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6 months after end of RT - good news

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User
Posted 28 Oct 2017 at 11:14

Hello all,

It is now 6 months since my RT and hormone treatment ended. I have just had my PSA result which was 0.5. The doctor said that I was "presumed cured" !! a phrase he used several times. I will have regular PSA tests everty 6 months but it is expected to stabilise at "your new normal"  he said.

I have had no bladder or bowel side effects in the six months, none. I cannot speak for sexual function, since I have not tried to test it and at age 68 it is no longer important to me. So I am writing this to give encouragement to those who have been just diagnosed, as I was 14 months ago, that there can be a good outcome with localised cancer, and that the hormones plus radiotherapy route is in my experience to be recommended.

I am very aware that there will be many others whose condition is less fortunate, and that I have been very lucky. There are many men walking around today with prostate cancer who don't know it. My message is to tell all your friends - Get your PSA checked Now! I started on this path purely by chance after a visit to a health talk at my local hospital and a visit to a helpful GP.

Paul

User
Posted 28 Oct 2017 at 11:14

Hello all,

It is now 6 months since my RT and hormone treatment ended. I have just had my PSA result which was 0.5. The doctor said that I was "presumed cured" !! a phrase he used several times. I will have regular PSA tests everty 6 months but it is expected to stabilise at "your new normal"  he said.

I have had no bladder or bowel side effects in the six months, none. I cannot speak for sexual function, since I have not tried to test it and at age 68 it is no longer important to me. So I am writing this to give encouragement to those who have been just diagnosed, as I was 14 months ago, that there can be a good outcome with localised cancer, and that the hormones plus radiotherapy route is in my experience to be recommended.

I am very aware that there will be many others whose condition is less fortunate, and that I have been very lucky. There are many men walking around today with prostate cancer who don't know it. My message is to tell all your friends - Get your PSA checked Now! I started on this path purely by chance after a visit to a health talk at my local hospital and a visit to a helpful GP.

Paul

User
Posted 29 Oct 2017 at 04:58
Hi paul. Have just read your message and find it very encouraging, I was diagnosed with localised prostate cancer in june and chose the path of treatment as yourself, I have just had my 4th monthly hormone injection and start rt on 2nd november. I wonder if you ever got really exhausted during hormone therapy?,I do and have just had to stop working because of it, my work (welder) is quite physical and I was so tired at the end of a shift I would just go to bed immediately after work, also get very tearfull as well.anyway paul im really pleased that that things are going well for you. All the best. Ian
User
Posted 29 Oct 2017 at 21:56

Here is some evidence:

 

The New England Journal of Medicine

10-Year Outcomes after Monitoring, Surgery,
or Radiotherapy for Localized Prostate Cancer
F.C. Hamdy, J.L. Donovan, J.A. Lane, M. Mason, C. Metcalfe, P. Holding,
M. Davis, T.J. Peters, E.L. Turner, R.M. Martin, J. Oxley, M. Robinson, J. Staffurth,
E. Walsh, P. Bollina, J. Catto, A. Doble, A. Doherty, D. Gillatt, R. Kockelbergh,
H. Kynaston, A. Paul, P. Powell, S. Prescott, D.J. Rosario, E. Rowe, and D.E. Neal,
for the ProtecT Study Group*

September 14 2016  NEJMoa1606220

Quote:

METHODS
We compared active monitoring, radical prostatectomy, and external-beam radiotherapy
for the treatment of clinically localized prostate cancer. Between 1999 and 2009,
a total of 82,429 men 50 to 69 years of age received a PSA test; 2664 received a diagnosis
of localized prostate cancer, and 1643 agreed to undergo randomization to active
monitoring (545 men), surgery (553), or radiotherapy (545). The primary outcome was
prostate-cancer mortality at a median of 10 years of follow-up. Secondary outcomes
included the rates of disease progression, metastases, and all-cause deaths.
RESULTS
There were 17 prostate-cancer–specific deaths overall: 8 in the active-monitoring
group (1.5 deaths per 1000 person-years; 95% confidence interval [CI], 0.7 to 3.0),
5 in the surgery group (0.9 per 1000 person-years; 95% CI, 0.4 to 2.2), and 4 in
the radiotherapy group (0.7 per 1000 person-years; 95% CI, 0.3 to 2.0);

Summary from Table 1

Out of 1643 men followed for ten years, there were 17 deaths from prostate cancer. 63 men showed metastases.

So this major study in the USA last year showed a survival rate for prostate cancer of around 99% over ten years for men treated for localised prostate cancer.  96% had no metastases.  I'll take those odds as a presumed cure. Furthermore, treatment today is more effective than it was ten years ago.

Paul

 

Edited by member 29 Oct 2017 at 22:16  | Reason: Not specified

User
Posted 30 Oct 2017 at 20:56

AC,

"very good chance of a cure".

This is a fair phrase and is exactly how I understood the doctor's comment. It is a statistical judgment, as I said. The statistics in the New England Journal paper support that. Actually, in that study  545 men out of 1643 were put on active monitoring, that is, they received no treatment until other signs indicated progression (mainly PSA). 8 of the 17 deaths and 33 of the 63 metastases were from this group. So, of the other two groups that started treatment from the beginning, the survival rate and the metastasis rate over 10  years were significantly better than 99% and 96%.

I think my chance of snuffing it from a cause other than prostate cancer, by the time I am 78  (10 years) is probably worse than 1%. I do understand that I have some control over some of those other risks.

Stu,

I do get your message. It could happen to me too. Thank you for sharing your situation. Everyone on the forum knows that each case is different, I am defending the doctor's comment because it was based on his lnowledge of my case and, importantly, what has happened to others being treated similarly.

Paul

 

Edited by member 30 Oct 2017 at 22:20  | Reason: Not specified

User
Posted 30 Oct 2017 at 22:12

I think all three of you have made good points - perhaps it is simply semantics as so many of us have uros / oncos and / or attend hospitals where the word 'cure' is never used, 'full remission' being what we all hope for and aspire to. Personally, I don't believe that any cancer can truly be cured in the current times but as a family we do a lot of fundraising for research to find potential 'cures' for brain tumours and prostate cancer in the future.

Keep well Paul - your treatment was clearly the best choice for you.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Show Most Thanked Posts
User
Posted 28 Oct 2017 at 17:23
Great news Paul - it's always nice to read the outcome of another member's treatment as I think it helps others with their decision making.

All the best for the future.

Kevan

User
Posted 29 Oct 2017 at 04:58
Hi paul. Have just read your message and find it very encouraging, I was diagnosed with localised prostate cancer in june and chose the path of treatment as yourself, I have just had my 4th monthly hormone injection and start rt on 2nd november. I wonder if you ever got really exhausted during hormone therapy?,I do and have just had to stop working because of it, my work (welder) is quite physical and I was so tired at the end of a shift I would just go to bed immediately after work, also get very tearfull as well.anyway paul im really pleased that that things are going well for you. All the best. Ian
User
Posted 29 Oct 2017 at 07:33
Hi Stocky. I did six months of HT, after the first 3 months i was fine. Then had 37 sessions of RT, IGRT. It wasn't until right at the end of these sessions that I had to stop work due to fatigue, partly due to not having a good sleep at night, the hot flushes waking me just about every hour. Was off work about 3 months and then did a gradual return to work.
User
Posted 29 Oct 2017 at 11:50

Hello Toad, Stocky,

Yes I did get tired during the hormone treatment, and also during the radiotherapy. I had 7 months of hormones, injections and tablets, and 20 sessions of intensity modulated radiotherapy. I had hot flushes and some poor sweaty sleeping. The poor sleep continued for a couple of months after the endof the treament but is gone now. Fortunately I am retired so I was able to take rests, though my wife is convinced that I had some mood swings.

Overall, the treatment was easy and non-invasive with minimal effects, to treat a serious condition. What more could I ask? It did take some time, however.

Best of luck gents,

Paul

User
Posted 29 Oct 2017 at 12:03

Hello Andrew,

I did not consider the doctor's comment to be a personal guarantee, but rather a statistical judgment based on the hundreds of cases that come through his department every year and the thousands of follow-ups.So it is better than a guess, and is not meaningless.  Maybe you have access to better statistical data than the Royal Marsden, or perhaps your personal situation has not turned out so positive? Of course I am conscious of such outcomes. Likewise there are other risks to be faced in my remaining years, there are no guarantees. A few weeks ago some fanatic put a bomb on the tube line which I used to travel daily for the treatment.

Best of luck,

Paul

User
Posted 29 Oct 2017 at 20:13

There is overwhelming evidence that talk of a cure at 6 months - in prostate cancer - is meaningless. Indeed, I have never heard of a reputable doctor, anywhere who would say that.

With many cancers, clear at 5 years is often called a cure. With prostate cancer, few doctors would look you in the eye at 5 years and say you are cured.

Ignore the facts if you wish. But they remain facts for all that.

Edited by member 29 Oct 2017 at 20:18  | Reason: Not specified

User
Posted 29 Oct 2017 at 21:56

Here is some evidence:

 

The New England Journal of Medicine

10-Year Outcomes after Monitoring, Surgery,
or Radiotherapy for Localized Prostate Cancer
F.C. Hamdy, J.L. Donovan, J.A. Lane, M. Mason, C. Metcalfe, P. Holding,
M. Davis, T.J. Peters, E.L. Turner, R.M. Martin, J. Oxley, M. Robinson, J. Staffurth,
E. Walsh, P. Bollina, J. Catto, A. Doble, A. Doherty, D. Gillatt, R. Kockelbergh,
H. Kynaston, A. Paul, P. Powell, S. Prescott, D.J. Rosario, E. Rowe, and D.E. Neal,
for the ProtecT Study Group*

September 14 2016  NEJMoa1606220

Quote:

METHODS
We compared active monitoring, radical prostatectomy, and external-beam radiotherapy
for the treatment of clinically localized prostate cancer. Between 1999 and 2009,
a total of 82,429 men 50 to 69 years of age received a PSA test; 2664 received a diagnosis
of localized prostate cancer, and 1643 agreed to undergo randomization to active
monitoring (545 men), surgery (553), or radiotherapy (545). The primary outcome was
prostate-cancer mortality at a median of 10 years of follow-up. Secondary outcomes
included the rates of disease progression, metastases, and all-cause deaths.
RESULTS
There were 17 prostate-cancer–specific deaths overall: 8 in the active-monitoring
group (1.5 deaths per 1000 person-years; 95% confidence interval [CI], 0.7 to 3.0),
5 in the surgery group (0.9 per 1000 person-years; 95% CI, 0.4 to 2.2), and 4 in
the radiotherapy group (0.7 per 1000 person-years; 95% CI, 0.3 to 2.0);

Summary from Table 1

Out of 1643 men followed for ten years, there were 17 deaths from prostate cancer. 63 men showed metastases.

So this major study in the USA last year showed a survival rate for prostate cancer of around 99% over ten years for men treated for localised prostate cancer.  96% had no metastases.  I'll take those odds as a presumed cure. Furthermore, treatment today is more effective than it was ten years ago.

Paul

 

Edited by member 29 Oct 2017 at 22:16  | Reason: Not specified

User
Posted 30 Oct 2017 at 15:27

Not so good if you were in the 1% or 4% who was daft enough to believe in the "cure"... A better form of words would be "very good chance of a cure".

AC

User
Posted 30 Oct 2017 at 18:44

Paul,

I tend to agree with Andrew, I had RP & RT in 2006, it took nearly 6 years before my PSA reach your level of 0.5. But there is no way I have ever thought I could be in the cure camp. It's now nearly 12 years since diagnosed and a recent PET scan shows that it has spread to 3 lymph nodes along my spine. I hope to have these zapped RT in the next couple of weeks. But a cure is not on the cards in my case, it never has been. It's just a case of battling on and fighting this bloody disease as best I can.

Cheers
Stu

User
Posted 30 Oct 2017 at 20:56

AC,

"very good chance of a cure".

This is a fair phrase and is exactly how I understood the doctor's comment. It is a statistical judgment, as I said. The statistics in the New England Journal paper support that. Actually, in that study  545 men out of 1643 were put on active monitoring, that is, they received no treatment until other signs indicated progression (mainly PSA). 8 of the 17 deaths and 33 of the 63 metastases were from this group. So, of the other two groups that started treatment from the beginning, the survival rate and the metastasis rate over 10  years were significantly better than 99% and 96%.

I think my chance of snuffing it from a cause other than prostate cancer, by the time I am 78  (10 years) is probably worse than 1%. I do understand that I have some control over some of those other risks.

Stu,

I do get your message. It could happen to me too. Thank you for sharing your situation. Everyone on the forum knows that each case is different, I am defending the doctor's comment because it was based on his lnowledge of my case and, importantly, what has happened to others being treated similarly.

Paul

 

Edited by member 30 Oct 2017 at 22:20  | Reason: Not specified

User
Posted 30 Oct 2017 at 22:12

I think all three of you have made good points - perhaps it is simply semantics as so many of us have uros / oncos and / or attend hospitals where the word 'cure' is never used, 'full remission' being what we all hope for and aspire to. Personally, I don't believe that any cancer can truly be cured in the current times but as a family we do a lot of fundraising for research to find potential 'cures' for brain tumours and prostate cancer in the future.

Keep well Paul - your treatment was clearly the best choice for you.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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