How many men with Pca actually die from it?

I am just curious... I know that men with a true gleason 6, or organ confined low & intermediate risk Pca are usually cured and don't die from it.
But what about the rest of the guys?
If you are stage 3 and young with say a G7... you get treated, then undetectable for a while... then BCR after a X years, treat that with SRT... how many of those guys are cured by SRT and how many eventually develop mets?
Does anyone know statistics?

I don't know that I've ever seen a breakdown like you're asking. However, one could go to the MSKCC nomograms and possibly get something....

Trying to define "cure" with PCa is difficult since recurrence seems to occur sooner or later if you live long enough. Most of the statistical information is defined in 5, 10, 15 year time periods at best and there are so many factors that seem to influence recurrence that it is impossible to define with any certainty.

Let's say you just had RP with favorable data and results and wanted to know your stats for some atypical G7 example like you suggest. The 10 year probability of being recurrence free might be 90% with a 99% chance of surviving 15 years.

If you had RP with later SRT due to rising PSA > 0.20, you might expect your probability of remaining recurrence free to drop to 50-60% over some similar time period with a maybe a 10-15% chance of metastasis at some point.

There are a number of calculators at MSK and Cleveland Clinic so you can play the what-if games endlessly like most of us have at some point. Obviously, any recurrence after initial treatment increases the probability of future recurrences so we all hope that we stay undetectable as long as possible.

Guys, I will be honest. I have been freaking out a bit.... I am 41 years old and my husband is 45. I have not been able to stop thinking about PCa and how it might take him away from me. I am trying to be positive... But this is very scary. His case is so weird which adds a whole element of stress to the table. It's so confusing... I don't know what to think!

Here is some stats. https://zerocancer.org/learn/about-prostate-cancer/facts-statistics/

Mattam… My Pca anxiety was nearly zero... UNTIL the surgeon told us that his G6 invaded the muscle at the bladder neck... He told me he literally went to the lab and had to see it for himself because G6 is not supposed to do that! True G6 cells are very prostate like. They don't like things like bone, muscle or other organs, which is why they virtually never metastasize.
I'll report back after I hear from Epstein.

I just got this news last week... I went from thinking all was dandy to OMG- this might actually kill him. I am trying to be calm... and trust me... I stay calm, cool and collected around him and others... but inside I am freaked out. I think most people would be.
I know the 10 or even 15 year mortality rate is low... but when you thought you might have another 40 years ....

Hey, Leah,

Another wife here. I do understand your fear and anxiety. I'm so sorry. But just for perspective, my husband was diagnosed 5 years ago. His initial diagnosis was Gleason 7 (4+3). We were told it was organ confined and that surgery should do the trick. Like you, I was relieved that all would be OK. Post surgery pathology was a nightmare. Gleason was upgraded to 9, lots of positive margins, SVI, lymph node involvement, persistent PSA that never went below 10...you get the picture. At that point, I was certain that PCa was going to take my husband away from me sooner rather than later. The terror of unexpected pathology results is real. We followed up with ADT and salvage radiation and his PSA shot up again as soon as he went off ADT. For about a year and a half, I lived in constant anxiety. It's now five years down the road. He still doesn't have one single detectible met. He looks good, he feels good. He goes to work every single day. He plays with our grandchildren, goes fishing, and tinkers with old boats and cars in the back yard. (Makes an awful mess, but no complaints from me.) He still does (almost) everything he ever could. So, now I've realized that PCa may kill him, but it's not going to be anytime soon. We have a date to dance at our granddaughter's wedding. Considering the fact that she turned 10 in June, he has to hang around for a while to make that happen.

I've said all that to make this point. Right now, you probably feel like PCa has surrounded you and it's all you can see. You need to reach a point where you focus on what you have instead of what you might lose. It's not easy. Especially when you've built your life with and around the person you're afraid of losing. It takes time and perspective. You can't make that leap just because other people tell you to, so give yourself some grace. Most likely, a few years down the road, you'll be telling some other terrified wife that it will all be OK. Go ahead and make those long-term plans. The odds are very good that your husband will live a long life. If you need to chat, you can e-mail me.

-Donna-

Then there are the cases where Pca may be a contributing factor but not the direct cause.

My dad died at 65 from a heart attack. But he had dealt with advanced Pca for years, and I'm sure the strain of dealing with it and the treatments contributed to his heart attack.

Leah77 said...
I am just curious... I know that men with a true gleason 6, or organ confined low & intermediate risk Pca are usually cured and don't die from it.
But what about the rest of the guys?
If you are stage 3 and young with say a G7... you get treated, then undetectable for a while... then BCR after a X years, treat that with SRT... how many of those guys are cured by SRT and how many eventually develop mets?
Does anyone know statistics?

I'm a G4+5, and was told by Dr. Walsh that I might get three years if I was really lucky. This week will be TEN from diagnosis.

My docs have no idea how I'm still here, other than doing every treatment I could get past insurance.

I will likely die of cardio / stoke issues, or a fall that results in a critical bone break. But that will be because of PCa, death as a result of it, even if from "something else".

My father died from it. He and his doctor neglected to test his PSA until 63 years old. His PSA was triple digits when they found it, growing outside the gland, had surgery, chemo, radiation, hormone therapy, the cancer moved to the lower spine, then the arm, then neck, then brain, then he died at 71 after fighting for nine years. The lesson ... test early.

Smo,
What a wonderful and wise post. It gives me hope that maybe I can have a good run like you and your husband - with the understanding there will likely be tough times along the way. A ton of resilience is evident from both of you.

I hope things go as well as they possibly can during your husband's hospice.

Thanks for posting.

Thank you for this, Donna. My husband's situation was a bit similar to your husband's, upgraded to 4+5, postive bladder neck margin, +SVI, +EPE, and 1 positive node. I have gone through periodic episodes of anxiety just as Leah has. He's on ADT now and finished radiation back in May. PSAs holding at OSU's nondetectable standard of <0.04- we are very thankful. The ADT is a bit of a rough road for him, but his attitude is that it's just another treatment that he has to endure. It was comforting to read what you've written. I need to keep this post handy to read again, whenever my mind wanders into the darkness a bit.

RandyJoe said...
Hey, Leah,

Another wife here. I do understand your fear and anxiety. I'm so sorry. But just for perspective, my husband was diagnosed 5 years ago. His initial diagnosis was Gleason 7 (4+3). We were told it was organ confined and that surgery should do the trick. Like you, I was relieved that all would be OK. Post surgery pathology was a nightmare. Gleason was upgraded to 9, lots of positive margins, SVI, lymph node involvement, persistent PSA that never went below 10...you get the picture. At that point, I was certain that PCa was going to take my husband away from me sooner rather than later. The terror of unexpected pathology results is real. We followed up with ADT and salvage radiation and his PSA shot up again as soon as he went off ADT. For about a year and a half, I lived in constant anxiety. It's now five years down the road. He still doesn't have one single detectible met. He looks good, he feels good. He goes to work every single day. He plays with our grandchildren, goes fishing, and tinkers with old boats and cars in the back yard. (Makes an awful mess, but no complaints from me.) He still does (almost) everything he ever could. So, now I've realized that PCa may kill him, but it's not going to be anytime soon. We have a date to dance at our granddaughter's wedding. Considering the fact that she turned 10 in June, he has to hang around for a while to make that happen.

I've said all that to make this point. Right now, you probably feel like PCa has surrounded you and it's all you can see. You need to reach a point where you focus on what you have instead of what you might lose. It's not easy. Especially when you've built your life with and around the person you're afraid of losing. It takes time and perspective. You can't make that leap just because other people tell you to, so give yourself some grace. Most likely, a few years down the road, you'll be telling some other terrified wife that it will all be OK. Go ahead and make those long-term plans. The odds are very good that your husband will live a long life. If you need to chat, you can e-mail me.

-Donna-