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Even when prostate cancer returns, most survive

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Posted 8/25/2010 11:33 PM (GMT 0)
Interesting article from Reuters Health:

http://www.reuters.com/article/idUSTRE67O4RR20100825

Bill in San Diego

Posted 8/25/2010 11:54 PM (GMT 0)
Interesting, but not a surprse. Most men are diagonosed with a Gleason 6 and those rarely die whether treated or not. We need to know the risk factors of those who did die. I would assume that they were all G8 or above.
JohnT
Posted 8/25/2010 11:56 PM (GMT 0)
that is an interesting article. I do agree that just because PSA is rising that most men should not jump into treatment. I, for one have a rising PSA that has doubled quick however I have opted to wait for another test to see the pattern before considering what to do. I also agree with the report that the persons overall health should be considered too. I run, swim, bike, and work out five days per week and feel better than ever so for me I am in no hurry to go back to ADT3.
Thanks for sharing the article

peace to you
Dale
Posted 8/26/2010 12:38 AM (GMT 0)
Unless I misread, it doesn't make the case that radiation as a primary treatment is as effective as surgery at 10 and 15 years, based on the stats in the article, radiation was only about 50% as effective.
Posted 8/26/2010 1:02 AM (GMT 0)
I agree that the statistics in the article make it appear the surgery patients had a lower probability of recurrance. But, we don't know the pathology of the biopsies. It's possible back in the early 90's that surgery was favored for the less aggressive cancers and radiation for the more aggressive.

Regardless, it's an encouraging article. Thanks.

Dave
Posted 8/26/2010 3:06 AM (GMT 0)
I'm beginning to distrust many of these "studies" because they almost never give any details how they selected the men they studied...This article treats all PC the same and uses clever phraseology to paint a rosy picture. "Most men" = as long as 51% survive, you can say "most men"...

Another cause of death that almost certainly lowers the death rate from cancer, all cancers, is suicide. Suicide killed 34,000 last year and is the 7th leading cause of death among men...

"Doctors have discovered the most effective treatment for many forms of advanced cancer is a .38 Special, which uniformly produced a 100% cure rate." No person treated by Smith & Wesson has EVER died of cancer! Hallelujah!

You will NEVER read that in The New England Journal Of Medicine but Smith & Wesson cures MANY people...

230,000 men are diagnosed every year in the U.S. and 32,000 die from PC, 14%.

But the mortality risk is NOT evenly spread over the entire group. The Gleason 6, PSA under 10 group have a MUCH better chance at long-term survival than the Gleason 9, PSA over 20 group..The Reuters article reflects the battle now going on over the proper diagnosis and treatment of PC....Who gets treated and who does not....
Posted 8/26/2010 11:06 AM (GMT 0)
I think all this study projects is the typical long course of prostate cancer. Not long for everyone, but most. I think it is a 15-25 year cancer, which means that when you are dx at 65 or older you most likely will die with it and not from it. But if you live long enough it will probably get you. That is why I am skeptical when I hear things like a 99.6% cure rate for people like me who still have potentially 40 years of life left. The studies don't go out 40 years. If you look at yananow.net and sort by year dx. practically all of the the people dx. almost 20 years ago have had second line therapy. Although still alive, they seem to have advancing desease after 20 years. Hopefully there are a bunch of people dx. 20 years ago that aren't advancing, but have just put it behind them and we never hear from them....Who knows.... 

I am sure next month another study will come out contridicting this one....
Posted 8/26/2010 2:12 PM (GMT 0)
This story is missing large sections of important information. However, since the patients were Veterans treated from the early 1990's we can assume many were diagnosed as T2 or greater. Also, the men would have been older than those diagnosed today with psa (T1) and these two issues together indicate that the VA men would be older and sicker than those dx today. Relevance for a 68 year old man, treated at the VA, with conditions normal for the treatment site, time period, and patient background is different than that for a 56 y.o. today. Those VA doctors could feel "good" if their patients died of some other condition.
Those 12 years make all the difference in the world.
Posted 8/26/2010 3:05 PM (GMT 0)
To further complicate it back then psa was normal up until 4.0. I wonder how long many of us could have gone waiting to hit the 4.0 mark. Maybe some of us would have taken 10 or 15 years. Then we would be in the 68 year old dx. Time frame.
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