Cleveland Clinic Study

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Researcher87
New Member


Date Joined Dec 2006
Total Posts : 14
   Posted 3/1/2007 12:08 PM (GMT -7)   
Interesting study on survival of early stage PCa by treatment option.
http://www.prostatecancerfoundation.org/site/c.itIWK2OSG/b.2545301/k.2863/Some_Prostate_Cancer_Treatments_Show_Better_Survival_Than_Others.htm
**********
51 years old
PSA = 4.3 (jumped 0.9 in 5 months)
DRE: Negative
Biopsy on 11/7/06 (10 cores): 2 cores Gleason 6 and 2 cores Gleason 7 (3+4)
Surgery: open RRP done Jan 12, 2007
Pathology: Gleason 7, negative lymphs nodes and margins. Focal extraprostatic extension. Stage 3a
Six week PSA: Zero!


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 3/1/2007 1:09 PM (GMT -7)   

Researcher 87

many thanks for posting this significant study.  i am posting below a summary except from it.

"From 1996 to 2003, over 2000 men with low- or intermediate-risk prostate cancer were treated at the Cleveland Clinic and have been followed for an average of 59 months.

The overall survival rate 5 years after treatment was 93.8 percent for men treated with external beam radiotherapy, compared with 95.7 percent for men treated with brachytherapy and 97.7 percent for those treated with surgery."

this is the first study that I can recall for low and intermediate-risk that had such high survival rates after 5 years.  i would love to read more details relating to the study because the summary details could be misleading, especially with respect to the survival rate from external beam radiation.  it would be helpful to know what kind of external beam radiation was used (e.g., IMRT x-ray or photon beam which is the most sophisticated today).  i am personally in the process of taking proton radiation treatment for my PC and i doubt that the study included proton because there were very few proton centers treatment patients for prostate cancer at that time.  also, the cleveland clinic does not have a proton treatment center. 

another major factor missing here is what degree of radiation was given to the PC patients.  studies have been done in recent years which indicate that the survivial rate has increased with increased doseages of radiation. for example, doses have been increased from 73 to 79 gy in studies done with PC patients treated with proton radiation (which is a safer form of radiation than x-ray radiation) which increased survival rates.

in conclusion, no one should take this survey at face value or let it play a major role in swaying you on your treatment decision.  additional information is needed to fully assess the results of the survey.  the side effects of each treatment and quality of life issues relating thereto are critical factors to consider in making a treatment decision in additional to potential survival rates. another important point to consider is the quality of the doctors performing any type of PC treatment.  certainly having a top rated doctor can produce better potential survival rates whether it be surgery, seed implants or some form of external beam radiation. i suspect that the cleveland clinic has top rated doctors which may result in better survey results than would happen on average for all PC patients.

Dave



68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.

Post Edited (pcdave) : 3/1/2007 1:20:31 PM (GMT-7)


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 3/1/2007 6:42 PM (GMT -7)   

Pcdave:

Amen to that.

Dutch

 


Diagnosed Feb 2001  (Age 65)
PSA 4.8
Gleason 3 + 3 = 6
T2b
Completed Proton therapy @ Loma Linda - Aug 2001
5yr PSA   0.17
Have had no side effects.


pcdave
Regular Member


Date Joined Oct 2006
Total Posts : 444
   Posted 3/1/2007 8:15 PM (GMT -7)   
Dutch

thanks for your vote of confidence in my response to the original message here. i think i can confidently say that my response was not biased, despite the fact that i believe in radiation treatment, proton in particular because of its documented success and safety record. i also believe that i have as good a chance for a cure with proton radiation as i would have had with surgery or radiation seeds, at my age. while i have tremendous respect for prostate surgery which may well be the right treatment for many PC patients, i am happy to see that we are getting some new members here who are being treated with radiation whether it be IMRT x-ray or proton. this has made this website a little more balanced in terms of representing all of the treatment options, thereby making it more useful to all members who are here to carefully evaluate the various treatment options before deciding on their treatment. cheers!

Dave
68, Biopsy 9/27/06, Stage T1c, PSA 7.1, Gleason 6 [less than 5% in two areas], Gleason 7 (3+4) [less than 20% in third area], negative DRE, bone scan and MRI. Starting proton radiation therapy 2/22/07.


aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 3/2/2007 4:54 AM (GMT -7)   

I do not know anything about this particular study, but have noticed generally that radiation treatment is more often suggested to men who are older, have more advanced disease,  or who have health situations which preclude surgery.

If that's the case in this study, and they relate to "overall survival rate" , the results would not be meaningful.

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