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Q: Prostate cancer survivability ( Answered 4 out of 5 stars,   6 Comments )
Subject: Prostate cancer survivability
Category: Health > Men's Health
Asked by: headsetsdotcom-ga
List Price: $12.00
Posted: 09 Jun 2005 18:20 PDT
Expires: 09 Jul 2005 18:20 PDT
Question ID: 531616
i've heard that the survival rate for prostate cancer is about the
same whether someone get 'treated' or not.  Any data out there to
support either way?  I've priced this low but happy as always to tip
for over and beyone.  My preference is to get a response that i can
either read the summary and take as is, or i can read more if i like,
but i dont have to wade through lots of data to understand where its
going.  Thanks!

Clarification of Question by headsetsdotcom-ga on 09 Jun 2005 18:21 PDT
i'd like to get at least some data that ISN'T from drug companies,
medical institustion that have a vested interest in supporting the
"best spend money on treatment' school.

Request for Question Clarification by pafalafa-ga on 09 Jun 2005 20:04 PDT
The National Cancer Institute has a very good site on prostate cancer,
and they make the point that:

--a lot of men get the disease, especially later in life

--it manifests in a wide variety of ways, often-times symptom-free,
and with no obvious or serious immediate threat

--"watchful waiting" -- the term of art for no treatment -- is a very
viable strategy for many patients with prostate cancer.

In particular, the site notes the following:


...Many men who choose watchful waiting live for years with no signs
of disease. A number of studies have found that, for at least 10 or
even 15 years, the life expectancy of men treated with watchful
waiting (primarily older men with less lethal forms of prostate
cancer) is not substantially different from the life expectancy of men
treated with surgery or radiation-or, for that matter, of the
population at large.

So it seems that the answer to your question is "Yes, the survival
rate is the about the same", at least among the patients included in
the studies mentioned.

For patients with a more aggressive variety of the disease --
especially younger patients -- the watchful waiting strategy may not
be the preferred choice of treatment.

There is a lot of other material available at the NCI site which may
meet your need for additional materials to look through.  Please click
around, and then let me know what additional information I can get for
you to make for a complete answer to your question.

All the best,


Clarification of Question by headsetsdotcom-ga on 09 Jun 2005 22:29 PDT
Thanks Pafalafa,  yes, ok this makes sense. But for a 40 year old man
whats the stats on treatment?  here's my deal. I'm 40, have no reason
to believe i have it. But doctor says lets check you. Common reason
would say great idea.  But if they find a problem and the treatement
has as much chance of working as no treatment, then i wounldnt want
treatement, in which case why bother testing. I'd like to get real
stats, facts, so i can evaluate. FYI, i'm not losing sleep, i probably
wont go for any testing, but its got my curiosity of the value of the
whole thing.  hope this makes sense.

Request for Question Clarification by pafalafa-ga on 11 Jun 2005 16:11 PDT
I can look into statistics for 40-year olds, if you'd like, but I
really have to take issue with your overall premise.

Yes...there are numbers to suggest that for some groups of patients,
non-treatment can be just as effective as treatment.

So why get tested, you ask?  The answer is fairly straightforward: 
(1) to find out if you have prostate cancer, and if you do then (2) to
find out which group you belong to.

It's the latter point that is key.  If you belong the group that does
no better with treatment than without -- generally, patients with a
fairly mild form of the disease --  then you have one set of

But if you belong to a group with an aggressive form of the disease,
then treatment of some sort is the recommended course of action, and
the question then becomes, which sort of treatment?

So it's not an all or nothing affair -- you may be a 50-50 sort of
patient, and you may not be.  Hopefully, you're not a patient at all
as far as any sort of cancer is concerned.  But you still might want
to get a check-up.

Let me know what sort of additional information you might like on this
topic to make for a full answer to your question.

Thanks...and stay healthy.


Request for Question Clarification by cynthia-ga on 11 Jun 2005 19:53 PDT
The only information for "non-treatment" I found stated this was only
indicated in the EARLY states of the disease, in elderly men.  Here's
what I found, no sense in my keeping it to myself:

Prostate Cancer Survival Rates
..."The 5-year relative survival rate is the percentage of patients
who do not die from prostate cancer within 5 years after the cancer is
found. (Men with prostate cancer who die of other causes are not
counted.) Of course, patients might live more than 5 years after
diagnosis. These 5-year survival rates are based on men with prostate
cancer first treated more than 5 years ago. Men treated today may have
a more favorable outlook.

Overall, 99% of men diagnosed with prostate cancer survive at least 5
years. Further, 92% survive at least 10 years, and 61% survive at
least 15 years.

Eighty-six percent of all prostate cancers are found while they are
still within the prostate or only in nearby areas. The 5-year relative
survival rate for these men is nearly 100%.

For the men whose cancer has already spread to distant parts of the
body when it is found, 34% will survive at least 5 years..."

Prognosis of Prostate Cancer
There are lots of survival statistic numbers here. from many sources.

Prostate Cancer
..."Doctors will refer to the stage of prostate cancer by either a
number or a letter. In order to learn more about the most recent
information available concerning the treatment of prostate cancer,
click on the appropriate stage for detailed information on survival
rates with treatment..."


Clarification of Question by headsetsdotcom-ga on 13 Jun 2005 06:27 PDT
thanks Paf, and all for commentary on this one.  Yes, i realise it may
be the reason to get tested is see if there's a problem, and if there
is then which group.  But if in the high danger group, there's still
no realy eveidence that treatment outperforms not treatment, then why
bother getting tested and having a choice that is irrelevant?  I know
"get tested" is of course a medical mantra, but it would be as its
what they know and do.  I can get tested for baldness and find out i'm
bald, and pay for treatment, but all the evidence says i'll still be
bald, (ok weak analagy, its obvious i'm bald but you get my point.  So
i'm looking for is there any reason to get tested?

BTW, i've no reason to believe i do or dont have a problem, but the
doctor suggests i do a test, (that's what their paid to do), and i
want to consider if based on stats (not just drug/surgery company
motivated stats) there's any reason too.
Subject: Re: Prostate cancer survivability
Answered By: pafalafa-ga on 13 Jun 2005 08:23 PDT
Rated:4 out of 5 stars
One of the problems with modern medical therapies is that one often
has to make a decision about them in the absence of reliable, long
term statistics about their effectiveness.

This isn't really anyone's fault.  A cancer survivor who has survived
twenty years after first being diagnosed with, say, prostate cancer,
is a reflection of the success of a treatment approach taken twenty
years ago.  But it doesn't tell you much about more recent approaches.

For the case of prostate cancer, there is evidence to suggest that
some therapies are effective (more so than 'watchful waiting') for
some types of cancers.  For others, though, there doesn't seem to be
much of a difference between watchful waiting and active treatment, in
terms of overall disease outcomes.

And importantly, 'watchful waiting' itself is considered a 'treatment
option', and should not be thought as 'doing nothing' or a case of
treatment vs no treatment.  The watchful waiting does entail active
scrutiny as to the course of the disease, with the option of taking a
more active treatment approach should conditions change.  This is not
at all the same as having an undiagnosed case of prostate cancer, and
doing nothing to treat it as a result of not knowing about it.

Consider the following excerpts from the site regarding
Stage I (most localized) through Stage IV (most widespread) prostate
cancers (my own comments are in brackets):
Know Your Options: Understanding Treatment Choices for Prostate Cancer 

...Your chances of being alive, and disease-free, 10 or 15 years after
diagnosis are apt to depend more on the stage and grade of your cancer
than on the choice of treatment.

[this is similar to the sentiment of your question...your odds have
more to do with the nature of the disease than your choice of
treatment, which includes 'watchful waiting' as a treatment option. 
However, there are certainly profound differences to take into account
for each patient in terms of how their disease manifests itself, and
what treatments to consider]

Stage I and Stage II

...If your prostate cancer is limited to the prostate (Stages I or II)
and it is well or moderately differentiated (Gleason score 7 or
below), the 5- year outcome is considered excellent for all three
treatment options: watchful waiting, surgery, or radiation therapy.

[Again--and especially for Stage I and Stage II -- watchful waiting
can be as appropriate a choice as other treatment options. This is
especially true for older men]

...With a median age of 72 at diagnosis, many men with prostate cancer
die of a variety of other natural causes in the next 10 to 15 years.
Few men with low-grade localized disease die of prostate cancer. The
disease-specific survival rate-which excludes deaths from other
causes-is close to 90 percent. In other words, regardless of
treatment- watchful waiting, surgery, or radiation therapy-such a man
can consider his cancer a chronic disease because he is much more
likely to die of other causes than of prostate cancer.

[Re-emphasizes the same point as above -- watchful waiting can make
sense, especially for older men]

...Men with localized tumors who opt for watchful waiting, if they
live long enough, may run a greater risk of eventually developing
metastatic disease. In one series of studies, the chance of developing
metastases within 10 years was 19 percent for men with
well-differentiated tumors and 42 percent for men with moderately
differentiated tumors.

[But hold the's something to consider.  The watchful
waiters may, in fact, be running more of a risk than those actively
treating their disease in terms of future odds of metastases.]

...Only one small study has directly compared watchful waiting with
radical prostatectomy, and it found no significant differences in
survival. More reliable answers should be forthcoming from ongoing

[As I mentioned earlier, there's often not a lot of reliable
statistics to compare different treatment options, especially with
treatments changing over time.  But one small study, at least, doesn't
show much difference between the two options mentioned]

...Surgery or radiation therapy is chosen typically by those men whose
tumors, although apparently localized, are more extensive or poorly
differentiated (Gleason score of 8 to 10). Without aggressive therapy,
around three-quarters of such men will have developed metastatic
disease in the following 10 years, and twothirds will have died from
prostate cancer. Whether or not treatment can change these outcomes is
under study.

[For this group of men, a therapy more aggressive than watchful
waiting MAY be indicated, though again, the actual success rate of
different therapies has not yet been quantified]

Stage III

...External beam radiation therapy is often used to treat Stage III
cancers. Besides being less invasive than surgery, it is better suited
for bulky tumors. A few men have surgery, while others rely on
watchful waiting. Men whose tumors are reclassified as Stage III after
surgery (because cancer is found to have spread through the capsule or
into the lymph nodes) sometimes go on to have radiation therapy
postoperatively. Studies are in progress to evaluate this approach.

[More "studies are in progress" language, which hopefully will
elaborate on the differences between different treatment approaches]

Stage IV

...If your prostate cancer has spread to the nearby lymph nodes or to
distant parts of the body, it is called metastatic prostate cancer.
Hormonal therapy will generally improve symptoms and delay the
progress of disease for another 2 to 3 years. If just the lymph nodes
are involved, a man may use hormonal therapy to delay the progress of
prostate cancer even longer.

[An unambiguous statment that for this condition, some active therapy
makes sense, in that it can slow the progress of the disease].


This seems an appropriate time to remind you of the disclaimer at the
page-bottom, about GA being no substitute for professional medical

Bottom line on the write-up seems to be that precise
statistics comparing treatment options (including watchful waiting)
are hard to come by.  But there are bits and pieces of information to
suggest that there are indeed different outcomes in some cases, and
that active treatment approaches can make a considerable difference.

However, it does seem to come down to a judgement call.  Should I get
tested?  And if the tests show something, then what?  No one but you
can answer those questions.  But I trust the information I've provided
here will help you think through the options.

Let me know if there is anything else I can do for you on this.

All the best...and stay healthy!


search strategy -- Google search on  [ prostate cancer ]

Clarification of Answer by pafalafa-ga on 13 Jun 2005 11:54 PDT
Thanks, that was some very generous feedback. 

By the way, if there's something more you want by way of an answer,
just let me know what.  The information may be out there, it may not
be, but I'm certainly willing to take a look.

headsetsdotcom-ga rated this answer:4 out of 5 stars and gave an additional tip of: $20.00
Thanks Paf.  Not everything i wanted, but i supect you answered
everything available right now.  Appreciate the time and effort on it.
Well worth the fee and a tip.  :-)

Subject: Re: Prostate cancer survivability
From: czh-ga on 09 Jun 2005 19:50 PDT
Here is a long but very well written article by Andy Grove of Intel
about his experience with prostate cancer. He offers a fascinating
glimpse of his decision-making process about what treatment options
are avaialable and which one he should choose.
Subject: Re: Prostate cancer survivability
From: sailorbill-ga on 11 Jun 2005 19:37 PDT
I hope by now you've done some further research on your own.  I've
been diagnosed with prostate cancer and have spent hours and hours
reading books, looking on line, talking with doctors and surgeons and
with friends who have been treated.

As far as your question and the answer you received are concerned, I'd
like to point out that "watchful waiting" is suggested for men who

If you're eighty or if you're seventy with congestive heart failure,
watchful waiting is just the thing.  Because the chances are very good
that you'll be dead before the cancer has a chance to become a major

However, if you're young enough or in good enough health that you can
see yourself being alive ten years from the time cancer is first found
by biopsy, the there's nothing I've read that would suggest watchful
waiting.  For a man with ten years or more to look forward to, no
matter how aggressive the cancer, the choices are surgery, either of
two kinds of radioactive seed implants and/or external beam radiation.
 (With freezing a distant last.)

As Andy Grove says in the article cited by czh, he sits in meetings
with groups of men and thinks, "How many of YOU have had PSA tests?" 
It's the PSA that's making it possible for us to avoid very awful
years of advanced prostate and bone (that's where it usually goes)
cancer in later life.

My father was diagnosed before there was a PSA test.  That was only
fifteen years ago.  By the time they found it it was much too late for
anything but palliative therapy, mostly bone radiation and removal of
his testicles to stop hormone production.  Sound awful?  It looked
pretty awful to me.

I'm scheduled for surgery in July.  At age 61.

(For anyone interested, I had the choice of Johns Hopkins for the very
best hands-on operation but chose another hospital and "robotic
surgery" by a doctor who's done 1,000 radical prostatectomies using
the Davinci robot.  Outcome is said to be about the same but healing
is easier.  Wish me luck !)
Subject: Re: Prostate cancer survivability
From: crabcakes-ga on 11 Jun 2005 20:18 PDT
Well said, sailorbill!
Subject: Re: Prostate cancer survivability
From: 1tim-ga on 12 Jun 2005 07:22 PDT
I would like to add the one factor that is rearely discussed: QUALITY OF LIFE

I was diagnosed with PC 7 years ago at the age of 47. I would rather
have quality of life over quantity.  My father had PC and was treated
in his late sixties, this changed his life from being active to
getting up 7-10 times every night to urinate.  No more traveling,
depression and he died from another aliment.
If you decide on watchful waiting be sure to include a lifestyle
change(diet, emotional, spiritual, physical) . There is no right
answer for everyone, you have to do what you feel is best for you.
Subject: Re: Prostate cancer survivability
From: tlspiegel-ga on 13 Jun 2005 08:08 PDT
In reference to the Davinci robot, I answered this question:
recovering from da vinci prostate surgery
Subject: Re: Prostate cancer survivability
From: mrsb3-ga on 21 Jun 2005 11:04 PDT
sailorbill-ga.  am interested in what hospital you have chosen for the
da vinci surgery.  husband has same situation.  please help

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