PC: GUIDELINES for who needs treatment, who does not.

Clock, you have my vote on your last post, I think our friend Jack is missing the entire forest for the trees with his campaign here at HW PC.

It is a peer to peer support site. This is Peter Waite's vision and mantra here.

Way back, we did agree to the "big tent" approach, so all types of posts/threads could be made to feel welcome here.

We all have our doctors, and we are not suppose to doctor bash. We are not remotely experts, let alone to take the place of sound medical advice from real doctors and real PC experts.

I don't see the point of this thread, it seems to be feeding the mind and ego of the OP, Jack. Who is now nit-picking each and every sentence that has been written, especially his own verbiage. By numbering his sentences, one could almost pretend it was Holy Writ or scripture. It's not, it's just one member's opinion based on other PC expert's opinions. Not even first hand knowledge.

We do a great job generally of welcoming and comforting all those that come though our portal. And I am saying that on almost 6 years experience here. There are times that we have done better than at others.

And we have had these battle of the mind/wit contests before. They come and go, they get people all upset, and at the end of the day, no one changes their mind or opinion as a general rule. So why go there?

Our best advice here, is not by re-hashing reports and studies, that often are way beyond the scope of what a new comer is expecting to see or hear, but by offering help felt support, encouragement, and sharing of our own one on one personal experience dealing with the beast itself. How a person deals with ED issues, incontinence, surgical troubles, recovery issues, and the list goes on and on.

That's my opinion, and my feeling, and I will stick to what I do best at HW. And its sure not giving intense technical advice or hammering the nuances of any particular expert or study.

To Jack, you might want to try to lighten up, its not fair for you keep bringing up it's either that, or vacation photos. It is a big tent here. We enjoy OT threads from time to time, there are those here suffering from all kinds of horrors in their post PC-world, and those threads make a good mental distraction, and also show the humanity side of being a PC guy.

Don't try so hard to be right, or to look smart. You may win the battle, but you will lose the war.

Respectfully, and without anger or hostility,

David in SC

hrpufnstuf said:
"I think many primary care doctors are counseling their patients about the pros and cons of testing. Mine did. He wanted my permission to do it whereas before it was routine."

Over at my website pcadvocates.org, in the PCAF post john eludes to, an internist states that he does in fact discuss pro's and con's but that it has made little difference in the decision to screen. here is that post:

advancedpcatalk.freeforums.net/thread/125/screening-unchanged-regardless-uspstf-recommedation

Also today in the New York Times is a blog post by Dr. Barak Gaster, dedicated to talking to patients before screening...

tinyurl.com/n3snyq2

Interestingly the doctor makes reference to a decision all 50yo men must face. I found that curious because all the talk and resentment about guidelines and USPSTF recommendations etc, nothing has changed ~ at all. This doctor refers to a guideline that is no longer really in place. Makes no mention of high risk factors to screen earlier. And truly states what I have know to be true, screening is on a rise not a decline.

JohnT's quote is right, screening and treating is habitual in the medical establishment. Even in men that probably don't need either. But the "error" on the side of litigation prevention is probably the #1 driving factors. Perhaps it is as Klotz says when I asked him when we were on the air together "it's only a matter of time before lawyers start suing doctors for over treatment". I'll add "and over screening".

O.K. then..... this thread (and others currently and past) is yet another example of why I'm not here much anymore. All this BS bickering back and forth does NOTHING for the newbies, nor the guys who are still battling the beast. Yeah, some will say these "discussions" of differing opinions is helpful - to that I say hor$e$hit. All this promotes is negativism.

When I came here two years ago, I needed support and information - hell, I couldn't even spell "prostrate."  What I received was absolutely key to me - life saving, and I received it without any of the crap that's going on out here now.  When I initially thought surgery was the direction I might take, I got support, experience and information.  When I changed and focused on BT I got support, experience and information. 

I mentioned this several months ago and I'll say it again - IMHO HW/PCa is broken, and that is a travesty for both the newbies and those that continue to fight the beast - now we're also fighting each other - for what, to stroke our overgrown egos?  To make us feel better because we're bitter? 

From the "about Us" section of HW, from Peter:

Community. Support. Resources. Community and Support - "It is a community where people come together, reach out, find support and understanding, and share what works for them with others."  Resources - "blogs, videos, newsletters, articles and resources to help you actively manage the challenges of living with chronic illness."

I'll leave by asking all to consider these words again - and put the swords down unless the tip is aimed at the beast.

Done.

Jack:

Seriously???

This is YOUR QUOTE:

>>>>>>>>>>>>
medved added a comment about men “electing” to be overtreated (compiler also made a similar comment later).
>>>>>>>>>>>>>>>
Please show me where I ever made the comment that men "elect" to be overtreated.

I greatly resent when you mischaracterize my comments -- and that's being generous.

I think I made my point. I'll leave you to continue browbeating us.

Mel

This topic is possibly one of the most interesting (bizarre) that I've seen.

I feel like I am a juror, sitting in the jury box being detained, while missing my cruise to Tahiti...
I'm anxiously awaiting the evidence and closing arguments, but the opening arguments are still 4 pages in progress with the prosecutor re-reading aloud all that we've heard and that the court reporter has transcribed.

Seriously, when I showed up at HW if I had encountered this I would have walked away.

Instead, I arrived here and people were so helpful. I mean sincerely concerned helpful. They asked for stats, then told of possible options. I would report back with new information and again they would offer suggestions. They weren't trying to change the world... They were helping one person at a time based on that person's stats. They way it should be, since we all agree that no two cases are alike.

I am forever grateful that the members were of that mindset back then. They pushed hard in suggesting a second opinion when we were already at one of the best cancer institutions available. I took that lead and arranged for a second opinion that ended up being a life changer for my husband...and for me as well, since I stand indefatigably by his side.

Please let me out of the juror's box.

Thank you.

WW:

Why would a newcomer leave?

This is ONE THREAD. So, a spirited debate occurred. I credit the moderators for letting this one continue. As you even noted, it is interesting.

It seems to me a newcomer would also eyeball the hundreds of other threads and hopefully find them very useful, informative, and compassionate.

Are we to censor/delete every thread that gets a bit heated?

Mel

compiler said...
WW:

Why would a newcomer leave?

This is ONE THREAD. So, a spirited debate occurred. I credit the moderators for letting this one continue. As you even noted, it is interesting.

It seems to me a newcomer would also eyeball the hundreds of other threads and hopefully find them very useful, informative, and compassionate.

Are we to censor/delete every thread that gets a bit heated?

Mel

I said "I would have walked away."

Perhaps I am a bit jaded because I have seen too many of these and have seen how they turn out. Locked.

I never said anything about deleting or censoring anything.

Like others, I simply made my contribution to the topic. :)

Hey Guys,

FWIW, being a very low number of posts guy after a year, this thread has been enlightening. The subject, number of posts and frequency of posts made it pretty obvious that it was a controversial thread with the potential for flamefests before I started reading it. But there's good stuff here and I'm impressed that everybody's been pretty great discussing a topic that hits us all close to home. Passion is good.

Almost exactly a year ago I bounced in here, mostly lurked, and got grounded, empowered and enlightened. I posted very little, but I took a lot away. I also saw threads like this and just ignored them--I wasn't worried about policy, I was worried about making decisions and finding competent professionals. I did and I did. Thanks almost entirely to what I learned here and at yananow.

While this is a pretty rough and tumble thread, every participant here will, and probably has in the past, put their latest (possibly scathing) reply on hold while they reply to a newbie with questions, concerns or just needing to connect with someone. I know this because I got some of those replies and I read years of back threads--finding a few of these spirited debate threads versus hundreds that helped people like me. HW is a huge resource for new folks and, IMHO, it's working very well.

Cheers and Thanks.

Hi Dallas Dave,

I have been following your updates on HW. I am considering RARP, and was wondering if you can share your email or contact info offline. Can you make your email address available or send me a message? I would appreciate it very much. Thanks,

ATX

Totally agree with JackH response to davidg. Those days, over treatment is bigger problem then under treatment. Who can trust Fox News Health and NYT Health articles? They are more confusing then helpful. Low risk PCa like Gleson 6 does not need treatment in about 98% as mentioned multiple times here and elsewhere. Gleson 6 does not metastasize as confirmed in JHU research conducted on more then 10K Gleson 6 patients with no single metastatic case found. Those patients will die from something else.
On the other side, surgeons who claim very high percentages of urinary and erectile function recovery in 12 months or less are cherry picking Gleson 6 patients with favorable circumstances to bust their own ego.
Gleson 7 especially 4+3 gets a bit more complicated for treatment decisions.
I went into surgery with 4+3 which luckily was downgraded to 3+4 after surgery. Was not acceptable into AS which I wanted pursue even against medical advice.
Just wrote in another tread about my not so good experience with surgery a year later.
Mk