woody wrote...snip...

Woody...Imagine person A saying, "the temperature where I am at is 35C"
and person B saying, "the temperature where I am at is 50F."  From this
am I to conclude that person B is in the warmer location?  Just as the
definition of temperature is important in comparing temperatures, so is
the definition of failure (DOF) important in comparing treatment
efficacy.

Since few newly diagnosed, "low-risk" men will die within 10 years of
diagnosis, saying that various treatments have similar survival rates
at 10 years doesn't tell us much.  It's not a very meaningful
comparison since one of these men who does nothing will probably also
survive for 10 years.  On the other hand, a comparison of biochemical
recurrence rates (bNED) may be more telling since many men do recur
biochemically within 10 years.

If they were speaking to a bNED comparison of surgery, seeds and XBRT
they probably used a different definition of failure for surgery versus
what was used for the two RT treatments.  A number of papers have been
published on this point.  These various papers show that the ASTRO
method confers somewhere between an 8% and 35% advantage to the RT
methods that use this DOF, as compared to the PSA>0.2 ng/ml failure DOF
generally used for RP.  So if the two groups (RP and RT) had "equal"
bNEDs with the different DOFs, then subtracting this "correction" from
the RT numbers leaves the two groups no longer equal.

I don't claim to "know" which methods are better or worse, I merely
point out the conundrum...Best wishes and good health, Ron

This is indeed true.  When it comes to matters of subjective judgment,
dispute, or choice, I never listen to anybody who insists that THEIR
way is the "best" or , worse, the "only" way.  In a word, who try to
equate matters of relative truth with absolute.  Including medical
procedures, politics and religion.  This is fallacious reasoning, and
True Believers, I am becoming increasingly convinced, are suffering
from a form of mental illness.  The degree of emotional conviction of
the universality of the so-called truth is directly proportional to
the degree of its lack of credibility.

Well,  a year after, whatever procedure you choose, you won't have so
much to brag about.  I am emotionally convinced this is an absolute
truth, so take it with a grain of salt ;-)
--dt

I think this can depend on other factors such as the age of the patient.
 Avoiding impotence can be quite difficult for even the best surgeons
for men over 70.   But skilled surgeons can do quite well in that
department for younger men.  Impotence rates following radiation of any
kind doesn't seem to fall off quite as rapidly with age.

I agree with ron that survival at 5 and 10 years is pretty meaningless
for prostate cancer discovered by PSA testing, as is commonly the case
in the US.   In other countries where they don't routinely test, such as
Sweden, prostate cancer tends to be diagnosed five or more years later,
survival rates can be a significant criterion.

Excellent!  You've made your decision.  This may be the hardest part of your
experience.

What's the date?

Dear Woody,

I explored California/Oakland --- as well as Seattle, Florida and MSK in New
York ----- but went to Atlanta at  rcog.com which was good for me and worth
checking thier website.

Decatur