August 16, 2019

Case Stories: Réal, Jean-Michel and Louis

We have already shared the stories of Jean-François and Michel, Laurent and Charles, as well as those of Yvon and William. Here are those of Réal, Jean-Michel and Louis, extracted from the new book edition Prostate Cancer - Understand the disease and its treatments, 2019.

To learn more about the prediction tools found in these case stories, we invite you to click on Prognosis and survival to access the information.

"[…] Réal, 55, electrician"

“Réal is married and works for a large company as an elec­trician. His cancer scores 8 (grades 4 + 4) on the Gleason scale. He has a stage T3 tumour and a PSA level of 15 ng/mL. Partin table analysis indicates there is only a 6% chance the cancer is still confined to the prostate and a 26% chance it has spread to the pelvic nodes. The CT scan sug­gests his cancer has spread to the lymph nodes in the pelvis.

Given the lymph node metastasis, the chances of a cure are slim, even with surgery. In addition, Réal would like to minimize the risk of complications. He and his doctor decide on hormone therapy and radiation therapy

These two therapies together should help to control the dis­ease in the long term. Richard remains optimistic even if a cure is unlikely since he is well aware that there are options if the cancer recurs." (Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC, 2019, p. 119)

"[…] Jean-Michel, 67, retired math teacher"

“Jean-Michel is 67 years old and he is divorced. The doctor informs him that he is suffering from prostate cancer with a stage T2 tumour scoring 7 (3 + 4) on the Gleason scale and PSA testing at 8 ng/mL. According to the Partin table analysis, there is a 46% chance the cancer has extended beyond the prostate, but only a 9% risk it has affected the seminal vesicles and a 2% chance it has spread to the pelvic nodes. Jean-Michel is told that because the risk that the cancer has spread is quite high, he might need other treatments in addition to surgery. The doctor also informs him that the nodes will not be removed since there is such a low risk that they are affected. The Kattan nomograms are then used to calculate the risk of recurrence after five years, and Jean-Michel learns he has an 85% chance of being cured with surgery as his only treatment." (Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC, 2019, p. 98)

"[…] Louis, 64, foreman in a pulp factory"

“Louis’ prostate cancer scores 6 (grades 3 + 3) on the Gleason scale and his PSA level is 8 ng/mL. According to the Albertsen life tables analysis, there is a 68% risk that he will die within the next 15 years and a 23% chance that this will be due to prostate cancer; therefore, his chance of dying from other causes within this period is 45%. In other words, Louis is twice as likely to die of a cause other than prostate cancer sometime over the next 15 years.

The doctor suggests Louis opt for active surveillance instead of immediate treatment with its possible side effects. Louis doesn’t agree, however; he cannot imagine living with the sword of Damocles hanging over his head and insists on treatment. The doctor proposes surgery or radiation therapy, explaining the advantages and drawbacks of both. The doctor also uses the Kattan nomograms to calculate the risk of recurrence."(Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC, 2019, p. 84)

Take the time to visit each of our pages on this website, as well as our YouTube channel, in order to get familiar with the disease with our expert lectures, our section on available resources, the support that is offered to you.

Do you have any questions or concerns? Above all, do not hesitate. Contact us at 1 855 899-2873 to discuss with a nurse specializing in uro-oncology. It's simple and free, like all our services.

Pages of our site that might interest you
Want to know more? Just click on one of the links below.
Am I at risk
Signs and symptoms

PROCURE news that may interest you
Each week, we publish a blog article. Here are a few for you.
Case stories: Réal, Jean-Michel and Louis
Case stories: Yvon and William
Case stories: Laurent and Charles
Case stories: Jean-François and Michel
I was ready for anything except... Jean's story

Sources and references
Prostate Cancer – Understand the disease and its treatments; Fred Saad, MD, FRCSC and Michael McCormack, MD, FRCSC; Fifth edition, entirely revised and updated, 2019. © Fred Saad and Michael McCormack, 2019 - Annika Parance Publishing

Written by PROCURE. © All rights reserved - 2019

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