A: Our computerized prostate cancer database is a collection of medical information on all the more than 16,000 men we have treated over the past three decades. On all men, we have collected pretreatment information such as their biopsy reports including Gleason score, PSA, stage, etc. We then enter the radiation doses that we gave for treatment. Afterwards, we follow up with men every six months for ten years and then yearly afterwards forever. At each after-treatment follow up, a PSA test is done and urinary, rectal and sexual function is monitored and all entered into the database.
A: There are two basic uses. 1) To write research papers for publication in medical journals such as the 25-year report. 2) To analyze a man’s particular case of prostate cancer, such as yours, and calculate the chance of zero PSA at 15 years. The value of this database cannot be overstated. It is the key to our cancer program.
A: With few exceptions, doctors who treat prostate cancer rarely have a database. For example, we are the only group with a database in Georgia who can calculate your 15 year chance of zero PSA, which is the single most important thing you want to know about your prostate cancer. Without a database, a doctor will not have insight or documentation of how well he cures prostate cancer or how many complications his patients have.
A: It is a medical research paper from RCOG that was published in the Journal of Urology in March 2013 (JUrol 189:878:2013) that is entitled “25 Year Disease Free Survival Rate After Radiation of Prostate Cancer Calculated With the Prostate Specific Antigen Definition of Recurrence Used For Radical Prostatectomy.”
A: Because it is the first research paper that compares the treatment results of irradiation with those of Radical Prostatectomy calculated with an undetectable PSA of <0.2, or essentially a zero PSA for both treatments. Because it is so important, it was put in the title as to how the chance of men having an undetectable PSA was calculated. Although there have been literally thousands of papers published in medical journals comparing other treatments with Radical Prostatectomy since 1987, all are misleading for they compare Radical Prostatectomy calculated with a zero PSA with other treatments without any PSA goal. In other words, this 25 year report is the first apples-to-apples comparison of radiation with Radical Prostatectomy.
A: The chance of having PSA <0.2 fifteen years after treatment is given in the table displayed here: As you can see, the chance of a zero PSA 15 years after treatment is about the same. To get 15 year results, we analyzed men treated many years ago. Since then, there have been substantial improvements in treatment methods in both Radical Prostatectomy as well as the RCOG radiation program. Because of this, the chance of zero PSA in both programs, for men treated today, should be much higher than shown. It further showed the chance of a PSA <0.2 (zero PSA) is the same at 15, 20 and 25 year follow up.