survaval rates around the world

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Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/19/2009 11:19 AM (GMT -6)   
I found an interesting statistic showing the differences in survaval around the world. I dont know exactly how to interpret this, but would imagine that the medical approach has something to do with it. It also says 60-69 year olds have the best 5-year survaval rates. Go figure...
 
 
Here is the source:
 
 
Greg
 

Previous 5 biopsies over 4 years negative

PSA going from 3.8 to 28

Father died from PCa @ 78 - normal PSA and DRE

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)

1/8/2008

33.90

1/11/2008

29.50

1/31/2008

38.20

2/21/2008

32.00

3/13/2008

26.20

4/3/2008

26.60

4/24/2008

20.60

followed by RRP at Duke (Dr. Moul) on 6/16/2008

Pathology

Gleason downgraded 4+3=7

  Duke: T2c N0MX, one positive margin

  Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then

2/6/2009

0.10

4/26/2009

0.17

5/22/2009

0.20

6/11/2009

0.27

6 Months ADT started 6/12/2009

IMRT to start mid-Aug


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/19/2009 2:25 PM (GMT -6)   
Unless I'm on drugs, figure 3.2 tells a great story. First, detection and treatment is much improved since the PSA test. Second, the US is blowing away other countries in tretament success rates. I do understand that many of the health care systems in the other countries does not screen for PCa, but there is a wide disparity in that chart for 5 year success rates.

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


STW
Regular Member


Date Joined Jun 2009
Total Posts : 292
   Posted 6/20/2009 9:50 PM (GMT -6)   
Apparently not waiting for socialized medicine can save your life.
I'm glad I'm in the US.
Diagnosed at 54
PSA 8.7
Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7
Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09
Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5
Catheter out at 2 weeks no nighttime incontinence
Pad free week 5
PSA 6/6/09 <0.1


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/21/2009 6:11 PM (GMT -6)   
Yes the battle against PCa is outstandingly successful in the US. but without introducing a political argument it would seem that avoiding socialized medicine delivers the US at number 38 on national average life expectancy, behind most other developed nations (the majority of which operate "socialized medicine" to varying degrees).
en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
but what is astonishing is the infant mortality rate in the US.
www.geographyiq.com/ranking/ranking_Infant_Mortality_Rate_aall.htm
It is difficult to understand what is going on there.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01

Post Edited (BillyMac) : 6/21/2009 5:24:42 PM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/22/2009 2:41 AM (GMT -6)   
I believe that life expectancy is attributed to habits more so than the state of medical progress. Unfortunately, the US is also near the top in preventable health related issues. Let's face it, the US has a very high rate of obesity, poor dietary hanits, and other vices.

Still the PCa numbers here are excellent in comparison to other countries. Perhaps a good reason that the recent studies in the New England Journal of Medicine had such a disparity between the US and European. Maybe they were both right?

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4274
   Posted 6/22/2009 6:09 AM (GMT -6)   

Hi All:

A well balanced discussion on USA health care should not, IMHO, rest on a few selected statistics.  It's great that the US PCa stats are so excellent as presented by the orginal poster.  Of course Tony is correct re the life expectancy.  And, despite Bill's shock at the US infant mortality rate, it should be noted that there are reasons for this rate other than the fact the US does not have socialized medicine.  For example, one reason as to why so many babies are dying is that US doctors are saving more premature babies with advanced technologies.  But these "super preemies" don't always live. The younger an infant is born and the less it weighs, the more likely it is to die. These deaths also contribute to the infant mortality rate. But many countries that 'beat' the United States on the list either don't have the technology or the will to save super preemies.

For those of us in the USA with health insurance, we are privileged to be able to select from among some of the best physicians, facilities and treatment options in the world.  I do not think that can be disputed.  However, for those without health insurance, the options are more limited.  The key, IMHO, will be to find a system that retains the excellence and choice without the inherent disadvantages that come with socialized entities.  I wish I had the precise answer...I could save our Congress a lot of time, effort and money if I did!!!

Tudpock

 

 


Age 62
Gleason 4 +3 = 7
T1C
PSA 4.2
2 of 16 cores cancerous
27cc
Brachytherapy December 9, 2008.  73 Iodine-125 seeds.  Procedure went great, catheter out before I went home, only minor discomfort.  Regular activities resumed, everything continues to function normally as of 6/1/09.  6 month PSA now at 1.4 and my docs are "delighted"!

kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 6/22/2009 8:43 AM (GMT -6)   
Being that the US is - by and large - the wealthiest, most educated, resource-hogging, comsumption-driven population on the planet, we have a tendency to be the best and the worst of everything.

We have the best medical technology on the planet - but it is also the most expensive, and is completely out of reach for some of our own people. We have the best enviromental technology in the world, but we are also the leading (or very near the top) polluter in the world. And on, and on...

Sideways comment - After years of denial, it is dawning on me that our love affair with red meat may have a serious connecton with our (the US's) health status - which is a complete bummer becasue you GOTTA have a steak every once in a while. Right? Excuse me, I think I hear my arteries hardening.

kcragman
Age: 53; 52 at DX
March 2006: PSA 2.5
Dec 2007: PSA taken for insurance application. I did not see the results until late
Jan '08 - after I was rejected. Their lab said PSA 4.5.
Feb 2008: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
cancerous and the 6th was suspect.
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.
Feb 2009: PSA at 9 months was undetectable.
May 2009: PSA at 12 months was undectable.


Iggy
Regular Member


Date Joined Feb 2009
Total Posts : 27
   Posted 6/23/2009 2:03 PM (GMT -6)   
The chart seems to be comparing apples with oranges.
The US statistics are more recent than the foreign statistics.

Earlier detection will show longer survival because the countdown starts sooner.

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/24/2009 5:43 AM (GMT -6)   
Although the lifestyle theory has some merit (mind you, much higher per 100,000 pop. firearm and road fatalities probably help skew the figures) the infant mortality rate is based solely on live births. Therefore if, as has been suggested, these other developed countries were inferior to the US in attempting to save their "premmies", then their infant mortality rate should reflect it as a higher rate. Clearly it is not. As most of these countries run some type of universal health scheme then perhaps the higher life expectancy could be attributed to the general availability of preventative health care to all. Likewise perhaps the availability of quality pre-natal care is not dependent on ability to pay (or insurance cover). Given that approximately 15% of Americans are not covered by any form of health insurance and on their own, then it follows that perhaps 15% of expectant mothers may be missing out on this essential pre-natal care.
Sometimes what constitutes the least final cost to a community is not as obvious as it first appears.
Food for thought,
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 831
   Posted 6/29/2009 9:11 AM (GMT -6)   
U.S.A....U.S.A....U.S.A.....

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/29/2009 12:02 PM (GMT -6)   
Bill,
I believe that you are right about this point. In fact, I would believe that number of those who are uninsured is even higher at the common child bearing ages. But also other socialeconomic reasons exist that affect this number and it doesn't alone tell a story about the level of medical care in the US. I am hopeful that furture changes in the US healthcare system bring that 15% and not the 85% down...Just my thought...

Tony
 Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/29/2009 11:51 PM (GMT -6)   
Not to make this into a political discussion, but a lot of the uninsured are illegal immigrants and those who either can afford, but don't want to spend on the insurance or are elligable for medicaid, but don't want to get it (sould I say irresponsible?). The remainder is more like 5%.

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