Gentlemen and Ladies,
An interesting study was published in the June 9 Journal of the
American Medical Association (JAMA) from a group out of Sweden which
studied the "natural history" of early, localized prostate cancer.
This means that they observed the diagnosed men rather than treating
them. 223 patients (sort of a small study) were observed for a mean
observation period of 21 years. The study shows that in early stage
cancer, the clinical course tends to be indolent for 10-15 years but
then the disease tends to get aggressive. Interestingly, only 17% of
the total showed generalized disease after follow up.
They conclude that aggressive, early, radical therapy is warranted
when life expectancy exceeds 15 years. Although they don't say as
much, the converse implies that watchful waiting may be warranted when
life expectancy is less than 15 years.
JAMA. 2004;291:2713-2719
www.jama.com
CPW
jimhoney - 14 Jun 2004 21:52 GMT
Coincidentally, "15 years" was the answer I got from the urologist when I
asked him what my life expectancy would be if I left the Gleason 6 Stage 2c
disease untreated. Actually I asked him "if it's going to kill me." I
realized there was a chance I could get away with doing nothing (at age 52),
and although I could never work out the odds, they seemed too small to take
a chance.
jimhoney
standard RRP, cured, no aftereffects
Steve Kramer - 14 Jun 2004 22:07 GMT
15 sure sounds a tad on the high side, expecially for a study that started
over 21 years ago. But, I have to keep reminding myself they are not
talking about 46 year olds who already have aggressive cancer. I guess WW
might be indicated then in the 70s, based on the study, but based on
advances since the early 80's, I think it's a fool's play.

Signature
Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA .07 .05
Lupron 7/03, 8/03, 12/03, 4/04
> Gentlemen and Ladies,
> An interesting study was published in the June 9 Journal of the
[quoted text clipped - 13 lines]
> www.jama.com
> CPW
dale.j. - 14 Jun 2004 23:45 GMT
> Gentlemen and Ladies,
> An interesting study was published in the June 9 Journal of the
[quoted text clipped - 13 lines]
> www.jama.com
> CPW
From the above I can conclude that I may have had some big trouble at
around age 69 to 74, plus or minus some.
I'm quite happy I accepted my docs recommendation and took action at age
59. I'm not a gambler except for maybe a slot machine or two.
Dale J.

Signature
Email: dalej2@mac.com
Al - 15 Jun 2004 03:33 GMT
*Gentlemen and Ladies,
*An interesting study was published in the June 9 Journal of the
*American Medical Association (JAMA)
<snip>
My uro offered WW as well as the other treatments, as not to come
across as biased in favour of one over the other. At my age, WW was
out of the question. However, I think that if I were much senior, I'd
have chosen WW. Naturally, that would have depended on the cancer
aggressiveness itself.
Al
Please be quiet if replying via email,
flames will be deleted promptly.
I won't even read the whole message...
Outlivecancer - 18 Jun 2004 18:15 GMT
well,again it appears that scientific studies follow the money,i.e.countries
with universal healthcare are always looking for ways to delay expense and
funding studies.I question the ihtegrity of any of these tests.Just as in US
clinical trials can mean big market swings either way.I am all for good
science,e.eg.John's Hopkins,
now compare that to private research on brachiotherapy for instance.Watchful
Waiting for Good Science-WWGS,LET'S CALL IT A MOVEMENT.
Leonard Evens - 18 Jun 2004 18:52 GMT
> well,again it appears that scientific studies follow the money,i.e.countries
> with universal healthcare are always looking for ways to delay expense and
> funding studies.
I think you are jumping to conclusions. For example, according to
Walsh, in Sweden, they are in favor of testing for breast cancer and for
early treatment. Until recently, they have had the opposite point of
view about prostate cancer. He mentions this because their breast
cancer death rates have been going down while their prostate cancer
rates have not. Note also that Swedes do better than we do in almost
all aspects of health, including life expectancy.
In fact, the US is the only advanced industrial country without
universal medical care. In some countries---Great Britain comes to
mind---the doctors are employed by the government, but in others---e.g.,
Canada---the doctors operate as they do in this country, but the
provinces are the insurers. It is hard to generalize on the basis of
one example---the US---without universal health care compared to
everyone else who does have it.
> I question the ihtegrity of any of these tests.Just as in US
> clinical trials can mean big market swings either way.I am all for good
> science,e.eg.John's Hopkins,
> now compare that to private research on brachiotherapy for instance.Watchful
> Waiting for Good Science-WWGS,LET'S CALL IT A MOVEMENT.