Watchfull Waiting

If you DRE was positive I think that they do not recommend WW also I thing it is the same if you have more than 2 cores positive This site might help make your decision http://urology.jhu.edu/prostate/advice1.php

Zimmer said...
I am looking into all of my options and considering WW and wondering if anyone has gone down that road , I understand that it
is not for everyone as every case scenario is different , but in my case with 3 out of 10 positive samples and the % being 1% in
2 and 3 % in 1. and a PSA under 5 it may be an option for me. I would like to hear from someone that is in a similar situation that
I am in and maybe is doing the WW....thanks

WW is a viable option for you. There's a few guys here who are doing it. I could've too and maybe would have but for a minimally invasive clinical study I underwent, TFT with cryo. Take your time deciding as I always recommend, with your numbers you have time to consider all options. Do take into account this is a heavily pro surgery site, and that is what most will recommend here. You are the one who needs to weigh possible quality of life side effects short lived to permanent against possible added longevity. Take your time for afterward there aren't any do overs with any treatment if you choose one.

Zimmer

It would be terrific to really know the true extent of our cancers without removing the prostate.  Even following accessment after removal, how fast would have it continued without surgery?  I was very close to your numbers, and was surprised to find the extent was different than expected.  With WW, would it not have changed dramatically?  I have no clue, but am happy to have fought it aggessively.  Your sitution could be completely different.  We hope so.  You'll get good advice at this forum.  Good luck with your decision.

One may want to consult with a cardiologist when considering waiting to have potential major surgery

Picture this, 58 and healthy, waiting 5 years , PC gets worse but now age is 63 and a heart attack occurred at 62. Surgery and recovery is far more complicated than it would have been at 58

Steve, you hit it right on the head

While a lot of people chose to wait and it may be ok for their situation, I suspect they are really not looking at the entire picture when they decide. That is normal as PC is 1st and foremost on their minds

Its human nature to procrastinate and to wish problems away

In my case I had received a positive Biopsy of "only" 1 core, PSA seemed low at 1.9

But I decided on Surgery for these reasons

1. PSA several months earlier was 1.2 rose to 1.9 fairly quickly
2. Positive Biopsy
3. I was healthy, no heart issues, no diabetes, very able to go through surgery now
4. I had medical insurance ( no cost to me to do this now).
5. I had no bladder or ED problems related to PC

Rest assured every one of those 5 items could change in 5 years

The most important thing I heard from every single Dr I saw, " this is not going to go away by itself, it will slowly but steadily get worse"

One Dr (not a surgeon) gave me this scenario:
You are driving your car and you discover your tire is slow leaking and needs air.
Sure as the sun will rise you are going to have to stop for air, either now, when its flat or somewhere in between.
What do many people do, they wait, could end up being ok when you stop, but you also risk stopping at a less than safe gas station, stopping in the rain, a full flat, blowout, ruined rim, worn tire etc. A lot can happen, doing nothing will not put air in your tire, you can control when you resolve this problem.

Zimmer,

Have you considered Seeding w/wo IMRT added. Looks like you could be a good candidate for that. With the WW, if you wait a few years and keep an eye on things closely, and the PC keeps creeping up, you will be older, and that in itself will make it harder when you finally do seek treatment. With your stats, you should still have all options in front of you.

David in SC

Zimmer,
5 years ago there were only a few doctors that recommended WW. Today there is a groundswell of doctors from every PC speciality arriving at this conculsion. As Scardio recently said, surgery is a pretty severe recommendation for those with low risk PC, because only 2% will actually die from it and 100% will suffer major complications. Klotz in his studies indicates that 3% of G6 pc is a varient and no treatment will result in a cure, regardless of the treatment or time of treatment. Hopkins says that delayed treatment is just as effective as immediate treatment.
So on one side you have all the data that says that low risk PC is just that, low risk and the cure is much worse than the disease, and on the other hand you have emotion that says "I just want it out now".
It's your body and your choice, but get all the facts before you make a decision that is entirely based on emotion. If you want to feel a little safer then get a color doppler or a 3D mapping to give you a better idea of the extent of your PC so you can make a more informed decision.
JT