Long term Surgery Stats Question

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SHU93
Regular Member


Date Joined Aug 2008
Total Posts : 328
   Posted 1/6/2010 10:54 AM (GMT -6)   
Does anyone know why the stat's go lower of reoccurrence as the years go past after surgery.
 
For example my stats are better at 5 years then 10 years cant find anything past 10, is it that they consider PC slow moving? But I would think if I am PSA free at 2 years my chances of PSA free at 10 is better? Since it would show up now that I still have PC after my prostate is removed?
 
I would think the longer you go out if PSA free the stats would be better?  Would be great to have stats of inputting how many years free psa free after surgery to see stats of PC reoccurrenc...
 
I know stats are just that stats and we are all individuals but just wondering why the numbers go down......
 
LIVESTRONG!
 
Age Dx 37, 7/2008, First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008, Biopsy: 6 out 12 Postive all on right side, Gleason 7 (3+4). Bone Scan/CAT Scan: Clear 7/2008
Cystoscope: Normal 7/2008, Prostate MRI: Normal 7/2008
Da Vinci Surgery 7/2008, PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
5 Post OP PSA's from 9/2008 to 12/2009: <0.1
 
 
 


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 1/6/2010 12:54 PM (GMT -6)   
Well, in one sense your stats do get better. If you take your data and plug it in as if you had surgery 5 years ago then your chances of being cancer free 10 years after surgery do go up (of course you have by then used up half of that time)

I think the real answer to your question is simply PC can be very very slow. Thus, if your chance of not having a recurrence in 5 years is 99% and in 10 years is 98% it is because some small fraction of guys stay cancer free up to the 5 year mark but then have recurrence before 10 years.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/6/2010 1:32 PM (GMT -6)   
Interesting question. Food for thought; I don't know how many cancer cells are required to even show any PSA on the ultra-low tests, but if it you have very few remaining cancer cells, and the doubling time is 12 months or longer, then it could take quite a few years before enough cells have multiplied to give a detectible PSA reading. Thus I think they figure the 10 year mark is the "cure" threshold...but I did read from another forum a man that was <0.1 for 14 years before he became detectable again. Go figure. I also read somewhere, that there is no such thing as being cancer free....everyone has some form of cancer through out their system in small quantities from birth and sometimes they grow large enough to be detectable later on. So in a way...we all are cancer survivors from day one.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 1/6/2010 1:58 PM (GMT -6)   
geezer99 said...
if your chance of not having a recurrence in 5 years is 99% and in 10 years is 98% it is because some small fraction of guys stay cancer free up to the 5 year mark but then have recurrence before 10 years.
Or the guys at the 10 year mark are/were REALLY OLD GUYS and died of other things.
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/6/2010 2:21 PM (GMT -6)   
Happy New Year to ya Steve...but keep in mind...in 10 years you will be just 64....not an old geezer by any means and hopefully still around....lol
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 1/6/2010 2:29 PM (GMT -6)   

Hey Les...Hope you and yours are doing well...

I have actually spent a ton of time recently thinking about where I'll be in ten years.....not to mention where I'd like to be in ten yearssmhair

Then there's 10 years plus 8 to hit 72 and max out the SS check so that my paycheck I'll be getting as a WalMart greeter will be enough.


Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 1/6/2010 10:33 PM (GMT -6)   
Are you talking about published curves or the online nomograms or what?  I can only recall seeing mortality (not morbidity) curves in the articles I reviewed.  What was the definition/criteria for recurrance?
 
Of course one has to be very careful to interpret statistics correctly.  For example, with the mortality curves for death due to PCa after surgery, there are several causal possibilities which could produce the same curve shape.  E.g. one case could be that most of the recurrances occur early after surgery, but it takes a relatively long time to exhaust effective treatment options and finally succumb to the disease.  Or, an alternate case is that the disease course is shorter and it takes longer on average for the disease to recur. 
 
Which case was true would make a difference in how to interpret the info to determine your probabilities at a given point in time.  In the first case, each year you are disease free resets your point on the graph to the zero point and your probability of death due to recurrance remains very low.  In the second case you are walking along the curve year after year and your cumulative recurrance chances increase.
 
I honestly don't know which case is true.  But I think it is more like the former case than the latter.  Anyone have better insights?
 
 


51 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08 -- Great MD in New Haven, CT
Negative margins, no extra-capsular involvement
One nerve spared
PSA at 0 for just over a year now.
 
 

Post Edited (Rolerbe) : 1/6/2010 9:37:06 PM (GMT-7)

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