Prognosis of untreated G9+?

We all know the true G6s can possibly go a long time- or a really long time- with no treatment and no death from PC, not even mets or other problems. At least a lot of them can.

But what about untreated G9s-10s? Like me. What if I had said to heck with it, I'd rather die. Or what if I just never got around to that PSA test and the Bx that followed until several years later than I did?

Any one seen any statistics on this? Obviously men still die from PC. I just lost a HS friend- a couple of years younger than me- to PC at age 63. I know no other details like Gleason. But are there any statistics on how long the average G9 could expect to make it if they did not have any treatment? What % would be alive(on average) at 1, 5 and 10+ years? Any one have any idea?

Bill in MS

"But what about untreated G9s-10s? Like me. "

Like You?? You are not untreated. You had surgery...A survival prognosis at this point is impossible. Your PSA is undetectable..Without a doubling time, your survival can only be speculation...

Difficult question Billy. My Uro told me to expect 3-5 years, with treatment. Where he got those numbers I have no idea, I'm not banking on those numbers but he certainly didn't mention 10-15!

Cheers, Doug

My 67yo brother is G9 with lymph involvement at diagnosis. Pre-treatment, his local Dr gave him 5yrs. He got radiation treatment in his home town and is seeing Myers. about a year ago when he first saw Myers (pre-treatment), he gave him 80% chance of something else killing him. At his visit this month, Myers said his response to treatment was so good it "made my Friday", and said he won't die from this cancer. Doesn't mean this is the end of treatment but he will start reducing Zytiga in Aug.

Thanks Michael, I don't put much into any of the numbers I receive, other than the "hard" test results. I'm just merrily going on my way, it is what it is and I'll deal with things as they come. Right now I'm in remission until a PSA test tells me I'm not!

Cheers, Doug

Thx everyone for the replies in this probably unknowable question.

Fairwind said...
"But what about untreated G9s-10s? Like me. "

Like You?? You are not untreated. You had surgery...A survival prognosis at this point is impossible. Your PSA is undetectable..Without a doubling time, your survival can only be speculation...

OOPs, obviously some incorrect wording on my part. Maybe I can still go back and edit that, since I am in no way asking about me. Obviously, though any G9 would be like me because we are G9s, I am asking strictly about untreated G9s. The WWs or ASs of the G9 world you might say, though I doubt there are many(or any) of folks in that category on purpose!

EDIT: no, I don't think I need to edit that now that I look back at the post, because I said " Like me. What if I had said to heck with it, I'd rather die. Or what if I just never got around to that PSA test and the Bx that followed until several years later than I did?". So the like me was a like me IF. Probably still poorly worded but I'll leave it as is for now.

Post Edited (BillyBob@388) : 3/25/2015 10:08:05 AM (GMT-6)

Redwing57 said...
Well, here's an interesting link about untreated prostate cancer.
http://www.aboutcancer.com/prostate_untreated.htm

At the bottom of the page is a link for Gleason 8-10, and it presents graphs I've seen somewhere else too.

It's stratified by age at diagnosis. The younger one is diagnosed with high risk cancer, the more chance of succumbing to PCa. It seems the overall survival curve is the same, but death due to PCa is a smaller percentage if one is diagnosed at an older age. That makes sense, since other causes become more significant with age.

Jerry

Fixed your link

Well, there it is I guess! Apparently there are G9s-10s who choose conservative therapy? "A recent study (JAMA 1998;280:975) in men aged 55 to 74 who did not receive active therapy for their prostate cancer, looked at the odds of dying of cancer in 15 years based on their Gleason score as noted". Who would have thunk it. And I am also surprised to see that- even in apparently untreated men? - that age 65-69 men, only about 65% have died from PC at 15-20 years? For the younger men, looks like about 78% have died in 10 years, about 40% in have died in 5 years? Actually, these figures are not quite as bad as i would have thought, if this is indeed untreated. And I hope I am not reading the graphs backwards.

I guess the older you are at Dx, even with a G8-10, the more likely you are to die of something else? So for 70+, only 50% have died at 10 years, I guess because 50% have died of something else before the pC can do them in. Actually amazing to me.

But equally shocking is looking at the G6s. So I guess you can die from an untreated G6? Looks like at 20 years, about 20%(age 55-59) have managed to die of PC, while way more have died of something else. The age thing oddly reverses, and age 70-74, 30% have died of PC in 20 years, though almost 100% are dead from whatever.

So according to this, the G8-10 are not quite as bad as I would have thought, and G6 a bit worse.

81Guy, good link, I had forgot about that!

Like you said, they have all or most been treated, but still good to see the survival rates!

celebrate life said...
Billy, I am fairly certain Gary had PCa for three years prior to dx when he went to the Dr for difficulty urinating and his DRE was "suspicious" and needed to be "kept an eye on". Too bad his Dr forgot to do so and neglected a psa test. If only I knew then what I know now. I hope I can help educate others about young men and PCa and hope the medical community quits dropping the ball. Our story is not uncommon.

So sad but true: we must be able to correctly advocate for our selves when we enter the world of doctors.

Those are more like the stats I've seen, it is what it is.

Cheers, Doug

I agree with Michael T, "But...being devil's advocate here, does the period covered in Walsh's book include the period when treatments like Provenge were available, and drugs like Zytiga?"

In my husband’s case he was a G8 with bone mets to the spine when diagnosed in 2005, it is now 10 years later and despite spinal cord compression surgeries and various treatments he is still very much here. Amazing really!

Enjoylife, (Cathy)

The Walsh "dictum" is probably the most quoted statistic in the field. It actually deals with BCR. It goes like this, and mentions not grade. The reason is it comes from a study or maybe trial fro John Hopkins. TA would know... I got that info from one of his posts, i.e. where the stats came from.{ I read the stats in walshs book In 2009.} Great book, 90% of the questions asked have respectable answers in his book and follow up editions. Anyway, the dictum: the average time from "official" BCR, .2 with 3 successive rises, to Metastazation is 8 years{ member all grades are included}. Then 5 years to death. the kicker here is that means if untreated{secondary kine} The kicker to the kicker is the untreated part is supposition on my part as Walsh does not mention whether it is or not If anyone Knows please share that particular. More suppositions such as mine will confuse the issue , I feel. Even mine might anyway, but there it is…...but then again… How do you gather enough secondary untreated man in a study/trial. So as usual in anything….. caveat emptor. My feeling about the whole death schtick, is regardless of age, that time will appear, and it matters not, 99% of folks will not like it when it does. Ya know, the feeling we all have, especially in the present paradigm. Where the heck is the time going,…Damm.?! So Eat…Pray…Love and keep rowing the boat, but not faster than the flow….and certainly don't row backwards. I mean Who do you think you are anyway??? Tee Hee! PS If you say to yourself " It HAS to mean with secondary treatment " That will mean zip. I'm going with no treatment,{doesn't HAVE to} cause Im a dreamer until some one awakens. I saw a lot of Disney movies as a kid and actually believe in SantyClaus.

Shaba Doug It was an attempt on my part to add additional knowledge to Billy Bobs question. In no way was it an attempt to solve any individual's particular situation. That is to be understood, anytime studies, trials, statistics or any data points relative to a problem whose solution is still unfound. I also hope that like yourself, none of us put stock in negative data points to our particular situation and always invest faith and hope in those qualities that promote life. That, in my view, is the holy grail of all this crap and quite frankly the raison d'être of its genesis. fwiw!