Samadi aside, Prostate Cancer Foundation "His odds of being cured are 40 percent"

Bob,
You probably saved Dr. Samadi 20 grand in advertising fees this week alone by placing his name in the subject line of one of the busiest forums on the net. LOL.

I have heard this said and I have repeated it:

There are lies, dam.n lies, and there are statistics.

If I die and get judged in the wrong direction I would challenge the decision knowing that I am certain that I will have available legal representation that has never lost a case. (you know how most lawyers never lose cases even though they fight them against other lawyers...).

The truth be told, any doctor or organization can publish statistical data with whatever twist they can add to get favorable representation of the data. This is why anything below a Level 1 study is subject to interpretation. I remember thinking that Dr. Bruce Trock must be some kind of doctor when he was publishing numerous papers in PuBMed for Johns Hopkins. The problem I later found out was the Dr. Trock is not an MD kind of doctor. He is a PhD specializing on statistics. So all those "Trock et al" studies you see was not compiled by a patient experienced doctor.

Silly me...

Tony

We made not be statistics in the purest sense of the word, but we are statistical points. Each of us is a statistic in some doctors book.

We have seen studies that have shown Srt within 2 years has UP TO a 40 % chance of success.

However, a stage 4 that is systemic with G5 cells certainly has a much worse chance than a G6 that hasd a positive margin.

I agree Bob. Seems like the FDA or some other agency would be able to limit what a licensed doctor can say in advertising.

Goodlife

Thats all great and everything, but to take AN individual, regardless of age, and suggest that a given cancer treatment, regardless of of stage, provides him a 40% chance of a cure, as if that is gospel, proven or even provable is not very helpful to those still seeking answers.

Yes, numbers can be used to legitimize most any points. They are based on averages in this case.

I am familiar with numbers and averages, I dealt dice in Las Vegas for 4+ years.. I am quite well awaye of statistics and averages.

When the pca states he has a 40% chance of a cure, I am not sure WHAT they are atributing that 40% to?

Are they taking into account the stage 4 they mention? Are they including the fact they mention that Gleason 5 was found in his lymph nodes? That he already had radiation? That he will do 3 years of HT?

Understand my question? Are they saying that "taking all those patient specific variables into account, we pressume a 40% chance of a cure"?

If not, that's how they make it sound.

If so, what if there was no G5 found, does it become 47% chance of cure? What if he didn't have radiation, would it go to 42%?

What is a newbie to take away from this stiry abnd the 40% number. It IS NOT THAT SIMPLE.

Bob,
Statistics can only predict the probability of an event occurring, not an individual outcome.
If you flip a coin the probability of getting a head is 50%. Over a long period the number of heads and tails will be equal. You cannot predict with any degree of certainty what an individual flip will be; it is possible to flip 20 tails in a row, but the probability of the 21 flip will still be 50-50.
What they are saying is an individual with certain stats will have a 40% chance of being cured based on the past results of patients with similar stats.
JohnT

First off folks, I am not a coin.
Secondly, I fully aware that the 40% is a statistical probability number, and desperately aware of the fact that they cannot predict individual outcome. I've read all the monograms, over a year ago.

I dont take this lightly and I dont post statements or concerns lightly. Let me ask you this, getting back to the statement I have concern over;

*had his prostate and some lower lymph nodes removed.
*His cancer was upgraded to Stage 4.
*single Gleason 5 cancer cells were discovered in his lymph nodes.
*underwent seven weeks of radiation therapy.
*currently receiving a three-year course of hormone deprivation therapy.
***His odds of being cured are 40 percent***

1) So are they saying that THIS PATIENT'S factors result in 40% "cure" rate based on ALL of those factors, statistically?

2) Or, if you change ANY of his elements (No G5, or No Lymph node, etc).. that they would adjust that 40% upward or downwards accordingly?

"Statistics can only predict the probability of an event occurring, not an individual outcome."

John, I guess that's my point. THE DO IN FACT STATE THE 40% WITH REGARD TO THIS GUY'S OUTCOME. Without adding that qualifyer.

You know that, I know that, WE know that, But how is NEWBIE to know that?

Bob, fellow readers of this post, this is Dan Zenka speaking... No need to fight over my numbers. Yes,  every case is different (especially with 24 known sub-types of this cancer). That's a point I have stated many times in my blog since I was diagnosed last April 13.  In my case, I asked my oncologist for some guidelines. He is willing to apply the words cancer-free to me in five years. When I pressed for potential percentages, MY POSSIBLE percentages, he gave me the 40 cured/60 I will face recurrence at some point. I rely on my oncologist for guidance and want to have a realisitic grasp on what I am dealing with. As you know, we patients like to live to in context for OUR INDIVIDUAL case. We know these estimates are based on a physician's own clinical experience and interpretation of outcomes data. I know and patients know there are no guarantees.   Believe me, I am focused on staying in the 40 percent as my goal and doing everying I can to avoid the 60 percent area. If my 40 percent seems a bit optimistic, I'll take it! I share my story so others can pick and choose what they find to be useful and develop their context , their approach to their new reality with prostate cancer. Wishing every diagnosed man, every family and every caregiver strength and abundant health. Dan On March 29, I also posted:   ...navigating through prostate cancer can be confusing and frustrating–a fact that is exacerbated by the fact there are 24 known subtypes of this cancer. Some types are non-life-threatening while others are very aggressive. With this recent discovery and other breakthroughs including whole genome sequencing and the ability to capture circulating tumor cells, among others, we can now say there will indeed be a day when we can discern between the types of prostate cancer and match the right treatment plan to the right person. This will provide clarity, direction and much needed stress reduction for all. Until that day, patients need to be their own best advocates and make informed decisions with a physician and they trust. Right now, one size does not fit all when it comes to treatment. Progress continues.  

Thank you, James. It seems that we are all in good and sympathetic company!

As I approach my one-year anniversary, I created a personal tribute to prostates:

Pity the Poor Prostate
One year after mine spoke up, it’s time to pay tribute to prostates everywhere.

April is fast upon us. The 13th of the month will mark the one year anniversary of my diagnosis–365 days since my little gland volleyed a shot that was heard around my world and rocked it. During these 12 months–a measure of time that defies characterization in my mind–I have had a good amount of time to consider the life of a prostate. By my assessment, it’s not a glamorous one.

The male prostate plays a vital role in human sexuality, yet, unlike the female breast, no one is inclined to immortalize it in works of art. It stirs no sense of reverence or enticement. Certainly, no one is getting rich publishing photos of it on the web or in publications that tend to be hidden from sight. When folks do engage in discussion of internal body parts, we hear about livers, kidneys, gall bladders and an array of other fleshy parts, but rarely–if ever–about the prostate. In the rare cases it is talked about, many insist on changing its name by adding an “r” and calling it a “prostrate” instead of its proper name, prostate, which rhymes with late. No matter how ”prostrate (incapacitated) with grief” Miss Scarlett may have been in Gone with the Wind, it certainly wasn’t an ill prostate adding to her woes.

To add insult upon injury, consider its place in life…

Every prostate is destined to live in the industrial part of town. With a bladder hanging over its head and the rectal wall to its back–it is constantly being pushed around and bullied by our bodily tides without so much as an excuse me, coming through or a thank you. Oh, how it must shudder at the thought of beer and chili outings with the guys.

Its professional life isn’t much to brag about either. It is forced into the workforce early in life to produce copious amounts of seminal fluid, long before a young man can even comprehend, much less find, a meaningful relationship. Then, with the assistance of miracle drugs such as Cialis and Viagra, it is often forced to work well beyond what was once considered–by some obliging partners–a respectable retirement age.

It’s only when a series of biological events triggers a potential health problem that prostates get any respect. If they are lucky, they are treated with antibiotics for bacterial infection (prostatitis) and given a reprieve. As they age (like many of us) they can lose their youthful shape and grow in mass (benign prostatic hyperplasia). If they are unfortunate enough to be suspected of harboring renegade cells (prostate cancer), they are poked, prodded and bombarded by needles. This often leads to the spectre of being subjected to radiation, toxic chemical substances and powerful drugs. Often, they are separated from the only life they have ever known by a cold, razor-sharp scaple. REALLY… they’re just doing their job, not asking for much in return when their environment turns on them. It’s just not fair. What’s more, once they heal from their surgery, many men who are glad to resume their sex lives without the prostate’s standard contribution (depending on age, physical fitness and treatment) do so without giving much thought to a once loyal but now lost friend.

In short, prostates everywhere are misunderstood, underappreciated, overworked and forced to live in the shadows. If I could, I’d personally train them to belt out a good round of “R-E-S-P-E-C-T, DON’T KNOW WHAT IT MEANS TO ME” at full party volume… I believe it would certainly become the most preferred vocal uttered by male derrieres around the world.

Yes, one year after diagnosis and ten months following my surgery, I miss my prostate. I wish I never had to let the little guy go. But I did. I remain grateful for its years of service and remain steadfast in my assumed role as Defender of Prostates. So, this April, I pay tribute to prostates everywhere and ask that their owners take a moment to familiarize themselves with this amazing little part of their anatomy. Appreciate it and learn how to care for it. Because, all too often, we don’t fully appreciate what we have until it’s gone.

Dan, welcome, nice essay on your prostate. I don't miss mine, I just wished its cancerous friends had entirely left with it.

David in SC

Mine went in the trash along with my apendix (part of the urostomy surgery) and my gall bladder back in 1981, due to pancreatitis. Losing my parts one at at time, lol.

David

Hey, Jim

If you go to YouTube and listen to "Ral Donner-the Original Voice of Elvis," you might really begin to wonder.  But then, one day Elvis will come out of hiding and all will be revealed.  Maybe we'll find out he developed prostate cancer and decided to go into permanent seclusion 'cause he wasn't so good with chicks anymore.

 

Bob, No offense taken. Just wanted to let everyone know that I CONSTANTLY try to explain how complicated this disease is. All cases are unique. Believe me... given where I work and the patients and families that I meet, I have a full understanding of where all of this might take me. It's why I was encouraged to read this week's study data about the advantages of neoadjuvant ADT before AND after radiotherapy. But still, it is read with a grain of salt.

Glad you liked the post.

Paryers and wishes for you and all of us.
Dan

Welcome DanZenka, thats a kinda indian name aint it? Think Little Big Man and follow the links, lol