Biochemical recurrence and mortality risks following radiotherapy and radical prostatectomy.

User

Posted 01 Oct 2024 at 11:30

An interesting read on very recent Swedish research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495864/

User

Posted 01 Oct 2024 at 11:30

An interesting read on very recent Swedish research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10495864/

User

Posted 01 Oct 2024 at 14:59

That is an interesting article (In fact I referred to it myself in an earlier post.)

But it is worth bearing in mind that some of the mortality statistics presented in this sort of long term research (even though they are not at all bad) are likely to err on the pessimistic side because they are inevitably looking at men who may have been diagnosed and treated decades earlier.

I found this recent video by Dr Scholz which is quite upbeat about the prognosis for prostate cancer in general and even ends by suggesting that, because of the great improvements in knowledge and treatments in the last 20 years, together with a number of advances which are now in the pipeline, the mortality rate for men with localised prostate cancer diagnosed in 2024 is likely to be "close to zero".

https://www.youtube.com/watch?v=GU7Cuou6dYg

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User

Posted 01 Oct 2024 at 12:08

As always Adrian, It is difficult to pick the bones out of this report (or maybe I am just being thick...). I saw a report on the same website last week, which seemed to be saying that for patients where tertiary pattern 5 was found in the post surgery histology, only 19% survived 5 years without BCR. This was not particularly encouraging reading.

I guess we all just have to live 12 weeks at a time for a few years. I seem to remember reading that the median time for BCR was something like 18 months after primary treatment? Who knows.

I hope you are keeping well mate 👍

User

Posted 01 Oct 2024 at 12:18

Hi Ian.

Weirdly, it seems there is less chance of BCR if you'd had radiotherapy than RP, but more chance of dying. Seems a bit contradictory to me.

I must admit I spend far too long thinking of the risk of BCR, when that outcome is completely beyond my control. I must stop trying to prepare myself for bad news. 🙂

User

Posted 01 Oct 2024 at 12:29

I am just trying to forget about this and get on with my life, as the thought of being on HT for life is scary, so much so that I will seriously consider an orchidectomy should it happen.

User

Posted 01 Oct 2024 at 12:37

Hi Decho.

If I read the results correctly, it mentions that in Sweden, they seem to be cutting down on HT for those treated with radiotherapy for low/intermediate disease.

User

Posted 01 Oct 2024 at 14:59

That is an interesting article (In fact I referred to it myself in an earlier post.)

https://www.youtube.com/watch?v=GU7Cuou6dYg

User

Posted 01 Oct 2024 at 15:17

Ok so the difference in BCR risk is possibly down to the vastly different definition of BCR between RP and RT and the impact of residual PSA in RT cases.

The difference in PC specific mortality could be because RP patients were 3 years younger on average than RT patients.

It could have a big impact on my decisions as I definitely fall into the low risk BCR camp according to the study definition (>1 year DT and <8 Gleason and long time to BCR ) AND I haven't actually got to the threshold yet. Previous risk scores have always made my T3 a high risk cancer regardless.

User

Posted 01 Oct 2024 at 18:35

Originally Posted by: Online Community Member

The difference in PC specific mortality could be because RP patients were 3 years younger on average than RT patients.

RT patients may also have been less fit and had more comorbidities than those that had surgery. However, surely it would be impossible to ever have a level playing field when comparing the two radical treatments.

Presumably these differences were also present during the Protect Trial?

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