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so i'm trying to fiqure out where my husband would be on this scale
his psa before the surgury was 9.9
6 months later 0.1
12 months later 0.8
then radation
6 months 0.2
than 12 months 0.7
here is the scale
Terry thank you so much !!!!
WHAT THE NUMBERS MEAN
If you have a Gleason score of 5-7 Your PSA increased more than two years after surgery
AND your PSA doubling time was greater than 10 months:
Your chance of not developing metastasis (having a bone positive scan) in:
Three years: 95 percent
Five years: 86 percent
Seven years: 82 percent
OR your PSA doubling time was less than 10 months:
Your chance of not developing metastasis in:
Three years: 82 percent
Five years: 69 percent
Seven years: 60 percent
OR your time to first PSA recurrence was less than two years:
AND your PSA doubling time was greater than 10 months:
Your chance of not developing metastasis in:
Three years: 79 percent
Five years: 76 percent
Seven years: 59 percent
OR your PSA doubling time was less than 10 months:
Your chance of not developing metastasis in:
Three years: 81 percent
Five years: 35 percent
Seven years: 15 percent
If you have a Gleason score of 8-10 AND your time to first PSA recurrence was greater than two years:
Your chance of not developing metastasis in:
Three years: 77 percent
Five years: 60 percent
Seven years: 47 percent
OR your time to first PSA recurrence was less than two years:
Your chance of not developing metastasis in:
Three years: 53 percent
Five years: 31 percent
Seven years: 21 percent
Thank you for the additional information Joyce – although you omitted the Gleason Score, which is one of the most important items. But I’ll assume that the GS was not greater than 7.
It is important to understand a couple of things about the table you referred to and to some general background issues, including this statement by one of the authors of the study:
''When men see their PSA levels rise again, they think that means the cancer is back and they need to get treated right '' says oncologist Mario Eisenberger, M.D., a co-author of the study. ''But men often live for years without having the cancer spread. This information will better equip doctors and their patients to decide what treatment -- if any -- is most appropriate.''
1. The study involved men who were diagnosed between 1982 and 1997 (or between 27 and 12 years ago). Many things have changed in the prostate cancer world since then, so although the article refers to the ability to predict the future course of the disease, of course it doesn’t. It shows what might happen.
2. The article refers to averages – the average time to metastasis, the average survival time, but it is likely the study would have referred to the median. It is important to understand that a median is the half way point in any measurement. So, for example if, as the study says, the median time it took for the disease to spread after PSA increase was eight years, then half the men would have had the spread in less than eight years and half would have had the spread more than eight years. So what is important to know is – what is the shortest time from rising PSA to spread and what is the longest time to spread. This is known as the range but unfortunately there are no references to range in the articles about this study, although there are some clues in the table.
3. Because your husband was diagnosed in 2007, his Gleason Scores would have been affected by what is termed “Gleason Migration” – see my note to Ron Crane in this connection.
4. This study only refers to men who had surgery – it excludes men who, like your husband had radiation therapy after surgery
So, looking at the data you have given (and assuming as I say that the Gleason Score was no higher than 7) , the first PSA recurrence was less than two years and the PSA doubling time was less than 10 months. This being the case it might be expected that the chance of not developing metastasis (spread) in three years is 81 percent; in five years it is 35 per cent and in seven years it is 15 percent.
Put another way, the figures in this table show a chance of developing metastasis (spread) in three years is 19 percent (or one in five); in five years it is 65 per cent (or two in three) and in seven years it is 85 percent (or seven in eight).
So there is a high chance, based on these figures, of your husband developing metastatic disease in less than the median of eight years.
Presumably it was for this reason that your medical advisors suggested immediate radiation therapy when the rising PSA was noted. Just how that therapy will affect the ultimate outcome is unknown because it did not form part of this study, but it should have improved the odds for you.
As things stand at the moment, based on the information from this site, it would be reasonable to say that there is a chance that your husband will develop metastasised disease in something less than eight years from February this year. Although the article says “…. Even after developing metastatic cancer (detected by bone scans and other imaging techniques), men still lived an average of five years….. later studies have shown that management of the disease with ADT (Androgen Deprivation Therapy) can extend the range of survival significantly.
For what it is worth, I have metastasized disease - a bone scan identified a metastasis on my rib cage in May last year. I have had ADT (Androgen Deprivation Therapy) which I have stopped for the moment. I do not expect that I will only live for four more years, but for a good deal longer than that.
This is complex matter and difficult to understand – it is also full of uncertainty – but I hope it has helped you in some way.
If there are still aspects that are not clear, please keep asking until it is clear. I think it would be a good idea for you to find a good oncologist and talk it over with him.
