What are the Odds No Cancer Ever Returns After a radical prostatectomy

Posted by bens1 @bens1, Oct 22, 2022

I had an MRI and it showed a lump in the prostate. My biopsy is November 1st. I have a friend who had a radical prostatectomy 22 years ago, is 72 and cancer free. I read in some of the posts that cancer has, or may have returned after a radical prostatectomy. Has anybody seen a number indicating the cure rate with a radical prostatectomy with no future treatments necessary? I admit I am looking for some glimmer of hope that it is a longer term solution. I am almost 70 and otherwise healthy.

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That will depend...

When you have your biopsy report, that will give you some clinical data if it shows prostate cancer.

If that clinical data leads you to a treatment decision (if it showed Gleason Score 3+3, you may decide on active surveillance vice treatment) , and if that treatment decision is prostate surgery, the next piece of clinical data will be the pathology report. That will indicate Gleason Score, the amount of involvement of the prostate cancer in your prostate (10, 20, 30%...), whether or not there was involvement of your seminal vesicles, margins where the prostate was removed were negative (or not), and other data. Your surgeon would also have his surgical notes.

That pathology report could be use in a nomogram to give you a population based statistical probability of a recurrence.

https://www.mskcc.org/nomograms/prostate

Kevin

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I agree with kujhawk. I hope you’ve also discussed the possibility of radiation as an initial treatment. Radiation, if appropriate for your case, is much more effective than it was 22 years ago when I had my surgery. It also can have less side effects if done by experienced doctors and techs. Information that has helped me along the way has come from PCRI.org. The Prostate Cancer Research Institute.

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Hello,
Good question. There isn’t any “one best” option. I know, I went all over the map before I had my surgery last January. Good luck and keep your options open.

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Great success with 3 mos injections of Zolodex to stop testosterone the fertilizer of PC

Need to remain castrate sensitive, not resistive to ADT

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@kujhawk1978

That will depend...

When you have your biopsy report, that will give you some clinical data if it shows prostate cancer.

If that clinical data leads you to a treatment decision (if it showed Gleason Score 3+3, you may decide on active surveillance vice treatment) , and if that treatment decision is prostate surgery, the next piece of clinical data will be the pathology report. That will indicate Gleason Score, the amount of involvement of the prostate cancer in your prostate (10, 20, 30%...), whether or not there was involvement of your seminal vesicles, margins where the prostate was removed were negative (or not), and other data. Your surgeon would also have his surgical notes.

That pathology report could be use in a nomogram to give you a population based statistical probability of a recurrence.

https://www.mskcc.org/nomograms/prostate

Kevin

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Thank you, Kevin. Part of the conundrum is even if everything is confined to the Prostate, is radiation/Androgen therapy a better decision than prostate removal. Since you wrote this my brother called from NYC and said he has prostate cancer and is going with a radioactive insert placed between his prostate and adjoining areas and his cancer is confined to the Prostate. Its almost as if one is deciding on which side effects and processes are more or less appealing, general effectiveness notwithstanding.

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@scullrower

I agree with kujhawk. I hope you’ve also discussed the possibility of radiation as an initial treatment. Radiation, if appropriate for your case, is much more effective than it was 22 years ago when I had my surgery. It also can have less side effects if done by experienced doctors and techs. Information that has helped me along the way has come from PCRI.org. The Prostate Cancer Research Institute.

Jump to this post

Thank you scullrower. I will consider radiation as well. As I mentioned above to Kevin, my brother has prostate cancer and has been told brachytherapy with, as he describes, a radioactive disk (did not mention seed) is inserted by/in prostate.
I did go to Pcri.org. Lots of great info.

I have yet to see a decent comparison of results, side effects and inconveniences between prostate removal and radiation/hormone therapy choices.

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@jerryegge

Hello,
Good question. There isn’t any “one best” option. I know, I went all over the map before I had my surgery last January. Good luck and keep your options open.

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Thank you, Jerry. So what made you decide on surgery?

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Hi, I was diagnosed at age 72 with prostate cancer. My doctor recommended surgery. He had extensive experience; however, it had been in a small town in Wyoming. I decided to get a second opinion from the Mayo Clinic. Between appointments, I listened to videos from PCRI and talked others who had radiation and surgery treatments. I got a variety of different ideas on what was best. At this point, I was interested in radiation. Then I talked with two doctors at the Mayo Clinic. They both recommended surgery. This was based upon where my cancer was located in my prostate. While it would be more difficult to recover from RP surgery, I decided to go that route. Also I liked the fact there are no residual longterm side effects. However, sometimes there are some that develop after five years from radiation.
I had surgery in the morning and went home in the afternoon. So far, I’m happy with my outcome. I’m an active person and have been able to continue with that lifestyle, which I’m grateful for. Good luck and keep looking at your options. It’s a big decision; my wife and I spent a lot of time discussing this and came to the same decision in the end.

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@bens1

Thank you scullrower. I will consider radiation as well. As I mentioned above to Kevin, my brother has prostate cancer and has been told brachytherapy with, as he describes, a radioactive disk (did not mention seed) is inserted by/in prostate.
I did go to Pcri.org. Lots of great info.

I have yet to see a decent comparison of results, side effects and inconveniences between prostate removal and radiation/hormone therapy choices.

Jump to this post

Sounds like you’re doing your research. Excellent! It’s important to take charge. Knowledge is power and helps one’s mental state. I have emailed questions to PCRI and the volunteers there are quick to respond and helpful. You might ask them about comparisons between radiation and surgery.

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Friend who had seeds died a few years later

I had 40 radiations best process as they attempted robotic surgery but stopped it as it would have made me incontinent as the cancer was close to the Apex

Forget sex Testosterone is the fertilizer of PC

Get on Zolodex injections which keep my psa 1.2

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