Another long term study. Median followup 18.6 years.

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ChrisR
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Date Joined Apr 2008
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   Posted 1/29/2011 6:32 PM (GMT -6)   
Another long term study.  Not much detail, but it has the longest median followup of 18.6 years and data ranging out to 30 years supposedly.
 
 
Dx @ 42 years old on 4/2008
Gleason 6 (50 Point Biopsy) (6 Cores positive - Small Focus Each)
open RP 10/08  Johns Hopkins
pT2 Organ Confined Gleason 6 (tertiary score 0)
PSA Since Surgery
1/15/2009 (3 Month) <.1
10/15/2009 (1 Year) <.1
10/15/2010 (2 Year) <0.03
10/15/2011 (3 Year) -

Post Edited (ChrisR) : 1/29/2011 6:32:29 PM (GMT-7)


Postop
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Total Posts : 385
   Posted 1/29/2011 7:42 PM (GMT -6)   
Seems that if you are organ confined Gleason 6, you are largely home free if you have surgery, but, of course, it doesn't say what happens if you don't have surgery. If you are Gleason 7 or more, surgery may or may not save you.

ChrisR
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Date Joined Apr 2008
Total Posts : 831
   Posted 1/29/2011 8:23 PM (GMT -6)   
This study said it contained people from 30 years ago. Before the PSA test most people presented with advanced cancer at diagnosis. I would expect Gleason 7 and other cancer fair much better today. I would like to find the detailed release of this study.
 
Dx @ 42 years old on 4/2008
Gleason 6 (50 Point Biopsy) (6 Cores positive - Small Focus Each)
open RP 10/08  Johns Hopkins
pT2 Organ Confined Gleason 6 (tertiary score 0)
PSA Since Surgery
1/15/2009 (3 Month) <.1
10/15/2009 (1 Year) <.1
10/15/2010 (2 Year) <0.03
10/15/2011 (3 Year) -

Post Edited (ChrisR) : 1/29/2011 6:32:18 PM (GMT-7)


Tony Crispino
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Total Posts : 8128
   Posted 1/29/2011 8:28 PM (GMT -6)   
Good paper, Chris.
I am printing copies for my UsTOO group. In fact it will be an interesting handout as we have a surgeon speaking at the next meeting...We need more long term studies like these...

Thanks for the post.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 1/29/2011 9:01 PM (GMT -6)   
Good finding.
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 Not taking it
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 9/23/10

John T
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   Posted 1/29/2011 10:04 PM (GMT -6)   
This is very discouraging. 55% of the men treated with surgery had psa that had risen. The only good news is that only 4% of the G6s had failures. Again the evidenc is pretty clear that the PC stage has much more impact than the treatment. A 45% success rate for any treatment is not what I would call a success.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 1/29/2011 10:23 PM (GMT -6)   
John,
I agree. But these are the numbers I see as consistent with history. Extending studies to longer terms can give us drastically different information. No one should assume that any other therapy over a study span with a median of 18.4 years will have any better results either. I can show you many ten year surgical studies that have far better results...

Tony

Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 1/29/2011 11:17 PM (GMT -6)   
I have studied this document and I have some interesting points I think that need to be considered. Here is what I see, I welcome what you might see:

1> If the median of this cohort is 18.6 years that means that at least 50% cohort was initially treated before 1992 and everyone else since. In 1992 the standard of treatment was radical prostatectomy. Radiation was still a wide beam that had many poor side effects. Seeds, Cryo, just about any other approach was still in the infancy stages as compared to todays versions.

2> Current technologies, drugs, and follow up hormonal and chemo care was not available back in 1992 and for many years since. So it is very likely that survival numbers have improved with time.

3> Surgeon experience matters! Ugh! All our new members and lurkers need to pay careful attention to this point. It is crucial!

4> There is a lot of disease activity that takes place after the ten year mark! But it does not necessarily mean death by prostate cancer.

5> There is a disease control and survival benefit with RP to all patients in the cohort regardless of risk category, but the benefit is more pronounced with men that have Gleason 7 or higher disease who also have significant lymph node dissection.

Peace...

Tony

Post Edited (TC-LasVegas) : 1/29/2011 10:15:54 PM (GMT-7)


English Alf
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   Posted 1/30/2011 4:02 AM (GMT -6)   
Glad to have a long term study of any sort.

I note its says the following:
-contience and ED issues are dependent on the skill of the surgeon as well!.

-20% of the men who had high Gleasons did not have any cancer outside the gland. A stat that is accompanied by the very honest comment that "This indicates that our ability to accurately assess the stage or extent of the cancer is often incorrect"

-24% (or nearly 1 in 4) died of prostate cancer, which is thus matched by the fact that
76% (or about 3 in 4) survived for more than 15 years

-19% (or nearly 1 in 5) had mets

As ever there seem to be somewhat clearer dteails about both those with Gleason 6 or 8-10 and a lack of info about us 7s in the grey area.

And it's still only statistics, we still can't get told what is actually going to happen to us.
It would be grim for those that got told the bad news but it would be nice to think that someone could develop a test in the path lab so they looked at your cancerous cells and came back with an answer as to whether you had the type of PCa that was going to kill you or not, rather than just give you stats that said you had a 1in4 chance of it killing you.

Alf

ChrisR
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Date Joined Apr 2008
Total Posts : 831
   Posted 1/30/2011 8:24 AM (GMT -6)   
John T,
 
I think the 55% recurrence rate is somewhat skewed due to the fact that this study has a lot of patients from before 1992 (Pre PSA).  Most people then presented with clinical symptoms and palatable cancer.  Recurrence was almost always going to happen for these men.  But let's say the 55% is accurate, even today,  only 24% of those with recurrence died of PCa.  Or, 25% did not die at the time of this study.  I don't think the paper is very detailed.  I would like to see all the particulars of this study.
 
Also,  I believe it said 4% of the G6 failures occured after 10 years, not only 4% of G6 people failed.  It also stated that none of the G6 failures developed metastatic cancer.  I don't know if it was any of the G6 or any of the 4% of the G6 that failed after 10 years.
 
We really need to get the details of the paper.

Postop
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Date Joined Feb 2010
Total Posts : 385
   Posted 1/30/2011 4:15 PM (GMT -6)   
I tried. I went looking for the abstracts from that meeting. They are published and available on line free at the Journal of Urology. The problem is, that the authors are not given in your link, and there are thousands of abstracts. Nevertheless I found a few interesting abstracts:

585 PROSTATE CANCER-SPECIFIC SURVIVAL THIRTY YEARS AFTER RADICAL PROSTATECTOMY
http://www.jurology.com/article/S0022-5347%2810%2901113-4/fulltext

53 NATURAL HISTORY OF BIOCHEMICAL PERSISTENT PROSTATE CANCER DIAGNOSED IN THE ERA OF PSA SCREENING
http://www.jurology.com/article/S0022-5347%2810%2901865-3/fulltext

1058 RADICAL RETROPUBIC PROSTATECTOMY VERSUS ROBOTIC-ASSISTED RADICAL PROSTATECTOMY: AN ASSESSMENT OF BIOCHEMICAL RECURRENCE RATES BY D'AMICO RISK GROUP AND SURGEON VOLUME
http://www.jurology.com/article/S0022-5347%2810%2902438-9/fulltext

1063 TIME TO BIOCHEMICAL RECURRENCE IS A STRONG AND INDEPENDENT PREDICTOR OF CSS AND OS IN HIGH-RISK PROSTATE CANCER
http://www.jurology.com/article/S0022-5347%2810%2902443-2/fulltext

1064 PREDICTORS OF LOCAL RECURRENCE OF PROSTATE CANCER FOLLOWING RADICAL PROSTATECTOMY WITH NEGATIVE SURGICAL MARGINS
http://www.jurology.com/article/S0022-5347%2810%2902444-4/fulltext

2023 THE SURGICAL LEARNING CURVE FOR ROBOTIC PROSTATECTOMY: A MULTI-INSTITUTIONAL STUDY
http://www.jurology.com/article/S0022-5347%2810%2902325-6/fulltext

130 HAZARD OF PROSTATE CANCER-SPECIFIC MORTALITY OVER TIME FOLLOWING RADICAL PROSTATECTOMY
http://www.jurology.com/article/S0022-5347%2810%2900437-4/fulltext

252 TIMING OF RECOVERY OF ERECTILE FUNCTION AFTER RADICAL PROSTATECTOMY: DOES ANYONE RECOVER AFTER 2 YEARS?
http://www.jurology.com/article/S0022-5347%2810%2900567-7/fulltext

285 OVERALL AND CANCER SPECIFIC SURVIVAL FOLLOWING DEFINITIVE THERAPY FOR CLINICALLY LOCALIZED PROSTATE CANCER IN THE PROSTATE-SPECIFIC ANTIGEN ERA
http://www.jurology.com/article/S0022-5347%2810%2900603-8/fulltext

Zen9
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Date Joined Oct 2009
Total Posts : 314
   Posted 1/30/2011 7:26 PM (GMT -6)   
I haven't had a chance to study any of these abstracts in depth; one would of course like to see the entire articles rather than abstracts; and all prior caveats expressed by others about "mixing and matching" studies - particularly studies involving pre-PSA era patients - should be recalled.

Having said all that, #585 may give those of us who are Gleason 7's some rare insight into our situation as compared to Gleason 6's and Gleason 8-10's.

And #285 should rekindle a lively debate.

Zen9

Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 1/30/2011 9:18 PM (GMT -6)   
English Alf said: And it's still only statistics, we still can't get told what is actually going to happen to us.

That's the whole problem with all these reports, graphs, charts, stats, and percentages, when push comes to shove, they are just numbers on a piece of paper, and depending on the motivation and purpose of the originator, they can mean whatever you want them to mean.

It still comes down to each of our own personal journey's. Percentages mean nothing, when you case doesn't follow suit. Treatment choices are iffy, even if you follow the best of stats ahead of time. So much of medicine and medical maladies is at the personal level of each and every patient.

I think sometime, we have wishful thinking while studying the plethora of reports, both old and new. Guess hoping to find something to that agrees with our way of thinking, or our particular numbers.

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 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 Not taking it
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 9/23/10

goodlife
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Date Joined May 2009
Total Posts : 2692
   Posted 1/30/2011 9:44 PM (GMT -6)   
Chris,

You have initiated one of the meatiest threads on PC in a while. My thanks to you and the rest who have contributed. I will be chewing for a while.

One of the hardest things for me and PC is not knowing. As Alf points out, they are still statistics, but statistics can be presented in ways that are more reassuring than the Uro saying "you have cancer". As someone pointed out, 3 out of 4 did not die from PC. Another point was that living 15 years with BCR was possible.

This was what I needed to hear today.

Goodlife

Postop
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Date Joined Feb 2010
Total Posts : 385
   Posted 1/31/2011 12:03 AM (GMT -6)   
Zen 9, these are abstracts from a conference. The actual studies are presented as either short talks or posters at the meeting. There are no full papers, unless the these meeting presentations get expanded into a paper that gets submitted to a journal for publication. So, for this meeting, all that is published is the abstract. There is a whole lot of stuff there. The Journal of Urology is at http://www.jurology.com/. The 2010 meeting abstracts are in Volume 183, Number 4 Supplement.

John T
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Date Joined Nov 2008
Total Posts : 4268
   Posted 1/31/2011 12:11 AM (GMT -6)   
David,
I have to take exception to your train of thought about statistics. Yes, everything boils down to an individual situation, but so does everything in life. Without studies and statistics we would not know if treatments were effective, in fact we wouldn't know if we even needed treatment until it was to late to affect anything. They are not perfect, what is? but they give us a good idea of what to expect and are very useful in decision making. The very idea of statistics and studies is that there are variations and they are to be expected. How else are we to get any type of factual information to guide our decisions except from studies. The only other options are trial and error and anacdotal stories or just using your gut feel.
I would never consider a treatment, test or medication without some study or statistics showing its effectiveness. Without data decisions are only as good as a coin flip.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

English Alf
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   Posted 1/31/2011 5:17 AM (GMT -6)   
John T:

All David and I are getting at is that while data such as this may say something such as: Three in four people with similar medical history to you will survive for 15 years (or whatever), it doesn't actually tell you if you are in the lucky 75% or unlucky 25%.
Statistics have to be viewed the right way. And statistics are of course relevant in everyday life, but treatment choices and outcomes vis-a-vis PCa cannot be compared to more mundane issues. If my house insurance company works out my premiums based on statistics about house fires etc that's fine, because they're not also telling me that in 10 years and two months my house will burn down, because that's how often there's a house fire in my neighbourhood.

We don't want to know that there are statistics that say that there's a three in four chance of us being alive in 10, 15 20 years time, we want to know if we are actually going to be alive then.

Also, to be frank, us guys with PCa are spolit when it comes to survival times (as are many ladies with breast cancer). This is a cancer where in almost all cases you are going to live for a lot, lot longer after diagnosis than people who get other cancers. Here we are worrying about how sick we may or may not be in 10 or 15 years time while those with other cancers are being confronted by the idea that they may not be alive in 10 months time, or even 10 weeks time.
(a friend of a friend of a friend, who was only aged 38 has recently died of skin cancer just 8 weeks after diagnosis!)

Alf

BobCape
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Date Joined Jun 2010
Total Posts : 416
   Posted 1/31/2011 7:56 AM (GMT -6)   
It seems rather silly to me for anyone to suggest that statistics dont matter because they only reflect OTHER people's results.
 
Obviously, if medicine didn't try to gather the individual results based on degree and state of pca, and then try and take an overview of who ended up where using whatever series of solutions (RP, Rad, etc..), then why bother?
 
To suggest that studies and stats are of no value because they represent the results of OTHER people, or to say "I dont want to know what happened to others, I want to know what is going to happen to me"...
 
Then you shouldn't be looking at anything other than your maker.
 
Because HE or SHE may decide you were NEVER going to die of pca, but that you WILL be hit by that bus next thursday.
 
In my opinion.

English Alf
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   Posted 1/31/2011 10:20 AM (GMT -6)   
Bob: you miss my point.
I still am "happy" to know that there is a one in whatever chance of things going wrong for me, I would merely like to have some real numbers as well as statistics.

Perhaps I can put it another way:

Imagine you are 55 and have been having trouble peeing and have an uncle who had PCa. You go to the doc and he merely says that based on your statistics you have a X% chance of having a raised PSA level rather than doing a blood test to find out what your actual PSA level is. Just relying on the stats would make no sense, so similarly, you need more than just statistics to understand what is going to happen to you rather than what is likely to happen to you.

Alf

Zen9
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Date Joined Oct 2009
Total Posts : 314
   Posted 1/31/2011 10:32 AM (GMT -6)   

Purg casts cold water on threads such as this one because he comes at the Healing Well forum from a different angle than some of the rest of us do.

His vision - and the vision of many others - is of a forum where one can get and give emotional support to fellow prostate cancer patients (past or present).  There is absolutely nothing wrong with that vision.  Obviously, however, it is ultimately incompatible with a lively discussion of papers, abstracts, and statistics pertaining to prostate cancer and its treatments.

In contrast, some of us come here in an attempt to follow the developing science - a halting, uneven, fragile development, to be sure, but one in which we have more than a passing interest.  This is doubly true if - like me - you are advising newly diagnosed men who contact you.

Obviously, this is not necessarily an either-or situation; some come here for both reasons.  But for those who come here solely for one or the other reason, perhaps the best option is to simply participate in the threads that interest you and leave the others alone.  Telling us the limitations of statistics isn't all that helpful; we already know their limitations.  Conversely, impatience with frequent "personal updates" is misplaced emotion.

This forum is by nature schizophrenic, and that's OK.

Zen9

 

 

 


Post Edited (Zen9) : 1/31/2011 9:40:11 AM (GMT-7)


Tony Crispino
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Date Joined Dec 2006
Total Posts : 8128
   Posted 1/31/2011 11:47 AM (GMT -6)   
"There are lies, dam.n lies and there are statistics."

I happen to side with David and Alf on this. There is something wrong in every statistic. It's true that we use statistics to try to better our lives but let me just say they don't assure that that's what we do when we use them. And prostate cancer is that gray area where misuse happens regularly. I am certain that other long term papers might paint a different picture.

For example, a little research let's you know that the Stanley Brosman is one of just two urologists on the PCRI medical advisory board. A board laden with radiologists. Was he influenced by the same biases at PCRI when he wrote this paper ~ I personally don't know. As Post Op points out, critical information was withheld for whatever reason such as authors and abstracts.

I wrote Dr. Brosman today to see if he is willing to show us what abstracts he is assembling his data from when he compiled this article. Until I hear back from him, we don't have a single study in front of us. We have an article.

Stay tuned!

Tony

Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 1/31/2011 1:26 PM (GMT -6)   
zen: i love being stereotyped and pigeon-holed on my views. it wasnt me that decided that HW was primarily a patient to patient support site, kind of has to do with the owner of the site's intention. i am not "throwing cold water" on anything. or does that simply mean that if one has a different opinion, perhaps negative to the normal ebb and flow of thread, it's a "negative" thing?

i think it does a terrible diservice to all here, newcomers especcially, when certain people (not you) come across as self-made experts in complicated medical matters. there is also a fair amount of "doctor bashing", which does not help a new comer, who already has enough fears going to choke a goat. when i want real medical advice, i go to my doctors, and unless common sense tells me different, i am compliant to my doctors, their advice, and their orders.

and zen, sadily, in my opinion, there are men here that are OCD about stats and reports, and they make decisions based on biased reports, instead of listening to their own doctors. There are guys here, that I am sure that their doctors cringe everytime they see them, because they are the "know it all" kind of patients, or worse yet, the "wilkipedia patient", that comes armed with questionable reports and stats.

there is a good place for numbers and reports, i have made my entire working life off of numbers. A PC journey is not about having a check list and picking the best dr. money can buy, going to the best facility, running numbers through a nonogram and looking sweet. We have plenty of brothers here that made all their choices like they were ordering a luxury car, going off the options list, and despite all their learning, still end up with miserable results. Were there choices wrong? Probably not, but goes back to each human body reacts in its own unique way. It's that simple.

My original point, was not to put too much faith into loaded reports and stats, that a person like us, can't really prove or disprove. I would make no medical decision off of anything that the reliability couldn't be proven in some real way.

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 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 Not taking it
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 9/23/10

Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 1/31/2011 1:36 PM (GMT -6)   
JohnT:

In a perfect world, you method of making a medical decision would be right on, but it doesnt work that way for most of us. When push comes to shove, when it comes to decision time, most doctors will go "mute" and make you make your own choice, even if you aren't remotely qualified to choose, or if you are in some state of shock or denial.

Just like surgery for Prostate Cancer has been the standard for decades, and for a reason too. Reading 10 books about it, pro or against, isn't going to change that fact. Not saying that surgery should be the primary treatment choice, just saying what the standard is considered.

I still think of the one radiation oncologist I "interviewed" over a year ago that was the only one pushing for HT with SRT. When I did push him for proof, he showed me a well aged photo copy of some article from years ago, and when I pushed him for an exact reason, he backed off and said that he couldn't prove that I needed it, and he couldn't prove that it would help.

Now what kind of advice is that? How do you make a decision off of any answer like that? In my case, it was the same thing as him saying no to HT. As it were, the other 2 that I spoke too, strongly disagreed and didn't want to mix HT with SRT in my case.

We are still stuck in the end, with making life changing and complicated medical decisions on our own. If one is going to depend on a given report to help in that decision process, they sure better be qualified to know if the report is accurate or not in order to make a decision with.

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 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 Not taking it
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 9/23/10

Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 1/31/2011 1:37 PM (GMT -6)   
Bob Cape:

I do believe you missed the spirit of what was meant in English Alfs and my post concerning reports and data. No one is against pure facts.
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 Not taking it
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 9/23/10

Casey59
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Total Posts : 3172
   Posted 1/31/2011 2:38 PM (GMT -6)   

I can understand how statistics can be scary and intimidating to folks who are unfamiliar with the basics of how to use them.  Making matters worse, some ads or public service announcements deliberately use statistics in a way that makes us feel vulnerable…with the underlining objective of motivating us to take action, which often beans “buy” (reference MBA class:  Advertising Techniques 101).

The general public would like to be presented with the facts in “black and white”, and not be told that “you have to do your homework”…unfortunately, many are either too busy or otherwise unmotivated to do their homework.  However, to infer that statistics are meaningless is naive.

 

Doing one's homework, however, with a basic knowledge & understanding of statistics is vital for evidence-based medicine and informed decision-making.  But, from reading the comments here, the very first and foremost concept one should understand before attempting to interpret medical statistics is that NO ONE CAN PREDICT WITH TOTAL CERTAINTY ANY PATIENT’S EXACT OUTCOME.  If you don’t get this concept (and clearly, from some comments, this is misunderstood by some), you should really limit your application of statistics to calculating restaurant server tips.  Statistics & nomograms tell you about the general outcomes populations with similarly characterized cases, not specifically who will end up with what outcome. 

Here's a good way to think about it:  Statistics tell you whether you’re in a great big fight, a medium-sized fight, or a little fight. People win and lose all three, so it just tells you what your fighting mind-set is.  It's about probability, or "likelihood", not certainty. 

 

Anyone else here a fan of NPR’s “Science Friday” with Ira Flatow?  Here’s a LINK to a radio show about Understanding Medical Statistics.  Unfortunately, of you don’t already have a good grasp of statistics; you probably already aren’t a fan of the “Science Friday” show.

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