Survival with T3b Prostate Cancer

Gord,

Welcome to our club that none of us chose on purpose. One tool that you can use is THIS: https://www.mskcc.org/nomograms/prostate/post_op

With your 4+3, that puts you to a slightly high risk level (high-intermediate) as opposed to a 3+4 which would be low-intermediate risk. A key factor will be your PSA 3 months from surgery. If it comes back <0.1 (or even better, something like <0.006) then you've got an excellent chance of never needing any additional treatment.

Not knowing all the answers (you'll need your pre-surgery PSA readings, and your post-surgery pathology report for things like margins or lymph node involvement), I made some basic assumptions and your PCa specific 15 year survival odds are >90%. Your odds of NOT needing additional treatment within 10 years is >70%.

To help us out to get to know you, you can create a signature line (go to profile and find the section for a signature)--in there you can put in the basics from your history--age, PSA readings before and after, and the high points of your pathology report.

As Rob indicates the T3b places you in the high risk category and indicates that surgery alone may not be enough to be curative. That your Gleason score indicated more than 50%of the PCa is G4 is also significant. I suggest that you prepare yourself for more treatment both mentally and physically.

For most men even high risk PCa can be managed for a long time if it wasn’t initially cured. The worst situation is when distant spread is evident at diagnoses. That does not seem to be your case. If the PCa is confined to the area that can be radiated then you have the possibility of a cure and the PCa would not have a direct effect of limiting life expectancy. If any PCa has spread outside the area, then it is generally not curable and has to be managed indefinitely.

When is your next visit with your urologist? Was there direct discussion when you learned of the surgical pathology? After surgery, it is normal to have a PSA test at the 90 day mark. Ideally the PSA should be undetectable. If there is PSA it usually indicates that there is cancer left that was not removed by the surgery and salvage radiation and ADT drug therapy is indicated.

Hal’s suggestion to use the MSK nomograms is good. Make sure you answer the questions regarding the extent of the PCa based on the T3b and full pathology report regarding the margins and any evidence of the cancer escaping the capsule. There are three specific questions to answer. These conditions can have a significant effect on the expectation of needing additional treatment. It will also ask about lymph node involvement. Were any lymph nodes removed during the surgery? If so, what does the pathology report identify?

Gord,

The guys that have responded have given you some good information. I am T3b and 5+4. I’m 3 years into the journey. I read about everything that I can. The best advice that I received was from Stuart Scott, former espn analyst. Stuart had a rare case of cancer in his appendix. The disease took him after 7 years. Stuart’s book is called, “Every day I fight.” Stuart’s advice was to never ask anyone how long you might live because it’s not up to anyone beyond your maker. It’s really true. We all want to know. I get that. Having said this, mental stability is our best weapon. I know that my disease will challenge my longevity therefore, I will live well while I can and avoid thinking about what nobody can answer.

I was the keynote speaker at a cancer research fund raising event on Navy Pier in Chicago. There were 1,300 people in the building. I closed my talk with this quote. It helps me develop my mental edge. It comes from a military story and was allegedly passed among the troops.

“Fate whispered to the warrior, you will never withstand the coming storm! The warrior whispers back, I am the storm!”

Some people think this is crazy. I think it’s right on. I think I know how long I will last. That’s what matters most to me. I wish you the best.

Great reply Naples. I'd like to read your speech. I just googled life expectancy and see that a 73 year old has about a 12 year life expectancy. Mine (for a 65 year old) is about 18. My guess is that neither one of us will reach our expectancy. So what? I never asked anyone before how long they thought I'd live and I'm not starting now. I'm living and enjoying. You should too.

This is a question of control - or lack of same. If you remain/become very active physically, eat right and live a healthy lifestyle you can literally add years to your life.

A recent study (longitudinal over 20 years) found that persons who got at least 2 & 1/2 hours a week of aerobic outdoor exercise (fast walk, run, jog, bike etc) plus at least 2 weight training sessions (load bearing exercise) a week had a 26% lower chance of dying from all causes and a 31% lower chance of dying from cancer compared to non-participants. There are several other studies that report similar results.

Additionally, there are a number of supplements that have been shown to have some potential of slowing/stalling prostate cancer (do a search or 2 online).

This means that there is no clear time limit for you, you have some measure of control, but it requires a very serious long - term sustained effort on your part.

MM, good to see you here.

Both my brother and I had the same as you. He’s 7 years out, no issues, I’m almost a year out with undetectable PSA. My thing is eat right, enjoy what you have. I’d check into a book called eat to beat disease by Dr William Li. Good advice. Be well!

Michigan man
Mike@meyergrowth.com aka Naples