A: Not necessarily. These calculations are based on thousands of men who were treated with us in each of three risk groups. You are in the moderate risk group, but this includes men with a lot of different combinations of Gleason score, PSA and stage. You want to know the information on your own particular case of prostate cancer and we can calculate that from our database on an individual basis.
A: From our database, we evaluated only those men who matched your Gleason score, PSA, and stage along with the number of needles positive for cancer that you have as well as the amount of cancer in the needles. Based upon this calculation, your individual chance of having a zero PSA is 85% at 15 years, not the overall 76%. Calculation by overall risk group is a good way to show the overall results, and this is what is typically published in medical journals. In fact, the results shared with you in previous questions that you asked me are updated ones that were published in our 25 year follow up research paper on prostate cancer. But what you want is information about your particular case of prostate cancer. Just as we did for you, we can calculate that rate for any man’s case of cancer.
A: It means that if we treated 100 men who had prostate cancer just like yours, 85 of them would have a zero PSA 15 years after treatment with our radiation program and 15 men would have had a detectable PSA, which means a PSA more than 0.2 within the last 15 years. These 15 men would have recurrent cancer.
A: Yes. However, this raises the single most important issue that you should learn about prostate cancer, which is – when talking to doctors, never use the words cure or cure rate. Instead, always talk about your chance of a zero PSA at 15 years.
A: Because not all doctors agree on the PSA needed to show cure. As discussed, without question you need a zero PSA to show cure. However, many doctors refuse to accept this and say that the PSA can go to any level after treatment – 0.7, 1.7, 2.7 or any level and can then increase some but will say you are “cured.” So, with doctors, the word “cure” can have all kind of different PSA meanings and that is why you will want to use a precise meaning, which is a zero PSA.
A: Us and urologists who treat men with Radical Prostatectomy are the only doctors who use zero PSA (<0.2). So, if you talk to doctors about “cure” or “cure rate” you never know exactly what they mean. That is why you ask a doctor for the chance of zero PSA at 15 years after whatever treatment he or she recommends instead of asking about cure. Then you eliminate confusion. This is how you compare doctors and treatment methods and decide on the best treatment for your particular case of prostate cancer.