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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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web265 | @web265 | Nov 20, 2022
In reply to @pamperme "I had an RP in September 2022 and the 6 week PSA was <.02. While I..." + (show)
@pamperme

I had an RP in September 2022 and the 6 week PSA was <.02. While I was informed everything is good some of the biopsy of the prostate bothered me. The biopsy of the prostate said the tumor focally approaches to margins at right bladder neck and peripheral margin at right mid. Cautery artifact precludes definitive evaluation of margin status. It also says extraprostatic extension present extensive at right anterior , lateral and posterior, apex to base and left posterior, mid. The tumor was 30% Gleason pattern 4 cribform identified. I am now waiting 3 months for next PSA. Should I be looking at anything else. It was rated 3a

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unfortunately this is the psychological side effect of this disease...
There's really nothing to do until you see rising PSA. Hopefully it doesn't rise but if it does the likely next step would be some variant of Salvage Radiation Therapy + ADT.

Should you be looking for anything else? Maybe making sure you're on a healthy diet, staying as active as you can and trying to enjoy your life as much as you can to keep your mind off your PSA. Other than that, I think it's a waiting game at this point.

As @melcanada suggests, ADT might be something to ask about, my doctors didn't start me on it until a chemical recurrence happened.

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mrscott | @mrscott | Mar 30 11:41am
In reply to @mrscott "It's a numbers game, as doctors don't have tests or scans that can examine every cell..." + (show)
@mrscott

It's a numbers game, as doctors don't have tests or scans that can examine every cell in your body (or at least not one you survive), so how could they tell? What is available is statistics for men with similar disease, age, etc.

Please see the 2022 Virtual Conference Day 1 at the PCRI.org YouTube channel, there's lots of info and IIRC percentages for each treatment.

What I am seeing as having the best numbers for my situation is EBRT + ADT + HDR brachytherapy boost.

If getting ADT, the side-effects are nasty (it has to harm the cancer cells, after all, and they are not as different from normal cells as would be convenient for treatment) so there are mitigations you really want to do.
https://youtu.be/6duRbpY-WkI

All I can say for the treatments is that they beat dying.

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This was a response early in my research, before I really understood that the treatments do damage as well. None of the options (including not getting treatment) are good (increase overall health or are fun) *as such*; however if you have Gleason 4 or above, usually treatment beats dying early in extreme pain. Unless something else is going to get you before the (usually slow) PCa does.
The goal is to spend wisely; get enough treatment, without over-treatment. And to keep monitoring for recurrence.

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jacksgland | @jacksgland | Mar 31 1:28pm

Your glimmer of hope is your friend at 72 with no clinical recurrence
This is a funny disease with no certitude ( even your friend).
My cancer came back 13 yrs after RP. No treatment till my PSA blew out to 120. Am 83 and on relugolix and daralutamine.
Labs are undetectable, no certitude. Jk

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