Michael Milken and Prostate Cancer: What a Public Disclosure Can Teach

What he has said about 1993

Michael Milken has spoken publicly about his own prostate cancer for more than thirty years, and the Prostate Cancer Foundation, which he started, publishes his account on its own site.

He was 46. At a routine physical he asked for a PSA blood test. The foundation records that his internist was reluctant, thinking him too young for one. The reading came back dangerously high, and a biopsy confirmed an aggressive prostate cancer that had spread to his lymph nodes. A bone marrow test came back clear.

He told AARP the diagnosis came in January 1993 and that he was told he had 12 to 18 months to live. The foundation's account puts the figure slightly differently: at a conference he attended shortly after diagnosis, a researcher presented survival for men with high Gleason scores whose cancer had reached the lymph nodes but not the bones as a range of twelve to twenty-four months, with a median of eighteen.

AARP reports his cancer was treated with hormone-lowering drugs and radiation. The foundation adds that the radiation was three-dimensional conformal external-beam treatment, and that he was fitted with a custom mold to hold him still during it. It says his PSA fell to zero and that he has since had three decades of remission.

He founded CaP CURE in 1993, the forerunner of the Prostate Cancer Foundation. That is what is public. Nothing beyond it is inferred here.

What "spread to the lymph nodes" changes

The prostate sits below the bladder. Cancer that stays inside it is one situation. Cancer found in the pelvic lymph nodes is another, because the nodes are the first place the disease travels to on its way elsewhere.

NCI's health-professional summary is careful about what that does and does not mean. Prostate cancer may be cured when localized, and it frequently responds to treatment when widespread. Growth rates vary from very slow to moderately rapid, and some men live a long time even after the cancer has reached distant sites such as bone.

Three things drive the outlook: how far the tumor has extended, its histological grade, and the PSA level. Grade is scored by the Gleason system, which AJCC converts into five Grade Groups running from Gleason 6 or less up to Gleason 9 or 10. Our page on Gleason scores and grade groups explains the scoring.

What treatment involves

Hormone-lowering treatment is called androgen deprivation therapy. Prostate cancer cells generally depend on testosterone, so the drugs cut off that supply. It is often combined with radiation when the disease is beyond the gland but has not reached distant organs.

NCI flags one trap worth knowing about. Androgen deprivation can lower the PSA level independently of what the tumor is doing. Clinicians cannot rely on PSA alone to judge whether hormone treatment is working; they have to follow clinical findings too.

Radiation technique has changed a great deal since 1993. Conformal external-beam treatment shapes the radiation dose to the target, which spares more of the surrounding tissue than older methods. Our page on radiation therapy covers what a course involves.

The numbers

NCI cites five-year relative survival for US men diagnosed from 2014 to 2020 as greater than 99% for local or regional disease, 37% for distant disease, and 97% across all stages.

SEER's current figures put five-year relative survival at 98.2% across all stages for cases diagnosed in 2016 through 2022. About 69% of cases are found while still confined to the prostate and 14% in nearby nodes, both at 100.0%. For the 9% found after spread to distant organs it is 40.1%. Separately, the American Cancer Society projects 333,830 new US cases in 2026 and 36,320 deaths — a forecast SEER republishes rather than a registry count.

NCI also explains why the headline number is so high, and it is not only better treatment. Widespread PSA screening finds many tumors with little or no lethal potential. NCI puts the prevalence of clinically indolent tumors at 30% to 70% in men over 60, based on autopsy studies of men who died of unrelated causes. Many men, especially with localized tumors, die of something else without ever being disabled by prostate cancer.

That is the honest frame for the encouraging figures. They combine real progress in treatment with a change in who gets counted.

When to get checked

Screening is a discussion for men who feel well, and the age at which to have it depends on risk. These symptoms are a reason to book now:

• A weak stream, or trouble starting or stopping urination
• Passing urine much more often, particularly waking at night
• Blood in the urine or the semen
• Pain or burning when passing urine
• New, persistent pain in the back, hips, or pelvis

For screening itself, the US Preventive Services Task Force sets ages 55 to 69 as the range in which PSA testing should be an individual decision made with a clinician, and recommends against it at 70 and over. NCI notes that some organizations advise routine PSA testing from age 40 or 45 for men at higher risk, including Black men, men with inherited BRCA2 changes, and men whose father or brother had the disease. Our page on prostate cancer screening walks through the conversation.

What this does not mean

• One man's outcome is not a forecast. Grade, extent, PSA, age, and other health conditions all shift the picture, and none of them are public here beyond what he has said.
• The 12-to-18-month figure he was quoted was a group statistic from 1993. It described men treated with the drugs and radiation of that time.
• A PSA of zero after treatment is a good sign in context, but NCI cautions that hormone therapy can lower PSA regardless of what the tumor is doing.
• "Aggressive" is a clinical description resting on grade and extent, not a fixed category. It does not correspond to a single number.
• Asking for a PSA test earlier than a guideline suggests is a decision with trade-offs in both directions, and it belongs in a conversation with a clinician.

Sources

• Prostate Cancer Foundation, Mike's Story: A Journey of Determination and Impact — https://www.pcf.org/our-work/our-founders-story/
• AARP, Prostate Cancer and the Progress to Zero Deaths — https://www.aarp.org/health/conditions-treatments/info-2023/michael-milken-prostate-cancer-survival-rate.html
• NCI PDQ, Prostate Cancer Treatment (Health Professional Version) — https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq
• NCI, Prostate-Specific Antigen (PSA) Test — https://www.cancer.gov/types/prostate/psa-fact-sheet
• USPSTF, Final Recommendation Statement: Prostate Cancer: Screening — https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening
• SEER Cancer Stat Facts, Prostate Cancer — https://seer.cancer.gov/statfacts/html/prost.html

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

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