Cure

Once again the urology/oncology community have been throwing around the word cure in regards to guys with advanced disease. I posted the link on my blog as well as my opinion in regards to my own personal case. It has probably already been posted here but I thought it to be an interesting read.

Hi Allen,
IDK really. I know Dr. V has stated that he believes I am a good candidate. Treatment has come so far in my 11 years since DX with many treatment targeting different mechanisms of the disease. Common practice is to leave the Prostate once disease has spread. It is the only cancer that we leave the mother ship. Studies have shown that if men with advanced disease have the Prostate removed and treat the mets with everything in the book that curative results are not only possible but have occurred.

Your right Allen. No studies! Just data on a number of men who were found to have Metastasis after Prostarectomy. There were a percentage of these men who were treated aggressively in regards to the mets. For all intended purposes, a high % of these men are considered cured. I will pull numbers when i am not at work and using just my phone

What the hyped media reports are referring to is the following study on 20 patients at MSKCC:

A Pilot Study of a Multimodal Treatment Paradigm to Accelerate Drug Evaluations in Early-stage Metastatic Prostate Cancer

The men, who were newly diagnosed with oligometastatic disease (either distant LNs or bone), were treated with ADT, prostatectomy, ePLND and SBRT to detected mets (in that order). After 20 months of follow-up, 4 of those patients (all with bone mets) had undetectable PSA (bNED) after their T levels recovered. 1 of the 20 patients is now 5 years from therapy with bNED. They plan to expand the study, and I hope, add a matched control group.

I would love to see the systemic therapies they employ expanded to include immunotherapy, chemotherapy and nuclear medicine. Maybe they can at least identify the characteristics of the patients who are potential responders, even if it is only 1 in 20.

Todd,
Thanks for posting that, for all of us with advanced PC, Allen thanks for your replies.
To me, the whole cure/not cured business is moot. If depends what one defines "cure" as. I choose not to define it as most would, being disease free,and not even terms as "biological,no evidence of disease". But rather I see my cure as I see my faith, and define it as the substance of things hoped for, (even in) the evidence of things not seen. I already found my "cure" and my Faith strengthened when I survived past the 3 year 'death sentence' that an idiot Urologist imposed on me.

I think it is encouraging that PCa treatment has reached the state where some Doctors actually mention cure and PCa in the same sentence. Much like in previous years and still today, many Doctor are adverse to even using the term 'Remission' . They don't want to disappoint or be seen as inaccurate or even give out 'false hope' if the cancer returns. However, some of us live in a world of unscientific, unproven, unstudied world of belief. However I would never term that as 'false hope", only hope not fulfilled as yet.

Clicking into that article cited by Todd about the MSKCC study, it states "

"The Sloan Kettering doctors are to be commended for their hopeful vision and their methodical work; but we are many years away from proof that this potentially costly, aggressive and potentially harmful combination makes any long-term difference to men with this distressing problem," he says.
"The doctors are taking the correct approach to building the evidence and we should pay attention to work like this with an appropriate optimistic skepticism in the hope they might be on the right track."
President of the Urological Society of Australia and New Zealand, Adjunct Professor Peter Heathcote, says multi-modal therapy for early metastatic cancer is the developing paradigm in many cancers.
While this pilot provides proof of concept for early metastatic prostate cancer with acceptable morbidity in 20 men, it should not be considered as standard of care.It will, however, stimulate further research and is an incremental step towards improving the survival rate and lives of men with this cancer.

Read more: www.afr.com/lifestyle/health/mens-health/provocative-study-raises-possibility-of-a-cure-for-advanced-prostate-cancer-20170424-gvr2ti#ixzz4gJAjGwlF

"Appropriate optimistic skepticism",?- Now that is an odd dichotomy for us!"!
Whatever you believe, I think we are all for more research and more "incremental steps towards improving the survival rates and (quality) of lives of men with this cancer."

Wings