My doctor and surgeon know prostate cancer inside out.

There is sometimes an immunotherapy solution, perhaps a cure, to prostate cancer, but it’s rare. I’m one of 2-3% of men whose PC has these 3 attributes: MSI-H dMMR, and high TMB (tumor mutational burden).

There was evidence that my prostate cancer was completely eradicated but for various reasons we stopped the immunotherapy too soon. There are cases, rare, of men who were entirely free of PC after immunotherapy of 2 years

Back to the odds: of the 2-3% of men w the “right” kind of tumor, only half respond and about half of responders have a complete response (NED).

So maybe 1% of prostate cancer patients will have a complete response to immunotherapy. Therefore, the population of compete responders is small & data on how they fared 3, 5, 7+ years out is nonexistent.

So - yes, we have no bananas and yes we have no immunotherapy cure for PC but if some of the complete responders are NED at 5 years+, we may start using the C word - but for only the extremely lucky 1%.

Btw, this is true for other cancers. The “miracle”, highly-publicized cure of multiple rectal cancer patients ant Memorial Sloan Kettering involved only patients with the genetic attributes I listed above. GI cancers have far more incidences of these “right” mutations and tend to be more immunogenic. But it’s important to remember that in most cases, immunotherapy only works on specific types of tumors. When the press picked up on the Msk miracle story, they often left that detail out. To Msk‘s credit, they put it in the press release.

I’m going overboard writing about this because I want people to be aware of immunotherapy but I don’t to mislead anyone. It’s a longshot and over-reliance on it may have been behind my advance to stage 4.

I want to try immunotherapy again but not until my lymph nodes get radiation & not without firm agreement on when we pull the plug if it doesn’t appear to be working