I have

To quote a very smart friend of mine, who is not a physician but also
has daily interactions with them as a hospital administrator:
"Generally, if someone is an a.shole before they go to medical school,
they are still an a.shole when they get out."  I would bet that the
same holds true for every walk of life.
CPW

Robert you did get it wrong I was responding to Justins's misguided attitude,
I like DR.s fine they are not the share happy financial killing machine
responsible for the two tier medical system in our country,and yes a few have
sold out to the hmos.Defensive medicine and medicine
directed by insurance and drug co. profits
is not about dr's, Bill Frist is a DR. is he your hero?

Ah, then the answer is, "I have no experience with prostate cancer."  You
might further expound, "I have no experience, knowledge, training, or
education in prostate cancer."

My PSA was about 1 in 1998 and 16 in 2000.  Were it not for treatment, it
woudl be.... well, I'd be dead by now.  My father's PCa at 42 took him at
50.

Now, let's talk about something you DO have experience with.  Why does
someone without PCa and without experience, knowlede, training, or education
in PCa, barge into a PCa newgroup and spout off?  I'm curious as to the
mental motivation here.

hi justin - as an retired educator myself, may i point out some hard
core facts.  

it is a fact that on average, it takes about 8 years for prostate cancer
to develop and spread outside the prostate gland.  it takes about 5 more
years to grow and overcome the organs that support life to human body
and the host will then die.  so, on average, it takes about 13 years to
die from prostate cancer.  given the fact that the average age prostate
cancer is found is 65 and given the fact that the average life
expectancy of the male is 72, then it would be safe to say that prostate
cancer, on average, would not kill you.

now, in the world of real, the factors left out were the aggressiveness
of the prostate cancer as well as the fact that the younger a male is,
the more testosterone, he has in his body.

now, i was 56 when they found my prostate cancer and i had a gleason of
6.  i was told by my doctor that i would not see 70 if i did watchful
waiting - plus my last 3 years of my life would be in pain and i had a
good chance for a cure if i were to get treatment right away.  should i
take a chance on the advice of this 11 year article you quoted?

i wish to point out that my dad was in his mid 80's when they found his
prostate cancer and he was a psa of 6 at the time, and he died FROM
prostate cancer at age 92 by doing watchful waiting and by doing nothing
and it killed him.  

since you have a psa of 2 and age 64, chances are you will not die from
prostate cancer.

i'm somewhat surprised that as an educator - you are exposed to a lot of
fresh ideas and usually have an open mind to new thoughts, that you
would  come into a prostate cancer support newsgroup and quote an static
article written 11 years ago as holding the truth is really stretching
it considering how much advances have been made in the area of prostate
cancer research since then.  

it also brings into the facts that the grass is always greener on the
other side and when one is on the other side of the fence, in your case
- where you do not have prostate cancer, it is easier to hand out advice
and tell us that the one person who can save our life "has no more
knowledge than what you can acquire on your own, with some time and
study, on the probabilities of survival from pc, given certain
variables. And in the majority of cases, they are totally ignorant of
relevant stats on survival, and studies done on that regard. "  really
pushes the envelop of being an informed person in higher education
development.

i'll be sure to tell the next person that is dx'ed with prostate to read
this 11 year document and "don't worry - be happy"

sorry, i don't buy it, but i'll also tell you that i've got a 66 yr
brother that believes along similar lines as you do, because our dad had
pca and his brother has pca and he doesn't bother to even get his psa
checked, but everyone has the right to make their own mistakes.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."

As a mathematics professor with some knowledge of probability and
statistics,  I am curious as to just how you derived that conclusion.
I've done several searches of the literature using Medline, and what
I've discovered does not seem consistent with what you say.  Just what
do you think the probability of no metastasis in 18 years is for an
untreated Gleason 7 cancer?

I have a personal interest in that question since I was diagnosed with a
Gleason 7 tumor at age 67.   I relied on my doctor---trying to be your
own doctor is usually a big mistake---but the information I was able to
accumulate suggested a rather significant chance of metastasis within
5-10 years if the cancer were untreated.   I didn't know if the
probability were greater than 50 percent, but it seemed to me it was
certainly greater than 20 percent.   We all differ in how risk aversive
we are,  but metastatic prostate cancer is not fun,  so it makes sense
to avoid it even if you have a better than even chance it won't happen.
 Everything I've seen since suggests that beyond 10 years, for a
Gleason 7 tumor, the chances of the cancer progressing are even higher,
and a sensible person would not want to risk it.

Again, I would be interested in seeing some references.

Doctors usually follow guidelines which are based on research by
experts.  The guidelines are established by those experts.  The usual
rule adopted by urologists for treating early prostate cancer is to do
so if the patient has a life expectancy exceeding 10 years.  There are
certainly other experts out there who argue with the urologists about
that, and the situation is not clear.   The reason is that the
guidelines are based on retrospective studies, and the critics will
accept only randomized studies.   So far there has only been one good
randomized study done in Sweden, and that doesn't really answer the
question.   There is a large study being done in the US but the results
won't be in for a while.  Also, the US study only follows the patients
for 12 years, which is certainly not long enough to answer questions
about how to treat men in the 40s and 50s.

In any case, despite your qualifications in agricultural economics, I
doubt if you are in a position to come to a firm conclusion about the
current ongoing research.   And suggesting that a random layman without
any expertise can do better than his doctor at evaluating the evidence
is nonsense.