In order to get FDA approval, drugs must first go through a clinical trial that demonstrates that they offer a better treatment result than the current standard of care. In some instances the better result can be a demonstration that the investigational drug provides an advantage which is only palliative (as Mitoxantrone does for advance prostate cancer), but the best treatment result is survival. Survival is the gold standard of positive results; extending life is the ultimate goal.

The pivotal clinical trial for prostate cancer chemotherapy using taxotere showed that it provide a median of 2.5 months additional survival over the then standard of care, Mitoxantrone. Cabazitaxel, which was just approved by the FDA to treat men who have failed chemotherapy with taxotere, provides a 2.4 month additional survival time and Provenge adds an additional 4.1 months of survival.

Recent debates have rocketed into the public debate about the economic value of these survival advantages as the median survival advantages are measured only in months while all these treatments come with extra side effects and significant additional economic costs. The big question is are these extra months of survival really worth the possible negative effects on your quality of life a