Am I Cured?

Being cured is what it is all about.  At least, it certainly is what all cancer patients dream about, the magical and miraculous goal.   To be cured is the opposite of having cancer, it is to have a second chance, to be born again and be alive and not have a clock ticking down.

We never know for sure if the cancer is cured.   Sadly there is no test you can do to prove the cancer is cured.  If you do another biopsy and it comes back all clear that’s great news, but there still could be cancer cells “hiding” in the prostate.  All we can say is that there are no signs of the cancer, and that there is a certain percentage chance that it is cured.  After treatment the PSA blood test should drop down to a low value, and stay there.  The more months and years that have passed since treatment is completed and the PSA remains low, the higher the chance that it is in fact cured.

For example, if we treat an early prostate cancer with IMRT radiation there may be a 90% chance that it will cure the cancer.  If 5 years have passed since treatment and the PSA is less than 0.5, I would say that there is about a 95 – 98% chance it is cured.  If 10 years have passed and the PSA is at 0.1 then I would say there is about a 98 – 99% chance it is cured.

You can never really be 100% sure you are cured of cancer, but you can be 99% sure if enough time has passed!   This is probably why some doctors are reluctant to say “you’re cured”, because they can never be 100% sure.

The Cure-O-Meter 

Cure, is in fact, a moving target. It is a statistical chance, a probability. It is almost never a 100% certainty. The chance continuously alters, like the arrow on a speedometer. Imagine having a meter that goes from 0% to 100% and continuously shows the chance that you are cured.  Once the treatment is finished and you have that first good PSA test, the cure percentage shoots up, maybe to 90%. With every good PSA, with every good checkup, and with every year passed the percentage goes up and up, slowly climbing towards 100%. But with every new ache, pain, or PSA jitter it stutters, halts, and reverses. If a recurrence is ever diagnosed, the cure-o-meter shoots back down towards zero. However, just like the cure-o-meter may never quite reach 100%, it also may never quite reach 0%. Even when there is a recurrence there still can be a chance of eventual cure. The cure-o-meter only finally reaches 100% when someone who is in complete remission (no signs of cancer) dies of other unrelated causes.

Q) I have heard that you can never truly be cured from cancer.
A) False.  You can be cured.  The majority of prostate cancer patients in the US are cured, i.e. the cancer never recurs during their lifetime.  However, you can never be 100% positive that you are cured.

Q) Is there a certain point in time that I can be confident that I’m cured?
A) I have found that the first 3 years following radiation are the most critical time, when cancer recurrences tend to happen.  If your PSA is very low, less than 0.5 at the 3 year mark, then there is an excellent chance that you are cured.

 

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