I was told on another site that the 5 year survival of 30% in MpC was out of date. I haven't come across across any newer data. Is anyone aware of newer survival statistics to reference?
Current Survival Statistics - Advanced Prostate...
Current Survival Statistics
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Blair77
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I read somewhere that today, most men with stage 4 live 5 years or more. I don't remember where, but I do remember being a little surprised. I was guessing around 50% for 5 years, certainly not 30%. That's an old number and doesn't take into account the new treatments that have come out in the last 8 years. Treatments such as Enzalutamide, Abiraterone, Apalutamide, Cabazitaxel, Xofigo, early use of Docetaxel and Aberaterone to name some major advances.
Schwah in reply to
Just focus on your statistic of one. At the end of the day nothing else matters.
Schwah
in reply to Schwah
I always do, but I'm answering someone else's question.
If someone asks me how long I think I will live, I say "Today".
spouse21 in reply to
Hi, Gregg and anyone else who can answer my confusing question. Does the 4-5 years survival statistic apply both to men originally diagnosed at Stage 4 as well as men who reach Stage 4 later on? In other words, if someone is T3a for several years, does that person get another 4-5 added to the years they already had at a lower stage?
in reply to spouse21
That's a difficult question because men diagnosed at earlier stages may live longer if measured from when they are diagnosed at stage 4, but not necessarily longer overall. Unfortunately, longer treatment time often does not equate to longer life expectancy for prostate cancer patients.
I guess you can assume that the survival rate will improve with the new drugs which were recently FDA approved. However, the statistics includes cases up to the year 2016, when these drugs were not available.
You can see the mentioned 30% in figure 4 ("distant")of this report:
The problem with calculating length of survival is that many factors play role in survival.
Some examples are:
(1) If you are Asian your length of survival tends to be longest , If hispanic ..imtermediate , in Caucasians shorter and in African Americans ..shortest length of survival.
(2) If you have Acinar Adenocarcinoma your survival is longest and if you have Small cell/ductal/neuroendocrine type carcinoma, your survival tends to be shorter.
(3) If you are thin and close to ideal body weight your survival can be longer and if you are obese survival is shorter.
(4) If you are vegan/vegetarian your survival is longer, if eat meat most of the time, your survival is shorter.
(5) If you have many comorbid medical condition your survival is shorter compared to someone who has less medical conditions.
(6) If you have good support system and financially resourceful.your survival is longer compared to lonely and poor person. (loving wives/girlfriends prolong your life and so do caring sons and daughters,)
(7) If you are educated and tend to know a lot about PCa your survival will be longer than the one who is not educated and do not acquire knowledge. (being on this forum can prolong your survival)
(8) If you walk a few miles a day or are gym rat. your survival is longer than couch potato lying in bed mostly and not moving.
AND there are other minor factors. So a uniform rate of survival is redundant. Every man has his own length of survival .
The survival curve of the Stampede trial was showing around 50% survival at 5 years, but that doesn't mean you'll be 50% dead in 5 years. You may be all dead, in hospice, onto a new drug, or in remission. There's really no way to know.
My interpretation of the stats are that 1) this is a disease to be taken very seriously, 2) there's a decent chance to live for many years with the disease, and 3) If treatments work, and you're not one of the unlucky men that don't get a response, your chances for living many years increases.
With metastatic prostate cancer, one can be dead or alive in 5 years. At the moment, you are in limbo like the Schodinger's cat in the twilight zone between dead or alive.
Please do not open my box, you might force me into a dead state by observing me! 
in reply to dac500
It's interesting that you mention Schrodinger's cat. I often feel that I am both 100% alive and 100% dead at the same time.. I have to make a choice as to which mental state I am in.
Schrodinger's Cat! I love it. I have found my kindred quantum physics junkies. Now where did I put my delayed-choice quantum eraser?
in reply to MateoBeach
It's very unlikey to be where you put it. It's not there at all if you don't look.
Garbonzeaux in reply to
It has probably tunneled out, but the exact probability of that can't be known.
One can be alive or dead 5 years from now regardless of ANY disease status or other circumstance. The statistical probability of either event for groups of people in similar circumstances or disease status can indeed be better or worse. Although such probabilities may be of some partial help for informing various treatment or life-planning decisions, each of us remains a "statistic of one". As mentioned earlier, there may be many things that one might try to incorporate into day-to-day life to better one's overall odds, and one's objective/subjective sense of balance and well-being.
"The Median Isn't the Message", by Stephan Jay Gould may provide some insight for those who may be hoping to live at the favorable end of the Overall Survival curve during the progress of their disease. Google it.
Sometimes Schrodinger's Prostate Cancer Cat claws its way out of the Box on its own quite early, much to our detriment, and sometimes it doesn't. Wrapping that Box in some additional layers of Zytiga, Xtandi, etc. might considerably help, sometimes.
I have come to think, feel, and believe that even though I have an ultimately Incurable disease (or even more than one), I can still be Healed in many ways, for as long as I live. For me, taking the little daily risks of Sharing and Compassion among others along the way seems to help. I am Grateful that I am still here.
Charles
in reply to ctarleton
We must accept the coexistence of life and death in each moment. As a good friend of mine likes to say: "Are you living today or are you dying today?"
Thank you Charles. I'm new to all this and it's scary with the different directions this disease can go and do in our bodies to disable us in many ways emotionally, physically and spiritually. I appreciate all of you who are ahead of me offering your advice to assist me on this journey which I now have to learn to navigate.
Now I've heard it all....shades of Woody Allen's 'Sleeper'...ie, what's consensually bad is actually good...turns out saccharine may be cancers next big stake in the heart...
What Schwa says below. No one knows that and it’s usually a mean average. If I change my heritage to Hispanic or Asian maybe I can fool my cancer....🤓
I recommend ignoring these statistics. Every man here is different. The only guy who knows the day and the hour isn’t telling.
No one knew how long they had to live before diagnosis. There life expectancy may be shorter but still no one knows.
The statistics which I cited above show, provided you have no bone mets, that the five-year survival rate for all men with prostate cancer is nearly 100 percent. Further, the relative 10-year survival rate is 98 percent, and 96 percent for 15 years. Since I have no bone mets yet, I do not have to worry that I will die any time soon from prostate cancer.
The trial that tested ADT plus Abiraterone for patients with bone mets reported a median overall survival of 53.3 months or 4.4 years. This is much better than the 30% of patients living longer than 5 years in the cancer statistics: ncbi.nlm.nih.gov/pubmed/309...
At diagnosis last Nov my Oncologist gave me a far worse prognosis than those stats, I was very advanced with Mets to every single bone and very high PSA, Marrow invasion etc, I was feeling pretty poorly then as well.
I met some friends last weekend and a neighbour today in the local Supermarket, they all said I look much better and have that spark back. I have to admit I do feel better and a lot more optimistic about my prognosis, some days are tough with pain but they have the dosage about right and I'm much more mobile these days.
It's pretty amazing how things have turned around for me. No matter how bad it gets don't ever quit, Happy New Year to all my Brothers in this fight.
in reply to Zetabow
As long as people keep saying "You look good" I figure I'm OK.
Hi Blair77, there is a post hoc analysis of the LATITUDE study that was just released, but you can only get the abstract unless you pay $35 to European Urology. I paid the $35 but your MO probably has it. A big driver of survival is how quickly and how low your PSA reduces. If you get a 90% reduction in PSA after 6 months, that is pretty good outcome and the median time to disease progression is about 60 months. They only had data through 40 months so my MO extrapolated to get 60 months. Then my understanding is you have about 3 years once the cancer comes back. So that’s a total median of 8 years. Of course it could be less based on your response to ADT but the majority in the study got the 90% reduction. That being said there are some who didn’t and have a lower time to progression. Hope that helps.
The combined ADT and Chemo got my PSA from 1386 to 0.028 in 6 months and has remained steady for 8 months now. I remember watching my PSA drop so dramatically, it was the best thing I every saw, I knew what meant and it injected so much hope into me.
in reply to Zetabow
I had the same thing happen with my PSA dropping every month. It felt so good to see it going down every month and I felt as long as that continued, I'd be OK.
I remember the first difficult thing was when it stopped going down evey month. I knew that would happen sooner or later, but it was great while it lasted.
Hey Daniel, I dont have this full article. Can you help me get an idea as to my probable survival: My data is below: I am on Lupron, zytiga and predni since diag 7 /1/2 monthsago. No chemo, rdiation,surgery yet. I am castration sensitive.
(1) PSA decline from 830 to 0.4 ( 99.95% ) in 7 1/2 months.
Last checked : 0.4 on 12/31/19.
(2) ALP decline from 191 to 59 in 7 1/2 months.
(3) No medical condition except high blood pressure. 3 pound more weight than ideal.
(4) Diet: 99 % vegan, 1% yogurt plus lots of herbs and spices.
Give me an idea ,Man...is it worth buying a vacation home in valleys of Himalayas..if I live long enough I will go for it. Please calculate now.
Hi Learnall, in my last MO visit my MO pulled up the LATITUDE post hoc analysis article and she showed me a graph that showed progression free survival (PFS) vs. months on Lupron+Zytiga+pred. The graph was based on 90% reduction in PSA after 6 months (there was also a graph assuming 50% reduction in PSA). The study only had results through 40 months but based on the trend line she extrapolated the results to get a projection of the median PFS of about 60 months. As some have mentioned above, it’s a population study so your specific situation may be different. Half of the individuals who had the 90% reduction in PSA are projected (my MOs projection) PSA progression before 60 months and half after 60 months. So even though the results are encouraging, someone with 90% reduction could have PSA progression in less than 60 months. Next time you see your MO you could ask them to help understand better the LATITUDE results. I don’t feel comfortable with you relying on my MOs interpretation of the results. Hope that helps.
Thank you. I understand that unless they take into account all major prognostic factors , who will be falling into first 60 months and who will be falling into next 60 months is impossible to determine. There are so many variables when it comes to individual survival Some of these variables can be age, race, diet, physical activity, support system, resources for treatment, general health, genetic factor etc.
Wish everyone of us could fall on second half after 60 months.
One more question..Daniel..Are they counting from starting day of any treatment or starting day of castration resistance ?
I like your explanation about other factors that aren’t being captured in the projected months. Would be great if the study could do a regression with all the the variables they captured to see the impact of the variables you mentioned. The starting day is the beginning of ADT treatment with Lupron+Zytiga for mHSPC, so starting with treatment in the hormone sensitivity stage. The endpoint is when PSA begins to rise and the beginning of mCRPC. My understanding is that once mCRPC is reached the median OS is approximately 2 to 3 years, but I don’t know what study that comes from?
Thanks 😄
One additional thought: in the LATITUDE study if you take everyone together and don’t stratify based on response, the median time to progression is 33 months. That corroborates with some above who thought 50% chance for 5 years OS, since on average it’s 2 to 3 years for OS once the cancer comes back.
in reply to Danielgreer
Just to clarify, these are patients that are stage 4 and are initially treated with ADT and Zytiga together. So when you say, "the cancer comes back" you mean progression following ADT+Zytiga, correct?
The numbers you give make sense. Many of us started with ADT alone, maybe with early chemo then went on to Zytiga after castrate resistance. You pretty much come out to same place in the end, around 3-4 years before ADT + Zytiga is no longer effective.
Danielgreer in reply to
Hi Gregg57, yes, I know, it’s only more recently diagnosed guys that this will be relevant for. I think it was the LATITUDE study that established the most recent standard of therapy, i.e., Lupron with Zytiga and prednisone for mCSPC.
I think survival statistics helps nothing but annoying yourself.we can’t count on them ,It depends on the type,location and extend of metastasis . Here in this community you see many people who apparently have same condition and get the same treatments but their response is so much different So Don’t be stressed out by these numbers .you’re right specially in last 2 years guidelines and approaches have been changed a lot and now gene -related therapy is considered much more than before so hopefully this helps more men to have longer life
I am not a statistic.
You're 50% right.
But we all know that 78% of all statistics are just made up
78.23%, last time I guessed.
Screw statistics! Everyone is different. Eat healthy, find a doc you trust, love your wife. Take vitamins. Be happy. Time flies when you are having fun. Zytiga predisone lupron xgeva for 24 months and counting.
One important factor that I don’t th8nk has been mentioned above it what state you were in on diagnosis. For me, spread to 3 lymph nodes outside the pelvis. Some men who have ignored symptoms or just been unlucky have it all over on diagnosis. I know many men who died within 2 years in th3 latter group, personally I am still here 5 years on in the former group.
So, notwithstanding all the statistics comments, if you have spread to 3 or less sites outside the prostate and not in bones you probably have a very good chance of exceeding 5 years. If on diagnosis you were full of it all over, you probably have a lot less.
However, we could all get hit by a bus tomorrow so make the most of each and every day , no regrets and plan something good for the next day, works for me.
I don't put much faith in any statistics. Before finding groups like this i did research on statistics that led me to believe i would be long gone already. A quote from a breast cancer survivor is "if you believe you are going to die, you might do that". Their belief in keeping a positive attitude and staying active has helped them deal with cancer for 27 years. I prefer to hold that positive attitude and believe i have a chance to beat or change the statistics. So i go on with life as normal as possible.
Well Blair , I have had one hell of a ride. 7 years ago stage 1V prostate with Mets. Lupron and exgevafor 6 years, in remission. 3 years ago bladder cancer under control, new diagnosis now bladder cancer stage 1V. Have now gone thru chemo still battling these beasts. Hoping my urologist and oncologist can figure this thing out. Hey 7 years in still fighting. Keep up the faith brothers, to the newbies you got lots of time, I was told at the start 3 years. Was 78 at the time now 85 and shooting for 90.
When I was diagnosed in 2017, I spent hours looking online trying to see how much time I had left. All that did for me was to make me sad... and think about what life events I'll be missing. My son Joe is still in high school.
When I went for a second opinion, I asked for my prognosis. I'll never do anything like that again! I didn't like what he said (don't ask). When the shock wore off and reality set in I realized that what we are all going thru is not like an hourglass and our life is over at a preset amount of time. Besides there are too many forks in the road, treatment decisions to make, etc.
I do still like reading the findings for all of the trials though.
Blair, thanks for sharing the data!
Bob
I figure you're alive -- able to think, act -- until you aren't any more.
I asked the Wicked Witch of the West for a second opinion. She flipped an hour glass over and said "This is how long you have to live." Like many others here, I have already lasted longer than the expiration date I was given. Like Don Quixote I take up my lance and sword to fight the windmills that I shall discover on my way. Perhaps I'll see you, as we travel this strange and mysterious path. All my best.
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