I found the following stats on BRFS (Bioehemical Relapse Free Survival) in "The Prostate Treatment Book" published by Seattle Prostate Institute/Swedish Cancer institute.
As in all studies the data may not be perfect, and combines data from various studies and hospitals. but it's the 1st head to head comparison that I have run across.
Risk Group 5 year BRFS 10 year BRSF
Surgery 3D CRT Seeds Seeds Seeds/ERBT
Low 83-85% 90% 87-94% 87% 84-85%
Intermediate 50-65% 70% 82% 76% 77-90%
High 28-32% 47% 65% -- 46-57%
The low risk group survival rate is pretty much equal for all treatment options and matches everything else I have read. So in treating low risk PC, the side affects are more important than the treatment option when it comes to making a decision.
In the high and intermediate risk groups there is a difference in the BRFS. This makes sense to me as these groups are at higher risk for extra capsular extension, seminal vessel invasion and tumors close to the urethea which are all more difficult to get a clear surgical margin.
If your surgeon or radiologist is quoting higher cure rates than these then he should be able to clearly explain why.
64 years old.
I had an initial PSA test in 1999 of 4.4. PSA increased every 6 months reaching 40 in 5-08. PSA free ranged from 16% to 10%. Over this time period I had a total of 13 biopsies and an endorectal MRIS all negative and have seen doctors at Long Beach, UCLA, UCSF and UCI. DX has always been BPH and continue to get biopsies every year.
In 10-08 I had a 25 core biopsy that showed 2 cores positive, gleason 6 at less than 5%. Surgery was recommended and I was in the process of interviewing surgeons when my wife's oncologist recommended I get a 2nd opinion from a prostate oncologist.
I saw Dr Sholtz, in Marina Del Rey, and he said that the path reports indicated no tumor, but indolant cancer clusters that didn't need any treatment. He was concerned that my PSA history indicated that I had a large amount of PC somewhere that had yet to be uncovered and put me through several more tests.
A color doppler targeted biopsy in 11-08 found a large tumor in the transition zone, gleason 6 and 7. Because of my high PSA Dr. suspected lymph node involvement, 30% chance, and sent me to Holland for a Combidex MRI, even though bone and CT scans were clear.
Combidex MRI showed clear lymph nodes and a 2,5 cm tumor in the anterior. I was his 1st patient to come up clear on the Combidex which has a 96% accuracy,
I've been on a no meat and dairy diet since 12-08 and PSA reduce to 30 while I awaited the Combidex MRI.
The location of the tumor in the anterior apex next to the urethea makes a good surgical margin very unlikely. Currently on Casodex and Proscar for 8 weeks to shrink my 60 mm prostate. Treatment will be seeds followed by 5 weeks of IMRT while continuing on Casodex and Proscar. So far no side affects from the Casodex.