If you or someone you love has been diagnosed with prostate cancer, you are probably asking, “What are the odds of survival?” As you read through the summaries of clinical studies, you’ll discover that there’s more to beating prostate cancer than simply living. Researchers have words such as distant metastatic-free survival to help them determine the effectiveness of a treatment. Specific definitions and research protocols indicate that a treatment effective in a study will also be effective in other men today and in the future. Below are definitions of terms that will aid your understanding of the results of the clinical trials.
Keep in mind that clinical trials most often compare similar therapies. For example, studies that compare general prostatectomy to cryotherapy are much rarer than studies which compare brachytherapy with neoadjuvant external radiation therapy to brachytherapy alone. Therefore, you should not look at the general survival rate of one study and assume that study’s treatment to be superior to a separate study’s general survival rate based on numbers alone. The numbers cannot tell you what to do, but the results can tell you what has worked for other men.
Here are the terms that will help you analyze the results of the studies:
Prostate cancer-specific mortality refers to those who have died as a result of prostate cancer, while the disease specific survival rate counts only the deaths that have resulted from prostate cancer. In most cases, prostate cancer usually grows very slowly, henceforth, an older man with a typical case of prostate cancer is more likely to die of a natural cause or other illness. Compare the above terms with overall survival which is the number of men who have not died as a result of the prostate cancer or treatment. At this point in time, there is no evidence that says the overall survival rate of any treatment is better than another.
Patients who are counted in the overall survival rate even if they still have prostate cancer may be termed as follows: Distant metastatic free survival is prostate cancer which is not spreading into other distant areas of the body. Distant lymph node metastasis, for example, is the extension of prostate cancer into lymph nodes other than those adjacent to the bladder. The lymph nodes adjacent to the bladder are known as regional lymph nodes. Metastases-free survival rate and progression free survival rate refer to the number of men whose prostate cancer is contained within the prostate gland. Right now there is no significant difference in these types of survival rates.
Survival rates which measure biochemical relapse rates are the best indicators of whether the treatment was successful in both destroying the disease and preventing recurrent prostate cancer. Biochemical recurrence free survival, biochemical relapse free survival, biochemical failure free survival, biochemical-free recurrence, biochemical progression free survival, and biochemical disease-free survival are all terms referring to the PSA level. After treatment, if the PSA level does not rise for at least 2 to 3 PSA tests, the patient does not have biochemical failure or biochemical relapse or biochemical disease. The cancer has been ablated and is therefore neither growing nor spreading. The PSA level should be nearly undetectable, and, if remaining so, the effectiveness of prostate cancer treatment gains validity.
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