RPP yields average 19 year survival.

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ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 685
   Posted 10/9/2010 5:08 AM (GMT -6)   
Interesting study. This is a long term illness.


http://www.hemonctoday.com/article.aspx?rid=76326

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 23543
   Posted 10/9/2010 7:53 AM (GMT -6)   
for someone 60 at dx, perhaps not bad news, but if dx in early 40s, a bit discouraging
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3086
   Posted 10/9/2010 9:37 AM (GMT -6)   

three perecent died of prostate cancer in 19 years.  sounds good to me.

ed


age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 685
   Posted 10/9/2010 10:54 AM (GMT -6)   
Ditto.
Dx 42
Gleason 6 (tertiary score 0)

open RP 10/08 Johns Hopkins

pT2 Organ confined Gleason 6

PSA
10/15/2009 <.1
10/15/2010 <0.03
10/15/2011 -

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 920
   Posted 10/9/2010 11:38 AM (GMT -6)   
It does sound good.

I always wonder, though, what these kinds of studies actually mean for a patient being treated this year. By definition, a study that shows a median 19-year survival rate is based on data from men who were treated at least 19 years ago. One would expect better outcomes for those being treated today, although how much better is anybody's guess.

My doc is skeptical of Partin tables, Han tables and the Bostwick calculator outputs for exactly that reason. He thinks today's patients will do better, and so do I. It'd be nice if we had proof, but I hope to live long enough to verify it personally.
Age 55

PSA:
8/09 2.69
7/10 4.00
8/10 4.11

Biopsy 8/10
Three of 14 cores positive: 10%, 60% & 80%
Stage T1C
Gleason 6

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 305
   Posted 10/9/2010 11:42 AM (GMT -6)   
Does anyone have a link to the original study? The article presents so little information as to be practically worthless.

Thanks.

Zen9

Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 196
   Posted 10/9/2010 11:43 AM (GMT -6)   
The title to the article makes no sense.
In fact, the whole article seems a bit senseless to me.
The "study" runs from 1987 to 2004.
During which time 3% of RP patients died as a result of PCa.
 
And they conclude that RP leads to a median 19 year survival rate.
Huh?

Post Edited (Dave7) : 10/9/2010 11:47:10 AM (GMT-6)


kbota
Regular Member


Date Joined Aug 2010
Total Posts : 472
   Posted 10/9/2010 12:07 PM (GMT -6)   
While not entirely worthless, the article leaves huge questions for those of us with a more intimate knowledge of this disease. As fairwind has pointed out on numerous occasions, those of us with Gleasons 8's, 9's or 10's represent an entirely different disease than those with gleason 6's and under. G 7's can go either way just depending.
So many folks think that PCa = PCa = PCa which is entirely untrue. As a general rule, G6's and under, if caught and treated early enough will live a long life with high QOL. G8's and over will fight hard for a shorter QOL.

I would like to see these type of studies done just on G8's through G10's, (and then again, maybe I wouldn't) and compared to studies of G6's and under.

I suppose it would be rather difficult to get participants to stay with the program for a lengthy period of time. If they are doing well, they tend to drop out which might skew the results in just a few years.

k
Age 57 at Diagnosis
May, 09 PSA 2.26
June, 10 PSA 3.07 Free PSA 18%
Met with Uro, DRE +
June, 10 Biopsy, 7 of 12 cores, up to 60%, 4+5=9
July 21, 2010 - RRP
Nodes negative
Vesicles negative
tumor contained in capsule, still 4+5=9
perineural invasion extensive
Aug 5, 10 catheter out
Sept 3, 10 PSA - 0.00 (great big whew)
As of 9/3/2010, I'm 99% continent - only occasional stress incontinence !

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 10/9/2010 1:07 PM (GMT -6)   
That was encouraging information. I am curious if the same study is out there for the stage 4 folks?

peace to you
Dale

Postop
Regular Member


Date Joined Feb 2010
Total Posts : 374
   Posted 10/9/2010 1:19 PM (GMT -6)   
All this has been presented, in a long term randomized controlled study comparing watchful waiting to radical prostatectomy:

http://www.ncbi.nlm.nih.gov/pubmed/16861118

Hematol Oncol Clin North Am. 2006 Aug;20(4):845-55.
Prognostic markers under watchful waiting and radical prostatectomy.

Holmberg L, Bill-Axelson A, Garmo H, Palmgren J, Norlén BJ, Adami HO, Johansson JE; SPCG-4 Study Group.

This seems to be the best data out there. Unfortunately there isn't a free copy of the article, only the abstract. It includes survival curves (comparing surgery vs control) as a function of things like age at diagnosis, PSA, and Gleason score.

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 472
   Posted 10/9/2010 3:31 PM (GMT -6)   
Now if one of the more educated guys can interpret;

http://www.smu.org.mx/revista_smu/eng/04/219-223%20radical.pdf
Age 57 at Diagnosis
May, 09 PSA 2.26
June, 10 PSA 3.07 Free PSA 18%
Met with Uro, DRE +
June, 10 Biopsy, 7 of 12 cores, up to 60%, 4+5=9
July 21, 2010 - RRP
Nodes negative
Vesicles negative
tumor contained in capsule, still 4+5=9
perineural invasion extensive
Aug 5, 10 catheter out
Sept 3, 10 PSA - 0.00 (great big whew)
As of 9/3/2010, I'm 99% continent - only occasional stress incontinence !

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 685
   Posted 10/9/2010 4:19 PM (GMT -6)   
It is studies like these that generate the statement " more men die with prostate cancer then from it. ". With the average age of PCa dx. at 68 and the average male life expectancy at 78 this all seems logical. It became apparent to me about a year after being dx. that the statement did not apply to me. What if PCa has an average course of 25-30 years.  Not only also will I probably die with PCa, but probably from it.

Post Edited (ChrisR) : 10/9/2010 4:50:56 PM (GMT-6)


Postop
Regular Member


Date Joined Feb 2010
Total Posts : 374
   Posted 10/9/2010 4:34 PM (GMT -6)   
Kbota,

I'm educated enough to figure out how to open that file. Its a report of 205 who received RRP at a hospital in Mexico city, and were followed for an average of 41 months. Men with lower PSAs at diagnosis, and lower Gleason scores were less likely to have evidence of recurrence on PSA testing.

John

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 685
   Posted 10/9/2010 4:54 PM (GMT -6)   
Dave7 said...
The title to the article makes no sense.
In fact, the whole article seems a bit senseless to me.
The "study" runs from 1987 to 2004.
During which time 3% of RP patients died as a result of PCa.
 
And they conclude that RP leads to a median 19 year survival rate.
Huh?
 
 
It says they were treated from 1987 to 2004.  Not that the study started in 1987 and ended in 2004.  The study obviously ran to this year as far as survival, but excluded anyone treated after 2004. 
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