Those of us who have had a radical prostatectomy and then have our PSA return are experiencing what the industry calls a biochemical recurrence. As with all things prostate cancer, there is a lack of agreement on how best to clinically respond to our situation.
In the May issue of the Journal of Clinical Oncology, Freedland and colleagues from Duke, USC, and Johns Hopkins analyzed data from 379 of their patients who had experienced a biochemical recurrence. They found that post radical prostatectomy, which eventually failed, 77% of men will eventually die of prostate cancer if followed for 15 years or longer.
They also evaluated their PSA doubling time (PSADT). They found that men with a PSADT of less than 3 months represented 13% of all cancer deaths, those with an intermediate PSADT (3 – 9 months) represented 58% of all prostate cancer deaths, and men with a PSADT less than 15 months (n= 221) accounted for 90% of all prostate cancer deaths.
The clear message is that those of us who have a PSADT of less than 15 months have a 90% chance of dying from our prostate cancer within 15 years! Those of us with longer PSADT still have a 77% of dying from prostate cancer within 15 years of a biochemical failure!
We are fighting for our lives and must insist that our doctors provide us with the most aggressive and creative treatments that are available. We should also consider actively participating in clinical trials, as they become available, as these may provide be our best chance to extend our lives.
Freedland S.J, Humphreys E.B, Mangold L.A, Eisenberger M, Dore F.J, Walsh P.C, Partin A.W J Clin. Oncol. 25(13):1765-71, May 2007.
Joel T Nowak MA, MSW
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