Paxton said...
I do feel sorry for the men who are lulled into complacency by a uro who offers AS, and then find themselves with more advanced PCa and worse prognosis because of it.
Indeed, a myth. A very good saying was already posted in the recent thread titled "Do you have a favorite saying?"
Somebody said...
“The great enemy of truth is very often not the lie—deliberate, contrived and dishonest—but the myth—persistent, persuasive and unrealistic. Too often we hold fast to the clichés of our forebears. We subject all facts to a prefabricated set of interpretations. We enjoy the comfort of opinion without the discomfort of thought.”
-- JFK, commencement speech at Yale University, June 1962
I, on the other hand Paxton, do feel sorry for the men...millions, now...who are lulled into complacency by a uro who nudges them into aggressive surgery when none was needed, then find themselves saddled with life-altering side effects that were much worse than the "pseudo-disease" they were so-called "diagnosed" with. All because (in many cases) they failed to properly research the benign or slow-growing nature of favorable-risk PC, and acted out of haste & emotion rather than fact & data.
So, between us we pretty much got it covered.
I agree that this study, the first Level-1 of it's type, did not tell us much
new. The Trib article previously mentioned (I also read) pretty much nailed the bottom line..."
The outcome is the same;" no benefit to treatment for favorable-risk men, but the only thing new was that this Level-1 re-confirmed what others have already shown...which was
pretty much the opposite of what Special Lady mythasized (is that a word?) about
...the fact was shown here (and elsewhere, previously) that low-risk PC will NOT metastasize and a more aggressive PC will not grow in many men, even after many years post-"diagnosis." It will for some, and when they are on AS, they are able to move successfully into treatment which is
equally as successful as immediate treatment. (For some goofy reason, some people think AS should CURE prostate cancer, not be equally as successful--which for favorable-risk cases is just slightly less than 100%--as immediate treatment.)
What was interesting from the study, in my opinion, was the significant numbers of men who were initially randomized into one of the two treatment buckets who--once they learned and understood the nature of Active Surveillance, probably due to their participation in the study--had the opportunity and lept on it to switch
before their aggressive treatment to AS arm of the study, instead. This was in the data, but not mentioned as a highlighted outcome of the study. It's too bad most other men today are not given the exposure to understand the true nature of low-risk PC
prior to leaping too quickly into surgery,and often regretting it later when the worked on their "patient education."
Of course, non-favorable risk cases are a completely different matter...and essentially a completely different disease and really should not be talked about
in a thread which has nothing whatsoever to do with them. Probably shouldn't even be called "branded" with the same name because blending the discussions does a dis-service to the high-risk cases. The relatively small number of unfavorable-risk cases, compared to the much larger number of favorable-risk cases, DO need treatment...anyone who blends treatment discussions without distinguishing between these types of cases should be noted with skepticism.
Kudos to the physicians who thought to launch this study 20-years ago. One of the main things we've confirmed since then is that even many 3+4 cases do not need immediate treatment, and may never need treatment. Geez, we HAVE learned a few things in 20-years...we are just a little slow sometimes in applying those things!
Post Edited (JackH) : 9/16/2016 8:21:53 AM (GMT-6)