Survival of male reproductive cancer (or any type of cancer) as described in medical literature can mean different things depending on the type of survival. When “survival” is discussed, it could mean anything from disease-free survival, disease-specific survival, event-free survival, progression-free survival, relative survival, or total survival.
Disease-free survival is the length of time after treatment that a man experiences a complete remission in which cancer is not detectable in his body, or the percentage of men who experience complete remission for a certain time. For example, if a type of male reproductive cancer treatment results in an 80 percent disease-free survival over five years, eight of every 10 men experience complete remission for five years after treatment.
Disease-specific survival describes the proportion of men who have one type of male reproductive cancer who do not die of that cancer after a specific time. These men may still be alive or may have died of some other cause. For example, 70 percent disease-specific survival for a certain type of male reproductive cancer means that 30 percent of the men who have that cancer die of the cancer and 70 percent either are alive or die of some other cause.
Event-free survival is usually used only in clinical trials to describe the length of time after treatment that a man remains free of certain negative events determined by the type of clinical study. Negative events may include severe treatment side effects, recurrence or progression of cancer, or death due to treatment side effects or due to cancer.
Progression-free survival describes the length of time during and after treatment that a tumor does not grow, including the amount of time men have partially or completely responded, as well as the amount of time the disease has not progressed.
Relative survival is the anticipated amount of time a person who has a particular disease will live, compared with people the same age who do not have that disease. Relative survival gives an idea of how much a particular disease is expected to shorten his life. Relative survival is often expressed as the percentage of people who have the disease who survive five years, divided by the percentage of the general population who will be alive at the end of five years. For example, if the five-year relative survival for early testicular cancer is 98 percent, the proportion of men who have testicular cancer who are alive five years after diagnosis is 98 percent of the proportion of the general population who are alive five years later. In other words, five years after diagnosis, the population of men who have testicular cancer has 2 percent fewer survivors than the general population does, or the chance of a man’s being alive five years after a testicular cancer diagnosis is 2 percent lower than it is for all men.
Relative survival is usually calculated for specific stages of cancer, which take into account the size of the tumor, whether or not it can be surgically removed, and spread to lymph nodes, bone, or other organs at the time of diagnosis. This is important, since survival is higher when male reproductive cancer is diagnosed early than when it is diagnosed after it has spread.
Relative survival considers only deaths due to the cancer, and not deaths due to accidents, heart disease, other cancers, or other causes.
This is the expected amount of time a person will live before dying of any cause. Total survival reflects the risk of dying of a specific cancer, plus the risk of dying of any other cause, such as an accident or heart disorder. Cancer experts calculate total survival as a way of figuring out how many years of life are lost as a result of having cancer. This has a major impact on choosing treatment. For example, a 90-year-old man who has a small prostate cancer is much more likely to die of another cause than of prostate cancer, so surgery to remove the prostate cancer may not be necessary. However, a 45-year-old who has a cancerous prostate has a higher risk of dying of metastatic prostate cancer if the mass is not completely removed.
See also survival rates.