What are the odds for real

[Jessie5]

Dx stage 3 w/ extraprostatic extension several areas PSA 20. Positive for ATM gene. My 50yo husband had prostatectomy 12/10/19 (g7, tertiary 5 at positive margins and aggressive cancer). Stage 4 now. First PSA at 3 months was 1.44–next few PSAs DT of less than 3 months. Axumin pet showed cancer in several iliac lymph nodes, area in sacrum and small area in bladder. He had his first Lupron shot in may (PSA at that time 2.7) and as of today radiation #14/38 completed. He is doing Lupron every 3 months indefinitely. The drs say at this point patients have up to a 40% chance of cure but at the same time they say they are pretty confident they can get him 5 years but unknown after that. What are the odds really? What are the chances the cancer is only in those few areas? What are we in for?

[pjoshea13]

Hi Jessie,

It's tempting to want a number. However, it's a single number that applies to the entire subset of men in the same situation. Your husband is an individual in that subset. You would learn more from a survival bell curve, but personally, I think that bell curves, medians and standard deviations are a distraction. They do not alter the things I do to improve my odds. In my view, a man can alway work to improve his position on that curve.

Some here rely solely on standard care & hope for the best. Others also target subclinical inflammation, altered coagulation, supplements, diet, etc. (We stay clear of crazy 'cures'.)

Being actively involved in one's treatment in a complementary way improves one's outlook & removes a feeling of helplessness.

Best, -Patrick

[Hidden]

Part of the problem is that people are most interested in their life expectancy right after diagnosis when there are the maximum variables ahead of them. You could come up with a median survival for stage 4 which I believe today is around 5 years. The problem then is you have to say plus or minus some other number of years.

It's like looking at a hurricane track when it's 10 days away. The "cone of uncertainty" as they call it is quite large. I think in another 6 months to a year you will get a much better idea depending on he responds to treatments and if the cancer progresses, etc.

It's really best to focus on living in the present tense and not really think about the future. That's how I've found happiness with this situation. I'm coming up on 3 1/2 years now since diagnosis. Nobody really knows how much longer they have anyway, there are just a lot of people that pretend.

[CalBear74]

Jessie,

There is no timetable for prostate cancer. In 2012 I was diagnosed stage four, Gleason 8, and two pelvic bone Mets. My Arizona Urologist put me on Eligard and Casodex. In 2015 I read Dr. Shamsuddin’s text “IP6 and Inositol “. I started taking IP6 powder. For more information see my previous posts. In 2016 we moved to Florida and my new urologist put me on Lupron. I am still on Lupron and not resistant yet. It will be eight years this fall. My MO Is satisfied and has not made any changes. He is the best oncologist at the Florida Cancer specialists and oncology research Institute: Dr. Mark Robbins.

Gregg’s Cone of Uncertainty analogy is brilliant. You can shift the path of your husband’s “hurricane” with the right decisions but knowing for sure what they are is more problematic.

[Tall_Allen]

I think he doesn't really have any chance of a cure using today's medical technology, but that doesn't mean he can't live with the disease. I think you should biopsy the bone metastasis in the sacrum before radiation destroys it (if it's not already too late). That may expand his life-extending options. If it's too late for that, he will have to wait for the next metastasis to occur.

[Hidden]

Bottom line.....no one knows.....not even the worlds foremost experts on prostate cancer. Six years ago they told me I had two years to live. At present my PSA is <0.1 and my scans are clear. I'm sure I have cancer cells all over my body but I will let my body and my Oncologist & Radiologist worry about it, my mind belongs to me, not cancer cells. I know prostate cancer is going to kill me but I'm sure as hell not going to dwell on it. I live a normal live and will continue to do so until the bell ring rings for the final round. Good luck.

[Gearhead]

If you heard your doctor say "40% chance of cure", I suspect that there has been some miscommunication. I suggest that you seek clarification on this. And I agree with other responders' advice regarding the impracticality of predicting life expectancy and benefits of focusing on and enjoying the present.

[j-o-h-n]

I went to a Gypsy fortune teller and asked her.... "Please tell me how long I have".....She looked into a crystal ball and replied "I can see that you will die during sex"..... So now I'm as happy as a pig in shit.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 08/07/2020 5:04 PM DST

[Hotrod65]

Only God has your answer...live in the present...I was told 6 yrs ago I might have 3-6 months to live, my Docs pushed the envelope, removed my prostate, had it extensively evaluated and Genomic sequencing from Foundation medicine indicated a HBM..High Burden Mutation which qualified me for several forms of precision targeted treatment, currently still in active treatment with checkpoint inhibitor immunotherapy..complete durable remission NED currently..can't ask for more than that..trust in continued advances in treatment that probably will never cure but certainly prolong our lives with Quality...God Bless.