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What?!? "Curing" oligometastatic prostate cancer???
I'm reading Dr Walsh's book cover to cover now, after skipping around to just the bits relevant to me the first time through. I noticed this throw-away comment in the section on PSMA-PET:
"Maybe it's just in one lymph node, or it's in a transitional state called oligometastasis: not widespread, but in just a few isolated spots outside the prostate and still possible to cure."
WHAT?!?! I've never heard "cure" mentioned for oligometastatic PCa, and the book's main section in Chapter 15 doesn't use the word. My own onco team has never used the word for my case, either. Is this some new research thinking that accidentally slipped into the book, or an old idea that hasn't been expunged yet?
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My post liver disease is considered SVR, sustained virologic response. They don't use cured.
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1 ReactionMy JH told me there was a 50% chance I was cured and a 50% chance my disease would recur but in a more indolent, less aggressive form which would be manageable long term. I was initially diagnosed with G9 and have had one bone met and one pelvic met. Had triple therapy and MDT as well as whole pelvic radiation. Off meds for almost 2 years with undetectable PSA. Was put on TRT more than 4 months ago and PSA continues to be undetectable. The testosterone has been like the breath of life for me.
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4 ReactionsCongratulations on continuing to be undetectable. We are just starting our journey. My husband is 62yrs, has G9 with 3 mets to bone. Did you have your prostate removed prior to the bone and pelvic met? Triple therapy has been proposed to us followed by IMRT to prostate/pelvic and SBRT to bone mets. What was your experience with chemo? Did it hit you hard? Also, how long were you on hormone therapy? Thank you in advance. 🙂
There are some who think in the oligo-metastatic state, PCa can be "cured." Some who do are distinguished medical practitioners. I certainly respect what they have to say. I actually "hope" they are right. Until there is more data supporting what they say, count me in "that's interesting" group.
There are others who say advanced PCa cannot be cured, it may be managed as a chronic disease given the plethora of existing advances in imaging and treatment.
Put me in the latter camp. I did triplet therapy, cured, heck no, long progression free survival period (PFS), yes, 4+ years.
I completed doublet therapy in April 2024, cured, too soon, progression free survival period, 14 months and counting. I told my urologist at the start when we settled on a treatment plan that if the outcome was 3-5 years PFS, I would consider that "success."
There are folks on this forum that 5-10 years after very "successful" surgeries their PCa has returned!
I do have two friends who had surgeries around the time I did in 2014, 11+ years later they see their urologist annually for labs and consults, talk about the weather...and close with see you next year! I will go out on a limb and say they are cured. So, if, when diagnosed your PCa is truly localized, it may be possible to cure, if not localized, even though imaging is negative, put me in the no category.
Even my surgeon when reviewing the pathology report and his surgical notes, did not use the word cured. He did say I should not have any future problems, which is close as he was going to get to say ""cured." Meanwhile I'm looking at the Mx in the staging and thinking, you don't know if it has spread!
Alas, I was right!
Kevin
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6 ReactionsYou're not wrong. There is no "cured" for any stage of cancer, really, just prolonged deep remission. The real question is whether the medical community has enough new tools now to keep many (not all) cases of oligometastatic PCa in functional remission until the patients make it to old age and die of something unrelated.
That's all "cured" ever means with cancer, but I'll gladly take it!