Measuring Prostate Cancer Treatment Success

Who Remained Prostate Cancer Free?

You want your prostate cancer treatment to be successful. But how does one measure prostate cancer treatment success. Often, a successful prostate cancer treatment is measured by survival. If the patient does not die during treatment, was the treatment successful?  Even if the cancer returns?  Prostate Cancer Free Foundation, aims for a much higher standard. We want the cancer to go away, and never come back. That is what we call success; anything else is failure.

The Best Method for Measuring Prostate Cancer Treatment Success

Measuring the Prostate Specific Antigen (PSA) level is the most important, and most common test to measure success of treatment of prostate cancer.  Regardless of the treatment you receive, the PS Blood Test is the test you will have each time you have a medical visit.  This is the test you and your doctor will use to determine if your cancer is controlled or not.  If PSA levels become elevated after treatment, it will mean you need further tests and very likely further treatment. The tests and subsequent procedures following an elevated PSA level after treatment can significantly worsen the quality of your life. Before deciding on an initial treatment, you need to understand how well that treatment does at controlling the cancer. What is the chance that you will need further treatment? PSA progression rates provide a level playing field to compare the different treatments.  Initially, PSA is used as a cancer screening tool. But after treatment, PSA is used to monitor for the recurrence of cancer.

 Why Measuring Survival is Less Important than Measuring PSA?

Using survival as the measure for a successful prostate cancer treatment does not tell you whether the cancer is gone. Only PSA level can tell you that. If you fail the initial treatment, and your cancer returns, you can live with prostate cancer for many years. For example, one treatment can have a prostate cancer control rate of 80%, but because patients can live with their cancer for a long time, the survival rate may be 95%. It is important to know the likelihood of requiring additional treatment and also the effects of additional treatment. Failure of the primary prostate cancer treatment will have a large impact on the quality of life once the cancer returns.  The measurement used by the Foundation, “Percent PSA Progression Free”, is an estimate, prior to treatment, of a particular treatment failure rate, and the likelihood of not requiring additional treatment. Survival measurement does not provide this important information. Please understand this important point. If the survival rate of competing treatments are equal, this does not mean the cancer control rate, long term side effects, or the quality of life are equal.

Why Survival is a Poor Measurement of Success?

After initial treatment, a rising PSA level indicates treatment failure. For this reason it is a strong indicator of a successful prostate cancer treatment. Survival reflects not only cancer treatment deaths but also all other reasons for death. For example, comparing a younger patient group receiving surgery with an older population receiving radiation can lead to very misleading results. The members of the older group may have other medical problems, and their survival rate may not have anything to do with success of the prostate cancer treatment, because other factor were responsible for their deaths. Many researchers don’t bother to tell you that their patients are 10-15 years younger, and in better health, than the comparison group.

Why would the author of an article, or cancer center marketing material choose to only tell me about survival and not PSA control?  The authors who write those articles have all done PSA testing on their patients so they are certainly capable of reporting PSA-based results. The only reason not to report them is that usually, the PSA results are poor and reporting overall survival makes their results look better. Prostate cancer treatment is a business. Bad results are rarely reported in medical literature because all medical literature is voluntary. Editors and publishers have no requirement for an author to follow any specific rules when reporting results.

What is the Impact on my Life if the Cancer Returns?

Fortunately, with backup treatment, survival can still be good. However cancer failure is accompanied by diagnostic tests and treatments that are ongoing for many years. While death can be often averted by secondary treatments, these treatments can come at a high cost to quality of life and much greater expense. It is better, by far, to choose the most effective treatment, and eliminate the cancer on the first try.

Here is an example: Consider a patient whose PSA rises after surgery. He will typically undergo 7 weeks of IMRT radiation, where the control rate is about 30%. Therefore, for a sample of 100 patients treated with surgery, if the failure rate from surgery is 30%, 30 patients will receive second treatment of radiation, and only 10 of those will have long term cancer control. The other 20, who fail the secondary treatment, will likely receive lifelong hormonal and or chemotherapy treatments. This treatment castrates the men and costs the system tens or hundreds of thousands of dollars per year per patient. Typically they will eventually fail this therapy and continue to suffer, as more experimental (and more expensive) approaches are attempted.

Prostate Cancer Free

Thirty Six Prostate Cancer Experts have analyzed the treatment outcomes of over 129,000 patients across the globe, following these patients for up to 15 years. The success of a treatment is determined by monitoring PSA for years after treatment. This data is presented to you, so you can see which treatments leave patients prostate cancer free. Watch this video to learn more.


Prostate Cancer

What is Prostate Cancer?

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Prostate Cancer Tests and Diagnostics

Prostate Cancer Recurrence.

For Some, Cancer Returns After Treatment.  Compare Treatments. Increase Your Odds of Remaining in Remission.

Prostate Cancer Treatments

Treating Prostate Cancer.

Patients have options when it comes to the prostate cancer treatments. Learn about your treatment options.

Remission versus Recurrence?

Relapse of prostate cancer is way more common than you might think. Many men treated for prostate cancer have their cancer return, which can lead to a lifetime of treatment. Prostate Cancer Free studies treatment outcomes documented in "The STUDY", recently updated for 2021. Take this Study to your doctor, and discuss your chance of cancer recurrence. The Study is available with the new, just released booklet, to help you learn about prostate cancer. Both the Prostate Cancer Free Study and the booklet, “What You Need to Know About Prostate Cancer” are available NOW for you to VIEW, PRINT or DOWNLOAD.

Get The Study

Help To Continue the Work!

The Prostate Cancer Free Foundation, reviews the results of hundreds of thousands of men treated for prostate cancer. Tracking them for years. This information is available to you, and others like you, to help find the best prostate cancer treatment. This work takes time, effort, resources all of it done by volunteers. Please help us continue. Please Donate!