Where are the Over Diagnosed and Overtreated?

When these threads start, I always expect these maimed individuals to come forward and angrily identify themselves as someone who has been overtreated.  Oddly, I think I may have seen only perhaps one such post in my three years at HW.  And when a survey was conducted a while back asking if participants here were satisfied with their treatment, the overwhelming reply was "Yes, I am satisfied."  Of course, it's then explained to us that this is a defense mechanism.....that these men refuse to acknowledge the obvious fact that they were, in fact, overtreated.

Sites like Amazon.com are filled with reviews from angry purchasers who are dissatisfied with their waffle irons and their digital cameras.  Review comments on those sites seem to show that people who feel ripped off or taken advantage of really don't seem hesitant to let the world know how they feel.

But here on HW, we see men who have been successfully treated who are, with all good intentions, determined to restrict those very same treatments to our fellow men who may need or desire it.  This seems odd, to say the least.

Testimony from those of us happy with our treatment is considered anecdotal, while testimony from men at support groups is considered conclusive evidence of overtreatment.

Yes, I understand that some men could probably live for many years with prostate cancer and die of something else before the cancer takes their lives, but does that equate to overtreatment if such a man decides to have surgery or radiation?  Or, has he simply exercised his choice, his human option, to take what he feels to be a legitimate course of action to minimize the likelihood of death by prostate cancer?  Or, as I've asked before, do we have men here on HW who vehemently support a "woman's right to choose" but who would deny men the same right to choose a medical procedure that they feel is important to their overall health?

So, if you're one of those hundreds of thousands of overtreated men, please come forward.  Given the way human nature operates, I would expect that overtreated men would flock to a site like HW to make their voices heard.  Or, if you regret having been screened, speak up, and please explain why you feel that way.  I really think we need to hear directly from you guys.  That would be a welcome alternative to hearing the successfully treated conjecture about over-diagnosis and overtreatment.

ed

Casey, there's no doubt in my mind, and I think I've expressed this many times, that it's a certainty that many men are treated for prostate cancer who would (or might) never have died from it.  I'm not sure that equates to "overtreatment."  Yes, it's treatment that (thankfully) turned out to be unnecessary, but we really have no way of knowing that minus an unexpected heart attack or traffic accident, or stroke, or something else, that man might have eventually succumbed to prostate cancer.  None of us possesses a working crystal ball, and divine revelation is a rarity.

I've also agreed many times that someone with Gleason 6, low volume prostate cancer should be very cautious about proceeding to radical treatment.  At the same time, I would never suggest that I have the right, or the government has the right, or anyone has the right, to tell a man in that situation that he CANNOT make the decision and request treatment.  That's a very personal and difficult choice for sure, and medical protocols should be put in place to ensure that these men, once diagnosed, are shown the reasonable courses of action available to them, and the downsides of those various choices.

But, I'm surprised you put yourself in the "overtreated" category.  Look where you are in your life:  newly married with, hopefully, decades of life ahead of you, with a couple of bright kids whose futures will unfold before your eyes.  I truly hope that your cancer surgery will help you stay around through those years.

My situation was a bit worse than yours, with six positive cores (though relatively low percentages), and a palpable tumor, Gleason 3 + 4.  But, since I was 65 at the time, I suppose it could be argued that I could have avoided the surgery, and that perhaps some other event might kill me before the cancer ever would.  But I don't think that's the way most of us live our lives.  We don't tend to avoid taking action today because unforeseen future events might render our current decisions unnecessary.  So, I put myself firmly in the "not overtreated" camp.

Good medicine will always involve some degree of "overtreatment."  People will undergo serious medical procedures only to learn that the doctors guessed wrong, or that the less than conclusive tests should have been interpreted differently.  In a perfect world, none of this would happen, but this world is just not perfect.  We've seen a lot of suggestions here on HW for reducing overtreatment.  I favor the ones that call for new treatment protocols, new methods of patient education prior to treatment. 

The claim of a million men living who have been overtreated seems to me to be a number based entirely on speculation.  That's about 25 percent larger than the entire population of Alaska and I have to wonder who came up with it, and how they arrived at it.