Importatnt for men on AS to continue to follow up there tests

duke -
Don't you think this is a straw man argument? 3% sounds like a comfortably low number to me.The "glass half full" statement would be that 97% of men on AS don't have metastases. And if it has already undetectably metastasized, what is the risk AS, other than unnecessary biopsies?

- Allen

JIB,
Based on successful outcomes among men with biopsy GS 3+4 and low volume, NCCN now includes AS as an option for them. Especially if f/u biopsies are frequent and mpMRI-targeted, there seems to be little risk of it getting away from you.

This is beside-the-point to the study in question because it dealt with men who had undetected mets at biopsy.

- Allen

You have some risk every day you're alive. I agree that living life without the SEs of treatment for as long as possible is worth the tiny risk. But that's easy for me to say now. I never had the opportunity to delay treatment. Tougher decision for those on the bubble I think. It's really important to have a comprehensive biopsy and nowadays a mpMRI .
Bob

Its called hype and writer got published. It used to be that this kind of stuff was only 3% of the media…now 97%…and we still buy it…. Actually that probably isn't true…The darker side of humanity hasn't changed a whit, but the technology is much more chilling…tho enlightening at the same time. In my crazy mind …its almost comedic. "It was the best of times..It was the worst of times" opening line to A Tale of Two Cities.. Read the lines that follow some time…Dickens was a freaking genius.. Oh well…carry on...

Gerry/duke68, when you write…

duke68 said...
Here is a notice about men on active surveillance.

…your "warning" to men on AS is perpetuating—especially when coupled with an alarmist thread Subject line—the ill-informed medical journalism which hovers around the periphery of real scientific literature. Maybe you unintentionally fell victim to promoting the unprofessional half-truth found in this link without realizing it, but you’ve helped them accomplish their goals via shady ethics nonetheless. The counter on the link just incremented by one more, unfortunately.


Let’s dial it back. The article in the link summarizes:

“The researchers confirmed that active surveillance appears safe in patients at low risk and in select patients at intermediate risk, particularly those with GS 6 and PSA greater than 10 ng/ml.”

Surprised at this confirmation by the researchers, after reading such an alarmist Subject line on this thread?

Anyone feeling informed enough to pass on links at a PC support site about PC shouldn’t be surprised, and shouldn't be thrown-off by the misleading half-truth article. An informed PC advocate will recognize that the broader, more complete findings from this ongoing study (Klotz at Sunnybrook, Univ of Toronto) are among the most widely vetted and distributed in the PC-world. The bigger surprise would be if either: a) you had never heard of Klotz’s study before, or b) you thought AS, or ANY form of cancer treatment, was risk-free. Or both.

The more valuable facts coming out of this Klotz study, which were also closely validated with a 15-year study from JHU, is that the rates of progression for men initially diagnosed with low-risk disease are statistically the SAME whether they pursue Active Surveillance or immediate treatment. A small number of the men in the AS group progressed, but the same small number of men who underwent immediate treatment also progressed…neither was risk-free; the risks of progression were the same.

While the risk of progression is the same for these two groups, but what’s different is the unnecessary suffering from side effects of an unnecessary treatment.

Was this article balanced enough to make it clear that there was no incremental risk to AS versus immediate treatment? And that the risks of progression were the SAME?

No.


.

Post Edited (JackH) : 4/12/2016 11:29:11 AM (GMT-6)

Apparently misinformation is as old as time itself..don't you all feel blessed that we are all equipped to parse it out ourselves to ourselves…with " a little help from our friends "
Instincts stink…choices blink… both less so…if you tink…honk…honk!!

duke68 said...
JackH Did you take the time to check my posts from the last 9 1/2 years?

hahaha...Noooo. Ain't nobody got time fo' dat.
/www.youtube.com/watch?v=LxrQmQ_kfDA



I agree, and I saw, that bozo did comment that the article was "hype." But now you, and everyone else who reads this thread after my post, will know WHY, and will be all that much smarter and be able to speak knowledgeably about the benefits of AS instead of issuing alarmist, inappropriate "warnings" (yes, a "notice" is synonymous with a "warning.") about the notion of AS.

duke68 said...
I have spoken to some men on As who no longer go to follow up visits.

That's a mistake on their part. Why are they not following their "doctor's orders" following their diagnosis of prostate cancer? Perhaps that's rhetorical; I suspect that you don't know. But I also see, upon further review, that this is not a topic mentioned in the article. That being said, I don't think that anyone diagnosed with any type of cancer, or not, should ignore their doctor's orders through pure neglect. That seems goofy...but I know that some men and women do.

take care

Post Edited (JackH) : 4/12/2016 2:12:53 PM (GMT-6)

Duke,
Just ignore his condescension , he's just that way.
But he is very intelligent and knowledgeable.

Hi


Bozolidat Mahalo

Best wishes
Gerry

There isn't a treatment available that is not "Russian Roulette," as you put it. Johns Hopkins reports biochemical recurrences within 5 years after RP in 5.5% of low risk men, 23.4% of intermediate risk men, and 45.4% of high risk men. So even for low risk men, there are about 6 live bullets in the 100 chamber revolver you metaphorically describe. There are no guarantees that come with any treatment or active surveillance. The decision is always a combination of head and heart.

- Allen

Tall Allen said...
There isn't a treatment available that is not "Russian Roulette," as you put it. Johns Hopkins reports biochemical recurrences within 5 years after RP in 5.5% of low risk men, 23.4% of intermediate risk men, and 45.4% of high risk men. So even for low risk men, there are about 6 live bullets in the 100 chamber revolver you metaphorically describe. There are no guarantees that come with any treatment or active surveillance. The decision is always a combination of head and heart.

- Allen

When I was making my decision I considered that no active treatment option was going to make the cancer worse than if I would take my chances and allow it to take its course. Treatment might not be 100% successful in stopping or preventing the advance of the PCa but it wasn't going to make its advance easier. I didn't want to sit back and not fight it. I wanted that post op pathology report and wanted to know what I was dealing with.

JoeinBucks, you've been around long enough to know this already, but I'll say it anyway. The vast majority of folks here, in fact almost all of us, support you , and any other individual, in making the right decision. If you feel your decision was made with your head, then it's good enough for me. There isn't a guy on here, that did not have some element of emotion nvolved in there decision, and nobody will ever convince me otherwise. Some may think they had no emotion involved, but they are dead wrong. Nobody has that much ice in their veins after a diagnosis. But that doesn't change the fact that each and every man here made the right decision, for themselves, and it doesn't matter what anyone else says or thinks.

I didn't read the whole thread, am just commenting on your last post above.