Pridiction tools / Nomograms

[ken12491]

There are two on MSK I think to apply to me, they are:

Post - Radical Prostatectomy - When I plug in my #s it tells me the following:

15-year prostate cancer-specific survival would be ---- 64 %

The BCR #s are not too favorable, but the overall survival rate isn't too bad, at my age of 67.

This would be without having any additional treatment and I did - I had SRT/ Radiation and ADT. Am I missing something, but considering I did additional treatment SRT, wouldn't that even make that 64% even a better survival rate? I might take those odds if it preserved my QOL.

The other tool is called - ' Male life Expectancy Survey ' This one you can plug in your #s, and assumes you had ' no treatment intended to cure your cancer '

This one says:

10 yr survival would be - 47% and only 18% would die from cancer - 35% would die from some other cause.

At 15 yrs: 23 would survive and 23 would die from cancer - 54 would have died from other reasons.

My SRT/ADT was done at Slone but I still can't get answers on how accurate these tools are - asked my Dr ( good guy ) he was too busy to discuss with me.

I am obviously trying to determine what my next steps would be if told additional treatment is proposed that would impact to a great degree my QOL.

Comments, thoughts are much appreciated. Thanks..

If other tools are available to me - please let me know.

[Tall_Allen]

MSK does not have any nomograms that show life expectancy after unsuccessful salvage radiation. Data from Johns Hopkins from 1999 shows about 13 years median survival.

[ken12491 in reply to Tall_Allen]

Thanks again - that is not average expectancy its median? Median, meaning 1/2 under the definition of median, live longer and the other 1/2 less and of course average being the combined numbers and doing the math.

Also, that 13 years is with or without additional treatment such as ADT?

BTW --- I take in information from what I believe to be reliable sources, and from about 4 or 5. The final decision maker will be me and my wife but I want to know as much as I can about this before any has to to be made. You are helping and others are helping me - many of these questions I would be asking the Dr ( some have been asked ) in person or via the portal, but don't get too many answers - time spent with me is very limited - but he is a good guy.

Also, that 13 years is with or without additional treatment such as ADT?

My PCa was regional, all scans clean, took several.

PSA at the start of RT was nadir ( with 5 months of Lupron's help ) - after RP it was .81 - before RP it was 2.3!!

And by having new T Levels ( 474 ) back close to where they were does that play into this 0.19 PSA? This new 474 # was a jump from 29 taken were taken in May 2018.

Also, am I correct by assuming from other reliable articles, that ' failure ' under SRT is PSA above .2 or is that above 2?

Could my 0.19 be my new Nadir?

Also, if additional treatment is sought, at what level does it start -- I heard 0.1 or 0.2?

I am obviously trying to figure out the next step if I need or decide to take it -- weighing the treatment path and taking in the QOL issue.

[Tall_Allen in reply to ken12491]

"Nadir" means lowest point - so saying PSA was at nadir is only saying the PSA reached its lowest point to date.

Survival stats are almost always medians.

13 years included ADT if it was used after metastases were detected (by bone scan/CT)

0.2 ng/ml after SRT is arbitrarily called "biochemical failure." When you wish to start ADT is a matter for discussion with your oncologist.

[Break60]

Why don’t you fill out your profile so we better understand ur situation and trend?