T3 20yr Survival Rate

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K2
Regular Member


Date Joined Feb 2011
Total Posts : 51
   Posted 6/16/2011 4:34 PM (GMT -6)   
And now for some good better news...
 
"Their study found a 20-year survival rate for 80 percent of patients diagnosed with cancer that has potentially spread beyond the prostate, known as cT3 prostate cancer, and treated with radical prostatectomy, or surgery to remove the prostate gland."
 
Surgeons looking for more patients?
 
"We have confirmed that patients diagnosed with locally advanced prostate cancer can enjoy a long, cancer-free interval."
---"interval"--- not my favorite term for my life :|
 
I'm not sure what to make of this study. T3 20 year survival is 80% -that sound pretty good. Doesn't seem to square with the monograms.
 
Advanced-Stage Prostate Cancer Patients Experience 20-Year Survival Rates With Surgery, Mayo Clinic Long-Term Follow-Up Shows
 
Do we believe this? Has any other study claimed T3 80% survival at 20 years?
 
K2

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24280
   Posted 6/16/2011 4:51 PM (GMT -6)   
k2,

if those numbers proved to be true, that would be enouraging to anyone dealing with a T3 situation.

david in sc
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 margin
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, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

K2
Regular Member


Date Joined Feb 2011
Total Posts : 51
   Posted 6/16/2011 4:52 PM (GMT -6)   
Note:

By "better" news I'm referring to Kobta's posted study by King's College London on PCa.

K2

FrackMe
Regular Member


Date Joined Jun 2011
Total Posts : 348
   Posted 6/16/2011 5:00 PM (GMT -6)   
The 80 percent survival rate for cT3 diagnoses at 20 years compares to 90 percent for cT2, or cancer confined to the prostate. This long-term follow-up of patients who underwent surgery between 1987 and 1997 is an important advance in understanding the quality outcomes for cT3 patients. The study sample included patients diagnosed and operated on between 1987 and 1997. Ongoing research will examine contemporary data.

How can you show a 20-year survival rate for someone treated in 1997?

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 589
   Posted 6/16/2011 5:38 PM (GMT -6)   
FrackMe,
Patients enter and leave the statistical analysis at different points, and a technique called Kaplan-Meier is commonly used in cancer survival statistics to allow those patients' survival to contribute to the data without skewing it. It's all beyond me, but you will see Kaplan-Meier mentioned in a lot of studies. This site outlines the reason and method:
http://www.cancerguide.org/scurve_km.html

Postop
Regular Member


Date Joined Feb 2010
Total Posts : 379
   Posted 6/16/2011 6:25 PM (GMT -6)   
-"interval"--- not my favorite term for my life :| -K2

“Be happy for this moment. This moment is your life.” -Omar Khayyam

K2
Regular Member


Date Joined Feb 2011
Total Posts : 51
   Posted 6/16/2011 6:37 PM (GMT -6)   
They must be calculating only cohorts that have crossed the 20 year mark i.e., <1992. It wasn't a published paper - the researchers presented their findings during the American Urological Association Annual Meeting in Washington in May 2011.

If making news was the objective they've done pretty well - a lot of sites have picked up the story.

BUT IT IS PRELIMINARY
"The study was slated for presentation May 15 at the annual meeting of the American Urological Association, in Washington, D.C. Research presented at meetings is considered preliminary until it is published in a peer-reviewed journal."

http://www.pcf.org/site/c.leJRIROrEpH/b.7323871/k.461A/Surgery_Viable_for_Advanced_Prostate_Cancer_Study_Finds.htm?msource=may11np&auid=8371415

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24280
   Posted 6/16/2011 7:02 PM (GMT -6)   
k2,

i find the various studies, nonograms, percentages as interesting as the next PC guy, there's definitely a lot to glean from them. At the individual level, I find them of limited use, i.e. pertaining to my own case. On paper, I should be doing much better than I am, and even if you eliminated all the side effects, complications, etc from my journey, I should have been in a better situation for controlling the cancer. When I was downgraded after surgery from 4+3 to 3+4, I sighed a big relief, thinking that would work in my favor. I always have the same wish, that one day (perhaps not in our generation of PC fighters), there will be more effective dx tools available to pin point the variants and aggressiveness of our cancers. Then, of course, treatment decisions could be more focused and determined for our actual needs. Even with patients that are well educated on their choices, and even when they are among the top doctors, it's still a shot in the dark at times, with the hope that the cancer can be stopped in its tracks.

not sure i will be alive 25 years from now, but would love to look into the future, and see what might get discovered or developed in fighting the beast. perhaps they will look back to these times as the "barbaric" times in PC related medicine.

one can only hope for better choices for the next generation of PC men.

david
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 margin
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, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Northfoot
Regular Member


Date Joined Mar 2011
Total Posts : 72
   Posted 6/16/2011 7:23 PM (GMT -6)   
Even though you can't extrapolate the Mayo data for one's personal future, it sure is nice to see a study that gives some hope.
Prostate cancer chronology:
• 4/07 psa 2.54
• 10/07 psa 2.66
• Biopsy 12/24/07
• Diagnosis 1/4/08
• Surgery 1/22/08 G4+5
• Psa tests 2/08, 3/08, 6/08, 9/08, 12/08, 4/09, 7/09, 8/09, 10/09, 1/10, 4/10 all negative
• Psa 6/22/10 0.06
• Psa 7/10 0.05
• Psa 9/10 0.05
• Psa 11/10 0.06
• Psa 1/4/11 0.08
• Radiation started 1/19/11 and completed 3/15/11
Psa 3/29/11 0.05

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 667
   Posted 6/16/2011 8:36 PM (GMT -6)   
20 years puts me at 73. From my checkered youth, I never thought I'd make it this long. I consider that a bonus!!!!
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 32 grams
Biopsy 12 cores with 7 positive
Gleason score of 7
1st PSA 38.7 10/05/2010
2nd PSA 49.9 11/23/2010
CT neg.
BS Negative
RRP on 01/25/2011
PT3a -40% involved
margin involved-Left anterior
lymph nodes -clear
1st post op PSA-0.26-03/16/11
2nd PSA-05/09/11-0.08

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 661
   Posted 6/17/2011 3:18 AM (GMT -6)   
As a T3a person myself, 20 years will put me at 91, so here's hoping!! yeah
age 67 PSA 5.8 DRE firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept 07 Totally dry
PSA 23rd Oct.0.5
Started SRT on 5th Dec.
Finished 24 Feb 08
PSA from 30th April 08, until now range- 0.5 to 0.7

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 346
   Posted 6/17/2011 8:45 AM (GMT -6)   
I do not see a link to the actual paper, presentation, or data. Only the announcement and the few details. Missing, among other items, is the age of the men under study. Since this study started quite a while ago I wager that the median age was 65 or very near to. That means that at 20 years out most of the men have died. Half of the group would have been older than 65 at treatment. Twenty percent died of PCa in the twenty year interval and most of the rest to the indignities of aging. That means that those who actually survived twenty years were a small proportion of the whole treated group and far below the 80 percent "survival" that appears, at first glance. Dying of some other cause is surviving cancer. The more who die of other causes reduces the number who will ever die of Prostate cancer.
This study reveals that, in statistical analyses, "The longer you live , the longer you will live".

don826
Veteran Member


Date Joined May 2008
Total Posts : 763
   Posted 6/17/2011 10:01 AM (GMT -6)   
I had my second opinion at Mayo and have read other papers published by Mayo along these lines. Keep in mind that the statistics are not based on a randomized study. They are based on Mayo experience only. However, it is still encouraging for some.

Here is a link to an older article on the same subject.
http://www.sciencedaily.com/releases/2005/04/050411112637.htm

There is a more recent study and paper titled "Surgical management of high risk prostate cancer: The Mayo Clinic Experience" that is available at Elsevier website but I believe there is a fee for this one.

Don
Diagnosed 04/10/08 Age 58
Gleason 4 + 3 DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85% Bone scan and chest x ray clear CT scan shows potential lymph node involvement in pelvic region
IGRT/IMRT with adjuvant HT (lupron) 2yrs
PSA:
02/08 21.5
07/08 0.82
10/08 .642
09/09 0.32
03/10 0.32
06/10 0.32
07/10 0.10
09/10 1.00
03/11 2.38
04/11 2.32

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 667
   Posted 6/17/2011 1:37 PM (GMT -6)   
I still consider it a bonus!!!!
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 32 grams
Biopsy 12 cores with 7 positive
Gleason score of 7
1st PSA 38.7 10/05/2010
2nd PSA 49.9 11/23/2010
CT neg.
BS Negative
RRP on 01/25/2011
PT3a -40% involved
margin involved-Left anterior
lymph nodes -clear
1st post op PSA-0.26-03/16/11
2nd PSA-05/09/11-0.08
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