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Posted 5/24/2014 12:32 AM (GMT 0)
Why are these so hard to find and why are doctors so reluctant to give you the low-down on cures (eg."You have a 10% chance of a cure based on others in your position")? Do these stats exist?

For example, I am cT3b and despire vigorous research I have not found any cure rates for this stage (or any other stages). It's one of the first things you look for after you are diagnosed.

It appears that research is very fragmented, scientists seems to be off doing their own thing, and numbers are not being collated properly.
Posted 5/24/2014 12:55 AM (GMT 0)
Doctors don't want to over promise. Mine just kept saying, "you'll be fine," and if this doesn't work we have other options.
Posted 5/24/2014 1:58 AM (GMT 0)
Ronnie-

There's lots of info. "Cure rate" isn't a term that doctors or researchers use. Instead, they'll use terms like "biochemical recurrence free survival," "biochemical no evidence of disease," "clinical progression free survival," "metastasis-free survival," "prostate cancer-specific mortality," "overall survival," etc. In addition, the time period of observation will vary from study to study. It takes a while to get used to the lingo and the sometimes subtle differences.

I believe I gave you a couple of such references applicable to your case in a previous post. In general, published results from university or major tertiary care hospitals (e.g., Memorial Sloan Kettering, Johns Hopkins, etc.) meet rigorous academic standards. Just make sure your sources are from peer-reviewed journals rather than random internet sources.

- Allen
Posted 5/24/2014 2:34 AM (GMT 0)
Doctors attend classes sponsored by their malpractice insurance underwriters aimed at minimizing their exposure to lawsuits. With cancer patients, promising a "cure" is high-risk conversation so they don't do much of it...

A true cure for cancer would devastate the medical industry. Fighting cancer is the most profitable thing they do. The Partin tables developed by Johns-Hopkins are useful if figuring your odds..
Posted 5/24/2014 3:05 AM (GMT 0)
I am getting used to terms such as cancer specific survival rate and I believe they count 15 years remission as the closest thing to a cure. Even then of course finding that data is not easy.

Taking their definition of a 'cure' we still don't really get the info. Its usually just a group of studies with relatively small groups of men.

The NHS in the UK should be capable of collating figures properly for massive amounts of people. I do seem to recall they were talking of such a scheme recently but I'd imagine it would require consent of those involved.

Post Edited (Ronnie44) : 5/24/2014 5:26:54 AM (GMT-6)

Posted 5/24/2014 3:46 AM (GMT 0)
It's not about wanting to withhold information or to prevent a "cure" so they can continue to charge for treatments. Neither medicine or science deal in absolutes. The language of science is statistics - e.g., based on your particular data you can be compared to others with similar data and then it may be possible to say something like "we can say with 95 percent confidence that your probability of being recurrence free at 6, or, 10, or 15 years is x percent." That's just the way it works, and I am happier with an explanation like that than something as ambiguous as "I think your cured."

You can choose appropriate nomograms that apply to your particular PCa history and plug in your numbers to get a percentage probability of recurrence at a particular time in the future. For many people, depending on their individual PCa history they will find that the probability of being recurrence-free at 10 or more years is very high -- e.g., 90 percent or more, which means that they are very unlikely to die of PCa, which is as close to a cure as statistical models allow.

prostate-cancer.org/prostate-cancer-algorithmsnomograms/

nomograms.mskcc.org/Prostate/index.aspx
Posted 5/24/2014 4:37 AM (GMT 0)
Extremely interesting thread guys! I have to say I thought I was in the clear after surgery.....the whole process of biopsy, diagnosis culminating in RRP was a total shock, I thought I was bullet proof!
Now, 10 months post op I'm faced with rising PSA, so yes you want to know the possibility of what's ahead.
Contacted my urologist with my concerns only to be told, go on your holiday open a wine or two, you've got 15 years....I thought that abit blasé but perhaps he's right...with the right care!!
Posted 5/24/2014 8:48 PM (GMT 0)
Ronnie,

With stage 3 or 4...Gleason 7 and up---I don't think we can ever say we are cured. Small amount of Gleason 6 after surgery with no sign of spread...that's essentially a cure.

My doc doesn't use the word cure. He says we will only know if I'm cured if I die of something else first.

Don't get me wrong...if the prostate cancer is under control and grows so slow for decades...do we care if it is "cured"

Jerry
Posted 5/25/2014 4:42 PM (GMT 0)
Ronnie,

Tall Allen, Jerry L., and others have addressed your question spot on. We understand your "what are my chances" attitude .. we have all been there. Truth be told, nobody knows. With seminal vesicle and perineal invasion your disease escaped the capsule. Focusing on odds of reoccurrence is wasting your time. There is no "cure" for PCa in this setting but there are so many treatment modalities that can address a reoccurrence that you need not keep your disease on the front burner. Find a top notch oncologist that specializes in PCa and establish a game plan that you're comfortable with, but most importantly live your life. The physical damage that prostate can inflict is becoming more controllable every year. The mental damage is far more ominous. Attitude is a major component in treatment. Use it to your advantage.

Jim
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