Are you one of "them" and have you made peace with it?

We all agree that there is a dire need for better testing and better treatment. Our little part of the cancer world does not get the attention it should.

But I am not one of the overtreated. My G4+5 was bursting out in all directions, and I was much closer to too late than we believed at biopsy time.

I am at peace with my decisions. I made the right choice based on what I knew then, and that is reinforced by what I know now.

I think the question will bring out discussions that we have beaten to death too many times.

Same discussion, as so many other endless threads on this very subject. I doubt this thread will change anyone's mind or thoughts.

As long as men act on fear, vs. facts, there will always be overtreatment of PC cases that never would have been harmful to the patient. And there will always be doctors (regardless of their inner motivations) who will encourage men that don't treatments to be treated. It's a vicious circle really.

Almost no one at HW, will clearly state that they felt they were over treated or didn't really need treatment. And I think the reason(s) for this lack of admission are all too obvious.

David

if it's coming from Brawley, watch your back.

Catalona doesn't agree with Brawley

www.drcatalona.com/quest/quest_spring09_1.htm

"There are two methods of estimating over-diagnosis. The first applies only to populations, not to individuals. With this method, statisticians look at population trends in prostate cancer cases and use statistical models to estimate whether more cases are being diagnosed than should be, considering past incidence rates of prostate cancer and prostate cancer deaths.

However, published criteria for over-diagnosis differ. For example, some consider a cancer over-diagnosed if it would not have been diagnosed during the patient’s lifetime. Others consider an over-diagnosed cancer one that would not cause suffering or death. But how can anyone really know?

The second method of estimating over-diagnosis is for a pathologist to examine a surgically-removed cancerous prostate gland and determine whether it contained only a tiny amount of cancer with no aggressive-appearing cells and that was completely encapsulated within the prostate gland. If so, they call it an over-diagnosed cancer.

Actually, surgeons and patients alike are delighted when the final pathology report shows such favorable features, because the prognosis is considerably better than when the cancer is larger, has more aggressive cells or has spread to the margins of the prostate gland or beyond.

Unfortunately, it is unknown what the final pathology report will show before a prostate gland has been removed. Morever, even a small cancer with favorable features could potentially be life-threatening in a patient with a life expectancy of more than 10 years. Thus, over-detection may be a larger issue for older men; whereas, in younger men, over-detection is nearly impossible to prove."

I think this is a worthy discussion to have over and over and over again. There are new people contemplating lots of things while they're dealing with the shock of dx. There should be voice to the idea they DO NOT need to just go out and start taking radiation or have a surgery. Now, there's little balance...just get dx and do something.

That isn't something alot of potential visitors need to hear. I truly wish I would've had someone, anyone, stand up to me and say... Take another look before you go and just do something out of fear. Even though I may not have been one of those who could've been helped due to my younger age, there are untold numbers here who see this site and feel like they just have to act regardless of their concern as "that's what everyone does" so to speak. That is what needs to be challenged.

I think that most people who chose a treatment, any treatment including a solid AS program, do so rationally and not out of fear.

I had G7 PCa at age 41. I doubt that I could have lived another 50 years without the PCa wrecking (and perhaps ending) my life.

I'm glad I was treated, and think that I made the right decision. Frankly, I don't care if Dr. Brawley would agree/disagree.

-Gedman

Until they get better tests it is too much like playing Russian Roulette to put off treatment to me.

Not one of "them". Unfortunately, my diagnosis left no doubt I needed very aggressive treatment, multimodal and right quick. Considering my various factors, surgery had too low a chance of being curative to pursue, so RT with HT became the plan. The easy part was that in my little sliver of the PCa universe there are darn few choices. I didn't have to face the doubt and complex decisions that so many with G6 and "easy" 3+4 G7 cases do. I'm sure I would get analysis paralysis.

I can only speculate what I would have thought with a 5% G6 case. But knowing what I do now about the variety of surgical outcomes I would probably wait until I was much more sure of an advancing situation. No PCa treatments make your life better. They all suck, just in different ways and different degrees.

I found out eight weeks ago, seems longer, that I'm 3+3=6, only one needle core out of twelve with 5% cancer.

Panic set in for most of the first two weeks, then depression. As I read and learned more about prostate cancer, it became a bit easier to deal with. Still tough though.

I met with a local surgeon who's performed just over 300 di vinci operations. He says to stick with AS with PSA testing every three months, followed by another biopsy at the twelve month mark. So, he isn't pushing surgery.

I scheduled a second opinion with a surgeon up at Johns Hopkins who has performed over 1400 di vinci operations. He recommended a Prostate MRI with contrast, which is scheduled for the 3rd of March. I'm hoping the MRI will map out the exact location/size of the tumor and provide me with more information as to what to do.

With my problems dealing with low stream, starting and stopping, etc. I'm not a good candidate for radiation, although I am reading a book on proton radiation which is interesting.

Then there's the Sperling group up in New York who want to take out the cancer with a laser guided by MRI. All I have to do is bring a check for 35 grand with hopes that the insurance company will reimburse me 70%. They've only had just over 300 patients thus far and no one seems to know much about it.

So, what do you do? Seems my choices for now are AS and maybe surgery later. In some respects, I believe I would have been better off not knowing I even had prostate cancer. At least that's what I feel like at times.

I am involved with a Man to Man group and the second meeting is coming up on the 28th. It's interesting. Most of the guys in the group who are my age or maybe eight years older, had surgery and seem happy that they did. I turn 60 in March.

For you guys who have made a choice for treatment and have it done with, I'm envious. For now, I'm learning all I can and hope to make the right decision when the time comes. This forum has helped a lot. Although I don't post often, I've read a lot. Thanks...Ed.

Post Edited (foxbo54) : 2/15/2014 7:15:25 AM (GMT-7)

I admit it. Will always have questions about my biopsy slides as I went from 7 to 6.

better to have questions the rest of your life than to find out you were a G9.

ed

Until such time as the technology is developed that guarantees the Gleason score, they refuse to take a chance.

and later they complain they they were overtreated ... unless the cancer comes back.

ed

The perspectives on display here are awesome as unique as our individual PCa stories.