Artist Mark said...
Just looking around HW this morning and came to the G9-10 thread and counted up the # of 5+4 guys and 5+5 guys and found that there have been only 7 in each group added since my Dx.
I'm kind of glad you did that. Interesting to look at those trends, isn't it? Looking at poster's signatures led me to wonder about
this early on, and that's one of the reasons I originally started this thread! It's also of note that in all of 2018 we added 10 members of the 4+5 group, and to my surprise NO members in either the 5+4 or 5+5 groups. (That could be a little off, since if a poster doesn't say their x+y I just put them in the 4+5 group, so there could be others in there.)
This is why these groups are very rarely specifically identified in studies. G9 is relatively uncommon anyway, but dominant Type 5 cell cases are rare indeed. When they are identified the statistics can be more concerning, with a significant degradation of outcome at each increased level. We usually get lumped in with a generic "high risk" group, including a lot of other factors (PSA > 20, G8-10, stage T2C or greater). A couple times I've seen a study like that say that there was a special outcome for the G9 or primary type 5, but not enough to draw a statistical conclusion.
All that really means is we end up throwing everything at it, including the kitchen sink, and more or less "side effects be darned". As SteelGuy (I believe) once said, "Blowtorch and pliers, whatever it takes!", or something close to that.
[Edit: just wanted to add, not all studies show worse outcomes across the 4+5 - 5+4 - 5+5 continuum. There are very few studies like that anyway, and some say there's not much difference. Just to clarify before somebody grumps about
Post Edited (Redwing57) : 9/8/2018 8:25:32 AM (GMT-6)