodes. He went on a clinical trial of Zytiga and Degarelix for a year that brought his PSA down to .02, then had a lymphadenectomy. His PSA remained .02 for several months until recently it went up to .05, then .06 a month later, then .08 another month later. He has started taking Degarelix injections again and will start Provenge in the next few months. Does anyone have experience with Provenge? Everything I read does not make it sound impressive. I am worried for the road ahead and feel like we are now on a slippery slope.

October 31, 2015

I was diagnosed with stage 3, Gleason 9 (5+4) prostate cancer in mid 2010 at the age of 49. I had Brachytherapy, 25 external beam radiation sessions and 18 months hormone deprivation. Initial psa was 8.2 in 2010. Note: I ate 300g tomato paste a day during and post radiation (i don’t know if this had a positive effect on my treatment….the lucoprene concentrates in cancerous prostrate tissue, maybe more absorbant?). it is now Oct 2015 my last psa was 0.04 ng/L. I also take one Ecotrin, slow release Asprin, a day (please read up the benefits of Asprin wrt cancer). Best wishes to all of you battling cancer.

August 24, 2015

I had surgery 12 years ago with for Gleason 6 PCA at age 44. Went 4 years and PSA started very slowly rising. I watched for 4 years until PSA went to .35 and had salvage radiation treatment. PSA dropped a little but never below .22. Over the last 4 years slowly going up and now at .58 but is at about a 3 year doubling rate. Please let me know any recommendations you might have. Age 57 now.

Peter Dobson
August 21, 2015

I was diagnosed 5 years ago at the age of 64. I had requested a PSA test from my doctor several times over the previous 5 years but he considered my concerns to be groundless and each time advised me that a test was not necessary or desirable. Finally a locum did the test and it returned a PSA of 125. By this stage my options were restricted to external beam radiation therapy and hormone treatment. Now 5 years on I am having intermittent hormone implants, the effectiveness of which is reducing as the doubling time gathers pace. Other drugs are coming on line however, and new treatments are becoming available. I have few illusions about my long term prospects but as I approach 70 I have overcome my initial bitterness at having been failed by the system and remain optimistic.

August 20, 2015

6 years ago I WAS in your shoes. I had a 46 yr old husband with Stage IV, with lymph node involvement, Gleason score of 9, the Prostate growth had escaped the capsule. His PSA doubling time was so short that time he had not had time to grow bone metastasizes to show on a bone scan. My youngest had just entered the teen years & the oldest was in college. Advice: Seek good treatment. It sounds like you are. There is always a flurry of treatment that first year with a “youthful” prostate cancer.

Prostate cancer is more like a chronic illness. My husband has continued to work. His cancer has progressed, but so have treatments for the cancer. Since my husband was diagnosed so young it is likely he will be someone that dies of prostate cancer. We are not near the end of the road yet, so take heart. My husband and I may not have the decades we had anticipated, but we’ve had years and still have more years to come.

January 9, 2016

I had RP 11-17-15. My numbers had been rising slow but steady. I was seeing Dr. Lee at Kaiser in Southern Ca. Lee was pushing was for biopsy. Never offering less invasive alternative. At later time I asked his partner Dr Robinson if urine test was available I heard about. No was the response. At no time was MRI mentioned BECAUSE of cost it would appear. Much later my surgeon ordered up one TOO LATE for me.
If I had known available would have paid out of my pocket. MRI shows capsule broken. Now stage three. I did not get what I paid for.
In another example my wife’s knee doctor told her she had torn meniscus. She requested MRI and proved her doctor wrong and he was extremely upset with her.
So don’t think the system can’t be wrong. Or won’t lie to your face.
Now I have to deal with the nightmare Kaiser could have avoided. But money more important.

October 26, 2017

I read your comment on here and am wondering how your husband is doing now (2 years after your post). I am currently in the same situation: husband in his 40’s with Gleason 9 and locally advanced cancer. 2 young daughters.
Best Wishes.

August 8, 2015

My husband is a 52 year old male with stage 4 prostate cancer. His PSA was 217 and his Gleason score was 9 with 12 out of 12 Biopsy came back positive.

He has had a radical-prostatectomy, 9 rounds of Chemo, he is beginning radium 223 and radiation everyday for 5 weeks. My husband wants to stay positive and believes that his time here is between him and god! However, I want to know his life expectancy because I have 4 children 3 of which are going to college to know how limited time with their dad maybe. They have all asked me numerous times if Dad is gonna beat this and I told them I don’t know Dad does not want me to ask. Help please let me know your thoughts. I know you can not tell me about my husband specifically but can you give me the law of average with these scores. Thank you!

Mike baker
February 17, 2017

Kathy your story was moving. My dad has prostate cancer. Was wondering how your husband faired his treatments? Did he have a family history?

richard bowers
April 23, 2015

Had RRP 16 years ago. Showed no detect until last test showed less than 3. doc was unconcerned. I less so. That test was months ago. Should I push for another?

April 9, 2015

My husband is 55 and has a PSA reading of 1300 with no other sign of prostate trouble or bone involvement Texotere brought his psa down to 200 then in 4 weeks it went up to 1300 :(– I’m so worried….

Naga Leela Kumar
April 2, 2015

My Father is 76 and having PSA reading of 950 with no other signs of prostate trouble. He went surgery in Nov 2013 and tenticles were removed. After that in Feb 2015 there is some prostate left which he underwent surgery and was removed.
During Feb 2015 the PSA reading shows as 300 and currently it shows PSA reading as 950. He is having some pain in the back bone near the base. Can we go for chemo theraphy at this stage.
Please do advice me.

ishbel askew
February 21, 2015

My husband is 76 and has a PSA reading of 1300 with no other sign of prostate trouble – what are his chances, I’m so worried….

Grozde Aleksovski
January 26, 2015

I am 60 years of age and I am having prostate CA with Gleason score 4+3=7. The cancer is also spread to the bones. I started hormone therapy 3 months ago. The PSA was 154 before the start of the treatment, and now it has dropped down to 11.95. Please comment this change of PSA level, whether it is normal, or it is exceptionally good, as I don’t want to develop false hope for fast recovery. When should I make additional tests (biopsy, bone nuclear screening, MRI).
Thank you.

Brian Haselum
December 3, 2014

I am 68 years of age, prior to my radical prostatectomy in 2010 I had a Gleason score 4+3 =7 and T3 my PSA levels were post op 0.04 the began to rise again. 2011 Salvage Radiation therapy took place and PSA levels were 0.001 up until May this year PSA level was 0.018 and one this last November risen to 0.051. My doctor informs me that there can be no treatment to halt this rise as it is so small, and that consideration for Hormone therapy would be considered when PSA reaches 5.00. What advice can you offer,

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