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Cancer: Prostate Message Board


Cancer: Prostate Board Index


Re: Scared wife
May 5, 2011
[COLOR="DarkGreen"]Hi pcspouse,

I'll welcome you to our board, one I'm sure you never included in your plans. None of us did, but we are a good group, and I hope you will get reassuring information and support.

I have been at this for more than eleven years now and have not heard of anyone - man or mate - who was not scared by the diagnosis. To many of us, that diagnosis comes as "The Big C". However, for almost all of us, it would be more accurate to think of it as "the little c" - something that is going to place an unwanted burden on our lives, perhaps for years, but very unlikely to be a killer. That's in sharp contrast to all other major cancers, though some are making remarkable progress.

I'll intersperse some comments in green in your post, but I want to jump ahead to your ten year question first of all. You asked:[/COLOR]

[QUOTE]And is it too much to hope for 10 years?[/QUOTE]

[COLOR="darkgreen"]Short but sound answer: no, it's not too much, in fact anything less would be extremely unusual! :D This is not wishful thinking or a minority opinion; it is firmly based on researched fact about survival of men in the US at the current time. Moreover, the numbers include not only men who are cured or curable (probably like your husband), but also those with hopefully chronic (but not lethal) prostate cancer, like myself. It took years for me to figure out that I was not going to die fairly soon from the disease, and I know that those of us with some challenging case characteristics (such as your husband's intermediate-risk Gleason score) need more reassurance.

Based on what you know at the moment, your husband is low-risk for PSA at 4.9 :) (not exceeding 10), low-risk for stage (currently believed to be well-contained at T1c :)), and intermediate-risk for the Gleason score of 4+3=7 :confused:(same as mine, but my first PSA was 113.6 :(); that makes your husband an intermediate-risk patient as of now.

I'm looking at the 128th Edition (Library Edition) of the Statistical Abstract of the United States, 2009, published by the US Bureau of the Census. Page 118 contains Table 173: "Cancer--Estimated New Cases, 2008, and Survival Rates: 1987-1989 to 1996-2004," which is based on infomration from the National Cancer Institute of the National Institutes of Health.

For patients of all risk levels, the survival rate for US prostate cancer patients at the five year point increased for White men from 85.4% in 1987-1989, to 95.3% in 1990-1992, to 96.2% in 1993-1995, and to 99.4 % in the period 1996-2004. For Black men the improvement rate was similar, with the success percentage just a bit lower, reaching 95.9% in 1996-2004. This table is especially encouraging as it shows the improvement trend.

However, as you can see, it lags our current year as the last year in the 1996-2004 bracket is now seven years old.
A lot has continued to happen in that time, and survival for low-risk and intermediate-risk men [I][U]at ten years[/U][/I]is virtually 100%! :D :cool: That is stated along with other key facts in a free pamphlet published by PCRI, a non-profit organization with the full name Prostate Cancer Research Institute. Here is what the pamphlet states: "Compared to other cancers, prostate cancer has an excellent 10-year survival rate. With High-Risk prostate cancer, 95 out of 100 men are still alive in 10 years.1 Remarkably, men with Low or Intermediate-Risk disease are not at any increased risk for dying of prostate cancer within the first 10 years after diagnosis.2"

The data come from:

Footnote 1: 1. Mayo Clinic Validation of the D’Amico Risk Group Classification for Predicting Survival Following Radical Prostatectomy. Journal of Urology Vol. 179 page 1354, April 2008.

Footnote 2. Long-Term Survival Rates of Patients with Prostate Cancer in the Prostate-Specific Antigen Screening Era: Population-Based Estimates for the Year 2000 by Period Analysis. Journal of Clinical Oncology Vol. 23 page 441, January 2005. [This paper used special techniques to estimate survival. You can read the abstract by using a site permitted on this board because it is Government sponsored. Just search for "http://www.ncbi.nlm.nih.gov/pubmed?term=%22Long-Term%20Survival%20Rates%20of%20Patients%20with%20Prostate%20Cancer%20in%20the%20Prostate-Specific%20Antigen%20Screening%20Era%3A%20Population-Based%20Estimates%20for%20the%20Year%202000%20by%20Period%20Analysis%22%20AND%202005%20%5Bdp%5D", without the quotation marks. "Moderately differentiated localized/regional" is more or less equivalent to intermediate risk.

By contrast, the next best survival figure for the 1996-2004 period is breast cancer, 90.5% survival for White patients and 77.8% survival for Black patients.
[/COLOR]

[QUOTE=pcspouse;4747223]My 53yo husband was just diagnosed with PC. Gleason 4 + 3, 4 + 3, 3 + 3, PSA 4.7, prob. T1c. In just the past few days I have read enough online to scare myself senseless.[QUOTE]

[COLOR="darkgreen"]I hope the information above is reassuring, but the treatments themselves are often a burden, and I hope the participants on the board will be able to help you understand the options from patient's, wives' and concerned family and friends'perspectives.

I'm a big believer in empowerment of patients and their key supporters. Three outstanding books that help orient the patient fast are:

"A Primer on Prostate Cancer -- The Empowered Patient's Guide," 2005, Dr. Stephen B. Strum, MD, and Donna Pogliano, PC activist/educator and wife of a PC survivor. The book is outstanding for its thorough presentation that aids decision making, including tables, photos and illustrations.

"Invasion of the Prostate Snatchers," 2010, Ralph H. Blum and Dr. Mark Scholz, MD. This book is outstanding for a more strategic look at the options, with great dual tracks for patient's and doctor's commentary.

"Beating Prostate Cancer -- Hormonal Therapy & Diet," 2006, Dr. Charles "Snuffy" Myers. I would try to read the first two books first, but, especially for a patient with a challenging case characteristic, this book is ostanding on both title elements, and it is one of the best sources for a great dose of optimism, based on hard fact. It is also easy to read and understand.[/COLOR]

[QUOTE]We have a bone scan tomorrow and a consult at UCSF. [/QUOTE]

[COLOR="darkgreen"]UCSF is a wonderful institution for assessing and treating prostate cancer, with extraordinary expertise in imaging. That may be why you are having a bone scan, which these days is no longer recommended for a Gleason score 7 case with a relatively low PSA. It's possible UCSF may be using some investigational bone imaging system that is better than the systems in standard use. It would be extremely unusual if the bone scan documents a prostate cancer metastasis.

The Gleason score, which indicates aggressiveness, is very important, and many general pathologists mis-rate the pathology slides a bit, more often underestimating, but sometimes overestimating, neither of which are good outcomes. Usually, pathologists at respected universities, especially centers like UCSF, do a fine job at interpreting Gleason patterns. It would be wise to find out whether the pathologist doing the rating had special expertise in prostate cancer.[/COLOR]

[QUOTE]Does this awful anxiety get any better? This is my first time ever on any message board, so hope my etiquette is OK.
Thanks[/QUOTE]

[COLOR="darkgreen"]Yes, the awful anxiety does get better, and often far faster than you would have thought possible. My wife and I wondered if we would ever have another joyful day after my diagnosis a few weeks before Christmas in 1999. It turned out we had joyful days within weeks, and the anxiety eased. However, prostate cancer is still no cake walk, and sometimes the anxiety reappears. Most of us will get better at dealing with it. A few patients and their key supporters may benefit from professional one-on-one counselling, perhaps supported with prescription drugs.

You are bound to have a lot of questions, and I hope you will feel free to ask them. You may also learn by searching the board for past discussions.

Take care,

Jim :wave:[/COLOR]





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