Doc says I am cured

"Cured" is probably an understatement.

Put it behind you.

JackH said...
"Cured" is probably an understatement.

Put it behind you.

I agree. Good for you!

NY-Sooner:

Congratulations!!!!!!

Boomer ?

David

Celebrate!
Get your PSA tested as part of your annual physical, still pays to be prudent.

sooner what do you think? If you want you could get a second opinion....

NY-Sooner,

In another thread, but within the last week, Chris R posted a link to an article (about a study) from the PC Infolink website which drew the same conclusion as your doctor. Perhaps your doctor is familiar with the study...it was published 5 years ago.

One of the conclusions was:

Annual PSA testing may be safely discontinued after 10 years for men with an undetectable PSA level and a pathological Gleason score of 6 or less and/or limited life expectancy.

Here's the link which Chris R provided several days ago:
https://prostatecancerinfolink.net/2011/06/23/psa-monitoring-after-prostate-cancer-surgery-how-long-is-long-enough/

BillyBob@388 said...
I went back and changed your pre-op PSA from 5 to 9, and your 15 years alive odds was still 99%. Then I changed it 15 and 20 and the odds were still 99% of NOT having died of PC at 15 years. Or, to quote MSKCC: "This probability means that for every 100 patients like you, 99 will NOT have died from prostate cancer 15 years after surgery, and 1 will have died from prostate cancer within 15 years.".

No, it doesn't say that.

A nomogram never reports anything as 100% certain. Even if it's a tiny, tiny, tiny fraction that will die, it will be reported as 99% probability of not dying. That is not the same as saying 1 (out of 100) will die. Words are important.

Dude, you are 65 and have been undetected for years, so move on, stop coming here unless you are one of our excellent advisors like Tall Allen. Just live your life. Put all this behind you. You have enough knowledge to advise other men to do what they have to do to regarding PC. So good bye. However, a PSA test periodically won't hurt.

JackH said...

BillyBob@388 said...
I went back and changed your pre-op PSA from 5 to 9, and your 15 years alive odds was still 99%. Then I changed it 15 and 20 and the odds were still 99% of NOT having died of PC at 15 years. Or, to quote MSKCC: "This probability means that for every 100 patients like you, 99 will NOT have died from prostate cancer 15 years after surgery, and 1 will have died from prostate cancer within 15 years.".

No, it doesn't say that.

A nomogram never reports anything as 100% certain. Even if it's a tiny, tiny, tiny fraction that will die, it will be reported as 99% probability of not dying. That is not the same as saying 1 (out of 100) will die. Words are important.

It does not say that? Then I suppose MSKCC should correct themselves, because I did not say it, they did. I agree words are important, so I will repeat the simple copy and paste once again. There was no interpretation from me or paraphrase, but a simple copy and paste from the MSKCC normogram:

Somebody said...
This number shows, as a percentage, the probability that you will survive prostate cancer for 15 years following radical prostatectomy. This probability means that for every 100 patients like you, 99 will NOT have died from prostate cancer 15 years after surgery, and 1 will have died from prostate cancer within 15 years.

While I am at it, since this says the odds for Sooner were at worst 1 out of 100 of dying from PC with in 15 years of surgery, I did not bother to give the odds for recurrence as defined by BCR(as opposed to actual clinical recurrence.) So I will give that now just because, even though it is the same 99% odds of no recurrence, with 1 of 100 having BCR:

/www.mskcc.org/nomograms/prostate/post-op

Somebody said...
Probability of Remaining Recurrence-free After Surgery
10 yr 99%

This number shows, as a percentage, the probability that you will remain free of a recurrence of prostate cancer at 10 years. This probability means that for every 100 patients like you, 99 will remain disease-free 10 years after surgery, and 1 will have a recurrence within 10 years.

Prostate cancer recurrence is present after radical prostatectomy when the PSA measurement has reached 0.2 ng/mL and continues to rise, and has been confirmed as such on a repeat measurement. In general, the longer one remains free of recurrence following surgery, the more favorable one’s likelihood of continuing to remain recurrence-free.

Post Edited (BillyBob@388) : 8/11/2016 7:35:26 AM (GMT-6)

BillyBob,

The news is all good for NY-Sooner, let’s not forget that.

You toyed with the nomogram. If I laid out two cases side by side, try to guess which one has a better 15-year prostate cancer-specific survival?

..............PSA....Age....Months*...DQ**...Gleason...+ Margin...ECE....+LN
Case 1......0.5.....70.....120........none.......3+3...........no........no......no
Case 2......50......40........3........none.......3+3 ..........yes.......yes.....yes
BTW, that's a PSA of 50 on the line above, not .50

 * Months = Months disease-free
**Disqualifying therapies: either HT or RT

These are very different cases. Case 1 should probably stop doing any PSA test monitoring all together because it is likely a complete waste of time, money and anxiety. Case 2 should perhaps be getting regular ultra-sensitive PSA monitoring tests.

I won’t make you guess which case has the better survival rate.

They are the same. 99% survival.

The nomogram cannot predict 100%; 99% is the highest.

I hate to imply that I’m smarter than the technical writers at MSKCC about the proper interpretation of these statistics, but I wouldn’t have written it as “1 will have died.” They did. Flaw, in my opinion.




BillyBob, I offer my my respectful apologies for writing (earlier posting) "it doesn't say that." What I probably should have said was, "it doesn't mean that."

NY-Sooner.....a super duper congrats to you! When I grow up I wanna be just like you!

Where Nomograms are concerned, interestingly enough, their future predictions are based on a statistically factual history, so if it says 99 live and 1 die, it is/(was) a fact at some point in time, however it cannot with 100% accuracy predict the future.

Some definition junk is below...

Predictive modeling uses statistics to predict outcomes. Most often the event one wants to predict is in the future, but predictive modelling can be applied to any type of unknown event, regardless of when it occurred. For example, predictive models are often used to detect crimes and identify suspects, after the crime has taken place.

In many cases the model is chosen on the basis of detection theory to try to guess the probability of an outcome given a set amount of input data, for example given an email determining how likely that it is spam.

Models can use one or more classifiers in trying to determine the probability of a set of data belonging to another set, say spam or 'ham'.

Depending on definitional boundaries, predictive modelling is synonymous with, or largely overlapping with, the field of machine learning, as it is more commonly referred to in academic or research and development contexts. When deployed commercially, predictive modelling is often referred to as predictive analytics.

Not like this needed any mud slung at it....but it is muddy.

about 10% of all surgical reoccurrences happen after 10 years. There was no reference to Gleason grade, but I must assume that these were higher grade cancers. There have been a number of reoccurrences after 20 years in the medical journals, but these are rare.
For a G6, I think you have nothing to worry about. I'm 7 years out and feel that I am "cured", but technically I'm in " remission".