Doctor, tell me the truth—how long do I have to live?

Survival and clinical metastases among prostate cancer patients treated with androgen deprivation therapy in Sweden. By Banefelt et al. 2014 

 

Key sentence from the paper: “[For prostate cancer patients, who are without confirmed metastasis when initiation ADT after biochemical progression], the 5-year cumulative incidence of metastasis was 18%. Survival was 60% after 5 years; results were similar for bone metastasis-free survival.”

 

For the full abstract, see: http://www.ncbi.nlm.nih.gov/pubmed/24875326

  

Commentary: When hormonal therapy no longer works, the disease is formally described as metastatic castrate-resistant prostate cancer (MCRPC). There is no getting around the fact that MCRPC is lethal. Sadly we have no curative treatments for the disease at that point, and what the physicians can best offered to patients at that stage is palliative care.

Many patients entering palliative care legitimately would like to know what their chances are for surviving the next few years. According to this paper, about half of those patients will survive more than 2.7 years, but the variation is large. There may be differences in the survival based on other health variables and genetics. The median estimate of 2.7 years is good for Sweden, but one has to be cautious in generalizing that number to other populations for the rest of the world. 

 

Banefelt J, Liede A, Mesterton J, Stalhammar J, Hernandez RK, Sobocki P, Persson BE. 2014. Survival and clinical metastases among prostate cancer patients treated with androgen deprivation therapy in Sweden. Cancer Epidemiology. 26 May 2014 [Epub ahead of print]