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Probability of Freedom from Biochemical Recurrence vs. Progression-Free Probability

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Posted 8/1/2018 1:49 AM (GMT 0)
Trying to understand estimated outcomes for various forms of treatment presented in medical studies and nomograms.

But I can't seem to find a clear delineation between probability of freedom from biochemical recurrence and progression-free probability.

When I had a consult with a surgeon today and asked about the probability of freedom from biochemical recurrence after RP, he pointed me to the Sloan Kettering nomogram fields on progression-free probability.

But many studies have different/distinct numbers for FFBCR and PFP.

Can somebody explain the difference (if any)?


PSA, 3/18: 6.1
DRE, 4/18: Stage T2a, right side
Biopsy, 6/18: Left = 2/6 positive, G3+3; Right = 6/6 positive, 3 @ G3+3, 3 @ G3+4; PNI identified in 2 cores
Posted 8/1/2018 4:26 AM (GMT 0)
I can't answer the question, we'll have to wait for Allen or another expert ;)

But if I was to guess, you're in some sort of engineering field...

Was the UR appointment today with UCSD?
Posted 8/1/2018 5:23 AM (GMT 0)
CAdogsRus:

Yes, hoping to see Tall Allen's input on this issue. He is the "Answer Man."

Thanks for taking a stab, anyway.

Not an engineer, not even good with numbers. But I have a lot of respect for science.

Yes, the surgeon I saw today was at UCSD. He was very smart, very personable, made the surgery case well. He asked where I got my detailed list of questions, and I named several books I had read, including the Patrick Walsh book. (He actually trained under Dr. Walsh at Johns Hopkins.) But when I also mentioned HealingWell, it could be my imagination, but I thought he winced a little bit.

I will meet with Dr. Mundt of the radiation oncology dept. on Thursday. I had tried to squeeze in an appointment with Dr. Einck for the same day, but the administrator said he's not available until late August, but they would try to see if they could make it earlier after I meet with Dr. Mundt.
Posted 8/1/2018 12:07 PM (GMT 0)
A biochemical recurrence is a rise of the PSA value. This will usually happen before clinical progression. That is an increase of the size of the tumor as determined via the type of imaging the particular study is using.

George
Posted 8/1/2018 2:12 PM (GMT 0)

RichBinSD said...
CAdogsRus:

Yes, the surgeon I saw today was at UCSD. He was very smart, very personable, made the surgery case well. He asked where I got my detailed list of questions, and I named several books I had read, including the Patrick Walsh book. (He actually trained under Dr. Walsh at Johns Hopkins.) But when I also mentioned HealingWell, it could be my imagination, but I thought he winced a little bit.

Yep, I know exactly who you saw. I saw him as well, and if I went the surgery route (which I was 80% on board with after meeting with him, but telling him I wanted to explore RT as well - which he fully supported) the surgery would have likely been with him.

He indeed was very personable and had excellent patient interaction skills -- my wife felt more reassured after the meeting as she was taking the "cancer" diagnosis much harder than me. I too had mentioned a lot of internet research and while I don't recall observing a body or expression reaction, I do recall a reasonably strong caution about being careful with what I read and/or the need for carefully sifting and filtering all the information in the cloud.

I think you will continue to find very good to excellent patient interaction from the doctors and nurse case managers at UCSD.

Best wishes as you explore your options to reach your course of action.
Posted 8/1/2018 4:48 PM (GMT 0)
It depends on how the particular study defines it. PFP usually also includes other signs of progression (imaging and/or biopsy) in addition to PSA. Because the other indicators of progression are not very likely in the absence of a PSA increase, the two measures are often about the same. Some men get a low PSA form of prostate cancer and they are only able to detect progression by other means.
Posted 8/1/2018 5:31 PM (GMT 0)
Makes sense now.

Thank you George_ and Tall Allen.
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