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davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/24/2011 8:04 PM (GMT -6)   
most studies don't go beyond 10 years post op or post radiation. Are there and good/reliable studies with statistics after 10 years?

I frequently find myself wondering if I'll make it to see my grand kids, enjoy retirement with my wife. I'm told verbally that i'll be fine, but where are the studies showing long term statistics of people in my boat ( scores, age, surgery outcome etc.)

Why do all these studies stop at 5 or 10 years?

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 3/25/2011 7:41 AM (GMT -6)   
Somewhere between "many" and "most" of men that start their PC journeys are Senior Citizens. Adding ten years to that and you've got some really old guys... Ain't too many of them make it to a 20 year mark cause they die from so many other things.  

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 3/25/2011 8:29 AM (GMT -6)   
A Gentleman who lives down the street from me had prostate surgery 28 years ago and is still going strong!
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

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 3/25/2011 9:55 AM (GMT -6)   
My dad was successfully treated about 15 years ago. His PSA has never risen. But chances are, he won't be around at the 30 year mark, for reasons that have nothing to do with prostate cancer--he's already past the actuarial average lifespan of a man in the U.S. And he was younger than the average patient diagnosed with prostate cancer, which is still 70.

I am interested in this question, too, since I was diagnosed at 43. I'm especially interested in long term survival after salvage radiation, an area where followups are even shorter, because the technology hasn't been around that long. I'm watching the research of Andrew Stephenson and colleagues, in particular. They first released a multicenter study with a followup time of 4 years post-SRT, then updated it to 6 years. Catalona has released his single physician data on SRT patients looking out 10 years (and it's dismal compared to shorter term results).

It's important to realize that when you get very long time series, you are likely including men diagnosed before the advent of PSA testing, before advanced surgical techniques (like those developed by Walsh) were widespread, before 3D conformal radiation, protons, IMRT/IGRT, and before today's ADT drugs.

Nevertheless, there are a few studies that look back 20 or 30 years:
http://www.modernmedicine.com/modernmedicine/Modern+Medicine+Now/Local-distant-prostate-cancer-control-strong-after/ArticleStandard/Article/detail/711793
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 3/25/2011 10:07 AM (GMT -6)   
Hello all,
Had surgery back in 1992 and the cancer had escaped and invaded both seminal vesicles and the rectal wall. I was in the hospital for 22 days after the RP. I thought I was going to die there. Can't tell you why I am still here but I am. Be positive and help others survive!

RalphV
Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 3/25/2011 10:22 AM (GMT -6)   
Ralph, you put the long in longevity!
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 3/25/2011 10:41 AM (GMT -6)   
Thanks Galileo! Glad to see you here and see that you are doing so well. It has been quite a while since the demise of the other chatroom or since you attended to support group at St. Joe's. Be well my friend!

RalphV
Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 3/25/2011 10:48 AM (GMT -6)   
There are quite a few 15 year studies for radiaton and 20 year studies for surgery. The long term studies for surgery show that 10% of the reoccurrances occur after 10 years. This means that with a reoccurrance rate of 30% you have a 3% chance of reoccurring after 10 years. The vast majority of reoccurrances from any treatment happen within the 1st 5 years and reoccurrance rates drastically reduce after that, but don't go to zero. Dattoli has 14 year data for radiation with risk of failure at 1% beyond 5 years.
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.

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3762
   Posted 3/25/2011 11:28 AM (GMT -6)   
Demanes and Martinez have published results longer than 10 years for HDR brachytherapy and I believe Critz has longer than 10 numbers for his ProstRcision permanent brachytherapy treatment. As I remember they are in line with what Jiohn T reports above.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010, HDR Brachytherapy 12-6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/25/2011 11:45 AM (GMT -6)   
Ralph is my superhero.

My surgery results were almost identical. Bilateral seminal vesicle invasion and the surgeon noted he stopped scraping suspicious tissue at my rectal wall to prevent damage to my rectum. 4+3=7.

As Brad Paisley says in a country song ~ I still got a pair. But I did shrink 'em with 28 months of HT...

I hope Ralph's good fortune extends over to me, too...

Tony
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:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 3/25/2011 12:04 PM (GMT -6)   
Tony,
I wish you better results than mine. After all you still have a pair and that has to be an improvement. smilewinkgrin

It is difficult to pinpoint the cause of such long survival. It was not predicted in the beginning. Quite the contrary as I was given no more than 4 years. I was so lost and unprepared that expected the worse but still dedicated myself to learn as much as possible as I felt that was needed to survive.I did improve my diet considerably by reducing animal fat.

Keep doing your good work!

RalphV
Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!

mr bill
Veteran Member


Date Joined Sep 2010
Total Posts : 688
   Posted 3/25/2011 5:53 PM (GMT -6)   
Hi RalphV,
 
Sounds like you took the bull by the horns and gave him a thorough thrashing.  When you say you cut down on animal fat does that include poultry?  Also, may I ask how much you cut down? I have eliminated red meat, but not poultry, and wonder if I should dump the barnyard birds also?
 
Mr Bill

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 3/25/2011 5:57 PM (GMT -6)   
Like most PC guys, I have pondered this question some. Eventually it gets me back tothe saying that more men will die with PC, not from it. In the 50 an 60 year old range, there are a whole lot of big snakes in the grass that don't give you much time to ponder your long term survival. Heart attacks and strokes, along with some more virulent forms of cancer, to name a few.

I have concluded that there is no good answer. In the absence of a good answer, I have decided to treat each day as thi it could be my last. I rarely fail to say I love you to members of my family, try to enjoy a sunrise or sunset, enjoy a good meal or time out with friends, and just enjoy life. There are no guarantees. Sometimes I think it is more frustrating and depressing to try and find the answer.

Life is good, until it's not.

Goodlife

tvwohio
Regular Member


Date Joined Sep 2010
Total Posts : 172
   Posted 3/25/2011 6:36 PM (GMT -6)   
i was 50 when I had RP. So far so good that was 10 yrs ago.
I will probably die of something else but that's life.
When I was 50 I wanted to live long enough to see my 5 kids successful and having good spouses. That was accomplised.
I have 9 Grndkids and 2 grnddogs ( got to get him producing yet) so every day my kids were successful and luckily had kids, I am lucky.
I could be killed in a car wreck tomorrow so everyday since I had the RP is a free day.
Live today and don't worry about tomorrow because you and I can't control that

Tom
Prostrate Cancer 2001 RP 50 years old PSA 6.8 Gleason 3 + 2 40% T3bNxMo moderately differentiated adenocarcinoma RP - cancer apex area, nerve sparing not successful Bulking using both collagen and teflex unsuccessful for continence. 4 sets of strictures within 1 yr after RP - 3 manual and 1 rotorotor -9/2010 stricture - suprapubic catheter folled by Homan Laser. AMS800 1/22/11. Dry 3/9/2011

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/25/2011 7:24 PM (GMT -6)   
Tom, that's a great testimony there, and a good way of looking at things.
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 2/11 1.24
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,

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/25/2011 7:33 PM (GMT -6)   
davidg,
Some are probably wondering why I didn't jump all over this question:

"Why do all these studies stop at 5 or 10 years?"

My reputation when acting as a prostate cancer advocate is well known by many in our community here. It has been my contention that study time frames that work for other cancers do not work for prostate cancer. Additionally, the end points of these studies are too often based on an imperfect test rather than prostate cancer specific mortality. This is largely due to the studies being too short to deliver more definitive data.

It's important to note that certain prostate cancer studies CAN be done in a shorter timeframe. For example late stage disease has shorter definitive end points on chemotherapy drug studies. But studies on primary therapies for clinically localized prostate cancer are all over the place right now. Ugh...

And these are things we seemingly should have control on...

Tony

Post Edited (TC-LasVegas) : 3/25/2011 7:40:34 PM (GMT-6)


davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/26/2011 12:39 PM (GMT -6)   
Tony - given our sheer numbers you'd think there would be better studies. I found that even surgeons don't have their own numbers form their own patients. You'd think that's pretty easy data to compile and critical for a surgeon to disclose.

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 3/26/2011 5:00 PM (GMT -6)   
Mr. Bill,
I did a macrobiotic diet at the start of this process. It was a hard diet to do properly. I switch to a mostly vegetarian diet. No red meat, no dairy, no eggs.
Eat fish 3 times a week and have eaten chicken when going out to eat and do not find a suitable menu.

RalphV
Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!
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