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Medical Forum / Diseases and Disorders / Prostate Cancer / February 2007Watchful waiting
Hello again, greetings from Estonia, Europe. I am interested in watchful waiting again. Where is statistics about patients who have Gleason 7. How many years they live? I have been waiting now over 4 years, without symptoms. My psa has gone up and down between 3.6 and 9.3. What hapens if psa rises to for example 50? And how we die in Prostata cancer? Is it always so that it spreads to allover the body? Or is urine stopping to come out or how? all the best to all sisu > Hello again, greetings from Estonia, Europe. > > I am interested in watchful waiting again. > Where is statistics about patients who have Gleason 7. Your biopsy showed a 3+4 = 7. That's a minimum, not a fixed number. Close examination after surgery often finds a higher grade, so you may have 8 already. And contrary to what your doctors tell you, Gleason 7 *is* cancer. Besides, You already had some 8 two years ago (the "4" in your 3 + 4). You and your doctors can debate numbers all you want, but you still have an aggressive prostate cancer growing in you, and the longer you wait, the more likely your 4 will dominate, at which point your 7 will be a worse 7 or your 7 will become an 8. (Both are already fairly likely, given the accuracy of biopsies and the years since your biopsy.) > How many years they live? Not enough, considering that the sooner they detect and treat it, the longer they live and the more often they die of something else (is that a statistically fair statement, folks, or just an educated gut feel?), which is a *good* thing if treatment allowed that. > I have been waiting now over 4 years, without symptoms. Symptoms are usually the beginning of the end. They are just indication that we found our cancer too late to cure it or waited too long after finding it to treat it. We have cancer when a biopsy says we have cancer, hopefully long before it develops symptoms; its progress is usually in *our* hands if we catch and treat it soon enough; if we wait too long, it is no longer in our hands. If I were you, If you are finally willing to teat your cancer and need a Gleason 8 to convince you, you should run to the doctor for another biopsy. If you are still unwilling to treat your cancer, there's no point in diagnosing it further. > What hapens if psa rises to for example 50? PSA 50 (or even just 10) with Gleason 7 for a few years and a prostate bump your doctor can sometimes feel in your early 60s and no other life-threatening health problems (I reviewed your 2005 messages) means it was time to act years ago, in my opinion. > And how we die in Prostata cancer? Is it always so that it spreads to > allover the body? Usually, yes. It is one of the more horrible ways to die. Surgery or radiation do not spread cancer, and are minor nuisances in comparison to death by prostate cancer. If you are still healthy at 64 and watching a Gleason 7 or 8 prostate cancer grow, you are fairly likely to die due to prostate cancer spread to your bones. That is something to be avoided if possible, and you may still have that opportunity. We need to know for your sake: is your refusal to treat this due to fear of treatment or to your educated and rational belief that ww is as likely as actual treatment to make your life better and/or longer? I.P. I'm no expert, but with a Gleason score of 7, it's time to stop watchful waiting and get on with surgery. I had a Gleason 7 on a biopsy done in August 2006. Had a RRP on 9/18/2006. Path report on the removed tissue was 50% encroachment. And my PSA in June 2996 was only about a 6.5. Currently 4 months out and PSA <0.1, no incontinence, and relatively full erections with assistance from Viagara. I am also on a therapeutic daily 25mg does of Viagara that is supposed to foster tissue growth. Prostate cancer may be slow growing, but watchful waiting with a G7 should point to surgery unless the patient has many other conditions that point to a very short lifespan. Don't forget, I am only a patient. > Hello again, greetings from Estonia, Europe. > [quoted text clipped - 14 lines] > > sisu > I am also on a therapeutic daily 25mg does of Viagara that is supposed to >foster tissue growth. Roy, can you point me to some evidence for this - I'd like to present it to my uro when I next see him. My experiences about viagra: I was sitting on doctors reception. We talked about "watchful waiting". Suddenly he asked if I want Viagra. I said no. I am a slow man of thinking. I ought to say: I did not ask, why you suggest? Then I noticed his writing pad. On it was printed "Viagra". I noticed that his duty is also market Viagra. I think I have lived 37 years marriage and living it still. Sexual power is much more week than it used to be, I accept it. We have two lovely daughters. This was my experience, no more. sisu Non Illegitimi Carborundum > My experiences about viagra: > [quoted text clipped - 6 lines] > > I noticed that his duty is also market Viagra. Are you going to a urologist? I cannot imagine an oncologist would try to sell Viagra to a watchful waiting cancer patient. If you are seeing a urologist, perhaps you should get a second opinion from an oncologist. > Hello again, greetings from Estonia, Europe. > [quoted text clipped - 14 lines] > > sisu It is very hard to say how long a man will live with untreated prostate cancer. The time varies greatly because disease characteristics vary a great deal from man to man. Men with Gleason 7 do not all have the same exact kind of tumor cells. According to studies cited by the U.S. National Cancer Institute: "A retrospective analysis of outcomes of men demonstrated a 10-year disease-specific survival rate of 94% for expectant management for Gleason score 2 to 4 tumors and 75% for Gleason score 5 to 7 tumors; this is similar to a previous study using the Surveillance, Epidemiology, and End Results database with survival rates of 93% and 77%, respectively." (http://www.cancer.gov/cancertopics/pdq/treatment/prostate/healthprofessional) If that is right, you have a 75% chance of still being alive six years from now (assuming we start counting from your diagnosis four years ago.) Your particular odds may be worse than that because your cancer is Gleason 7, at the upper end of the 5-7 range cited in the study. But on the other hand your odds may be better because your PSA has grown very slowly. Most men I know with Gleason 7 have faster growing PSA than you. I have not heard of PSA going down before, so your case may be less aggressive than most. From what I have read, your chances of still being alive 15 years from now are small without treatment. The symptoms vary depending on where the cancer goes after it leaves the prostate. Most men develop metastases in the bones, leading eventually to terrible pain in the back and in other joints. At the end, pain will be continuous and any movement will make the pain unbearable. Strong narcotics will be required. Urinary symptoms are also likely. A urinary blockage will often occur, requiring the permanent use of a catheter. In some men, metastases may reach vital organs leading to an easier death with less pain. However with some men there may be metastases in the brain, leading to headaches and personality changes. Whether you should seek treatment depends on many factors. The obvious one is how old you are now and whether you expect to die of something other than prostate cancer before the cancer kills you. Another factor is whether and what kind of treatment is available to you. If I were you, and if I were in good health, under 70 years old, and probably even 75 years old, I would seek treatment. For older men, radiation treatment is often recommended. It is painless and easy to take and often has good results. If you decide against treatment, and the cancer spreads, you may be able to control it with hormone therapy or castration. Some men may live many years more with hormone therapy. Some get only a very small benefit from it. Currently, there is no way to know how long hormone therapy will help. Best of luck. Alan >by "Alan Meyer" <ameyer2@yahoo.com> Jan 20, 2007 at 02:40 PM Thanks to you, Alan. Your answer helps me to go on considering what to do. It was one of the best I received. all the best sisu > Hello again, greetings from Estonia, Europe. Greetings, Sisu! > What hapens if psa rises to for example 50? I am surprised that you are still below 10. I guess the medical establishment is alarming us over prostate cancer for no reason in some cases. I don't know what happens at 50. I can tell you that Martin Howard had no real cancer treatment. When he was 63-years-old, his PSA was 145. He died a year later. > And how we die in Prostata cancer? Is it always so that it spreads to > allover the body? Or is urine stopping to come out or how? Usually, the cancer spreads first to bones in the area of the prostate. This can be extruciatingly painful if you do not get some good drugs. It can also, and later usually does, spread to organs around the prostate. This can cause pain, malfunctioning, and/or bloody discharges, and more. Then it will finally go to an organ without which you cannot live; like the liver or brain. If the liver, lots of blood an pain. If the brain, you just lose consciousness one day and never wake up. As Jimmy Stewart said to John Wayne, "I don't think that the death I just described to you is not the one I would choose."  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 PSA <0.04 Non Illegitimi Carborundum > Then it will finally go to an organ without which you cannot live; like the > liver or brain. If the brain, you > just lose consciousness one day and never wake up. Have we forgotten dear and brave Loreli so soon, whose husband's lengthy brain prostate cancer metastasis would have destroyed any lesser mate or relationship? I.P. >> Then it will finally go to an organ without which you cannot live; like >> the liver or brain. If the brain, you just lose consciousness one day [quoted text clipped - 3 lines] > brain prostate cancer metastasis would have destroyed any lesser mate or > relationship? Yeah, and one day he just lost consciousness and never woke up again. But, I take your point. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 PSA <0.04 Non Illegitimi Carborundum From: ankkurit@hotmail.com (sisu) Hello again, greetings from Estonia, Europe. I am interested in watchful waiting again. Where is statistics about patients who have Gleason 7. How many years they live? I have been waiting now over 4 years, without symptoms. My psa has gone up and down between 3.6 and 9.3. What hapens if psa rises to for example 50? And how we die in Prostata cancer? Is it always so that it spreads to allover the body? Or is urine stopping to come out or how? all the best to all sisu ======= hi sisu - you ask, so here's what will happen. having walked this path with my father. your quality of life will not decrease in the beginning, but as the cancer progresses, your quality of life will be affected. so much so, that it will pain you to sit up later. your psa can bounce around some, but will start taking jumps increasing the psa number. this is called the doubling rate. the numbers will take a shorter and shorter time to double. once the cancer has gotten out of the prostate and into the body, it sets up shop in other organs. for example, you may think that you have lung cancer, but in fact, you have prostate cancer of the lung. this is called, "secondary cancers". the cancer will grow in these vital organs until finally the organ can no longer function and you will die at that point. what did you die of? it depends on the organ that was affected the most and stopped working. what to expect in the future if you manage to live as long as i've described. the answer is pain. usually the cancer goes to the nearest area, which is the hips and lower back. it attacks the bones and since the bones support your body weight, they will slowly collapse and cause the nerves to be pinched - hence the pain. it also may grow into the bladder and give you prostate cancer of the bladder and you can have all the complications from that. i may grow into the colon and give you prostate cancer of the colon and you can have symptoms there too. do you have lower back pain yet? time from beginning to end. usually 13 years. 8 years for the cancer to spread. 5 years after that. they do have three levels of pain management in that particular stage. on your question, 'is urine stopping to come out or how?' what happen with my dad was that he started leaving drops of blood in the toilet bowl. when i told his urologist this fact, all he did was suck air between his teeth and shook his head. he never said a word. i hope this answered your questions. ~ 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." http://community.webtv.net/PALMER_ENT/doc Thanks of all the answers. I can not answer to all of them, so I answer this at least.(sorry my native language is Finnish, my English is limited) >your psa can bounce around some, but will start >taking jumps increasing >the psa number. this is called the doubling >rate. the numbers will >take a shorter and shorter time to double. How can we say so? Doctors say that about one patients prostate cancer no on can say anything sure. All are quessings. But we have statistics helping us. Who can say what happens to me? I appreciate very much of your kindly answers. I must decide what to do. I am responsible of it. Doctors are helping me. The doubling time of psa means something, but how much? How much is error % in measuring Psa. I doubt psa numbers are not same between two laboratories. One laboratory said error can be 10%. Have you thought of it? The Gleason definition is not easy too in microscope. By all this, I want to say that surely I start treatments, if enough (sure) evidence appear. One Gleason is not enough. One possibility is to take more biopsies now after four years. But I do not believe it is valuable now. In it is harm too. But as I said I appreciate your opinions very much. I am seeking the truth, and nothing but the truth in my case. Your honest experiences are very valuable. Those who here told honestly how one dies of prostate cancer made a good service to me, thanks of them. I have a friend with prostate cancer too. We met in meetings of patients of prostate cancer. His Psa is now 54. The diagnosis was done 14 years ago. No treatments. I think in all western countries together are thousands prostate cancer patients with "watchful waiting". How could I get contact to each other? Listening experiences of other in same situation we could get valuable information especially of what to eat and the way of living. >do you have lower back pain yet? Yes I have, but I think the reason of it is something else. I have astrosis too a little. Doctor said that it spreads to bones under 1% of patients. One reason why I think my Psa rose during last year is that I stopped using bicycle almost daily. I was earlier driving by bike about 2000- 5000 kilometers a year even in snow in winter. I also was eating food with fat. I also did not measure Psa so often, only 6 times during 2,5 years. It moved during that time from 5.6 to 9.3, going down also one time. So I do not exactly trust them. and as I said errors can be at least many per cents. Do you talk about errors over there too. About doubling time I have heard that if it is under three months, it is dangerous. But these are only assumptions, even made by doctors. My diagnosis was done a little over 4 years ago. I had no demand to take Psa. The doctors wanted to do so. So if it was not taken, even today I´d know nothing. I live a normal life. I do not fear very much, because I have made clear to myself that one day I will die at any rate. I wish you all the best times in your life. This is my case, not more. Greetings from Estonia and Finland sisu >> your psa can bounce around some, but will start >taking jumps increasing >> the psa number. this is called the doubling >rate. the numbers will [quoted text clipped - 3 lines] > helping us. > Who can say what happens to me? Then let us put it this way: your doubling time is almost certain to shorten, and that is not good. Of course, you may get hit in the head by a meteor before your cancer get serious. > The doubling time of psa means something, but how much? How much is error > % in measuring Psa. I doubt psa numbers are not same between two > laboratories. One laboratory said error can be 10%. > Have you thought of it? Yes. That is why we advise patients to use the same lab each time. > The Gleason definition is not easy too in microscope. To you and me, true. But for an expert in a top laboratory, Gleason grading gets pretty consistent. > By all this, I want to say that surely I start treatments, if enough > (sure) evidence appear. You have the sure evidence: Gleason 3+4=7. But you are not willing to act on it as we believe you should. I recommend you have a second, highly regarded, lab repeat your grading, but only if you would act if that lab agreed with the first Gleason grading, > One Gleason is not enough. > One possibility is to take more biopsies now after four years. But I do > not believe it is valuable now. In it is harm too. A delay of four years could very easily be fatal. I would: 1. Have your doctor send your existing biopsy sample to a top lab for a second Gleason opinion. 2. Do it *NOW*, not in four years or four weeks. 3. If that does not confirm a 7, I'd get another biopsy soon. You have some degree of cancer, and it is curable if caught and treated soon enough. Biopsies very rarely do any harm, and you probably know by now that they seldom hurt. > But as I said I appreciate your opinions very much. I am seeking the > truth, and nothing but the truth in my case. We get the impression that you are not willing to face the truth head-on and/or are not being exposed to it. Keep researching it. > I have a friend with prostate cancer too. We met in meetings of patients > of prostate cancer. His Psa is now 54. The diagnosis was done 14 years > ago. No treatments. I also know of one lady who was hit by a meteor with little harm. I'd say she is at the edges of two statistical curves, neither of which means much to you or me. > I think in all western countries together are thousands prostate cancer > patients with "watchful waiting". But I suspect and hope that most are older and less healthy than you, thus have less to risk. > Listening experiences of other in same situation we could get valuable > information especially of what to eat and the way of living. We have discussed that here many times, in depth. We agree 100% on only one thing about it: Eating and living "right" is no substitute for real treatment, or at least close medical observation for patients too old, too infirm, or to advanced to benefit from treatment. >> do you have lower back pain yet? > > Yes I have, but I think the reason of it is something else. I have > astrosis too a little. > Doctor said that it spreads to bones under 1% of patients. [Astrosis appears to be a liver problem.] If it's been diagnosed in you, rather than simply presumed, maybe it explains your back pain. I'd want to know for sure, rather than make any assumptions, if I had PC and back pain. > One reason why I think my Psa rose during last year is that I stopped > using bicycle almost daily. I was earlier driving by bike about 2000- 5000 > kilometers a year even in snow in winter. Riding the bicycle would tend to raise your PSA, not reduce it, and staying off the bicycle just for a few days should allow your PSA to normalize, unless the bicycle led to chronic prostate enlargement. But the bicycle did not cause your Gleason 7 prostate cancer. > I also was eating food with fat. I also did not measure Psa so often, only > 6 times during 2,5 years. It moved during that time from 5.6 to 9.3, going > down also one time. So I do not exactly trust them. and as I said errors > can be at least many per cents. Do you talk about errors over there too. Yes. But 10% does not change a 5.6 to a 9,3, and does not change the fact that you have Gleason 7 prostate cancer. The main purpose of PSA testing is to help determine whether we need a biopsy; once the biopsy says we have cancer, PSA tests just help us estimate how serious it is. Your Gleason 7 cancer is fairly serious at your age regardless of your PSA. > About doubling time I have heard that if it is under three months, it is > dangerous. Under a year -- even under three years in your PSA range -- is dangerous, because once our PSA begins rising by more than 2.0 per year, our odds of dying of prostate cancer increase dramatically according to some studies. > But these are only assumptions, even made by doctors. And verified by some studies. > My diagnosis was done a little over 4 years ago. > I had no demand to take Psa. The doctors wanted to do so. So if it was not > taken, even today I´d know nothing. Ignorance of their own cancer has killed millions of men and cured none. We've probably seen only one cancer "treatment" worse than ignorance, and that treatment is drinking our own urine. > I live a normal life. I do not fear very much, because I have made clear > to myself that one day I will die at any rate. Sure; we all will. But most of us would rather be shot at the age of 95 by a jealous 25-year-old husband for screwing his young wife after beating him in tennis, rather than dying in extreme pain at 70 from a disease we could have cured. (Got any promising baby grandotters who may become big, strapping, blond, blue-eyed Amazons in about 30 years?) ;-) I.P. Half-Norwegian your psa can bounce around some, but will start >taking jumps increasing the psa number. this is called the doubling >rate. the numbers will take a shorter and shorter time to double. How can we say so? Doctors say that about one patients prostate cancer no on can say anything sure. All are quessings. But we have statistics helping us. Who can say what happens to me? =====> hi sisu - you can take this to the bank. your psa will slowly rise at the beginning. how long it takes to get to where it starts doubling faster and faster is anyone's guess. but picture it like a ball spinning around a bevelled tub and as the ball rolls closer and closer to the center where the hole is, the faster the ball goes. and that is how your psa will go. at the end, it will jump 100's of points in just a matter of hours. how much does it take to kill you? well, again, that is anyone guess. i''ve seen it as high of someone who had 8,000 and my dad have a psa of 60 when he died. ------------- The doubling time of psa means something, but how much? =====> it means that the cancer is growing faster and your doubling time will get shorter each time frame. for example, it might take you two years to double your psa, then, 18 months, then, 1 year, then, 8 months, etc, etc, etc,. it is not linear. that is what you have to understand about the doubling rate. ----------- How much is error % in measuring Psa. I doubt psa numbers are not same between two laboratories. One laboratory said error can be 10%. Have you thought of it? ===>that is true. it depends on which lab is using what method of testing. i would stay with the same lab to do the psa testing to remove as much error from the psa reports. ------- The Gleason definition is not easy too in microscope. By all this, I want to say that surely I start treatments, if enough (sure) evidence appear. One Gleason is not enough. One possibility is to take more biopsies now after four years. ===> your thinking is in error. a biopsy is considered the gold standard for if you have prostate cancer. and if you have a gleason score, then the lab detected it and you have prostate cancer. having another biopsy isn't going to make the situation change. ------- I have a friend with prostate cancer too. We met in meetings of patients of prostate cancer. His Psa is now 54. The diagnosis was done 14 years ago. No treatments. ====> he's lucky to live so long, but his time is going to run out in a few years. you will see his psa start to double a lot faster in this time frame. ----- I think in all western countries together are thousands prostate cancer patients with "watchful waiting". How could I get contact to each other? ===> check with yahoo newsgroups. there is a newsgroup that does watchful waiting. ------- Doctor said that it spreads to bones under 1% of patients. ====> better check again, that's not what the stats say. it's very common to spread to the bones. ------ I also was eating food with fat. I also did not measure Psa so often, only 6 times during 2,5 years. It moved during that time from 5.6 to 9.3, going down also one time. So I do not exactly trust them. and as I said errors can be at least many per cents. Do you talk about errors over there too. About doubling time I have heard that if it is under three months, it is dangerous. But these are only assumptions, even made by doctors. My diagnosis was done a little over 4 years ago. I had no demand to take Psa. The doctors wanted to do so. So if it was not taken, even today I´d know nothing. I live a normal life. I do not fear very much, because I have made clear to myself that one day I will die at any rate. I wish you all the best times in your life. This is my case, not more. Greetings from Estonia and Finland sisu =====> i left all of the above in tact for a reason. you seem to believe that you don't trust what is going on with what the doctors and lab say. you feel healthy and that's the problem. when you have prostate cancer in the early stages, you do still feel healthy. you say you want the truth. well here it is. if you psa is under 10, normally, you have a very good chance for a cure from prostate cancer. from 10 to 20, the chance for a cure goes down as it gets near 20. above 20, then chances continue to decrease more. you ask about your friend who has a psa of 50, look at what i just said and see what his chances for a cure are. on the other hand, your psa is under 10, so my question is simply this. even though you say that you aren't afraid of dying, why do you wish to speed it up by ignoring the fact that this cancer is going to kill you? for example, if your natural age would have been 85 or 90, would you want to settle on the age of 70 for dying because you refused to get treatment because you didn't trust the medical system? i've tried to be very plain in explaining this to you. i hope this has helped. ~ curtis ps. and yes, you have a beautiful country over there. 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." http://community.webtv.net/PALMER_ENT/doc Hello from Estonia again! We have a sunny snowy, wonderful day. Temperature is about -10 in Celsius degrees. >your psa can bounce around some, but will start >taking jumps increasing >the psa number. =A0 this is called the doubling >rate. the numbers will >take a shorter and shorter time to double. That is possible. ------------- The doubling time of psa means something, but how much? >=3D=3D=3D=3D=3D> it means that the cancer is >growing faster and your doubling time >will get shorter each time frame. for example, >it might take you two years to double your psa, >then, 18 months, then, 1 year, then, 8 >months, etc, etc, etc,. it is not linear. >that is what you have to >understand about the doubling rate. That is quite probable, but not sure ----------- How much is error % in measuring Psa. I doubt psa numbers are not same between two laboratories. One laboratory said error can be 10%. Have you thought of it? >=3D=3D=3D>that is true. it depends on which lab is using what method of testing. i would stay with the same lab to do the psa testing to remove as much error from the psa reports. So we can say centimetre in one laboratory is 11 millimeters and in another 9 millimeters. May I say, that is not medicine. That is something else. That is one reason, why I hesitate to start treatments. Is it same with Gleason? Huuh...I hope not. ------- The Gleason definition is not easy too in microscope. By all this, I want to say that surely I start treatments, if enough (sure) evidence appear. One Gleason is not enough. One possibility is to take more biopsies now after four years. >=3D=3D=3D> your thinking is in error. I do not (yet) believe. I have studied Finnish medical magazines (aimed to doctors) back for 15 years. One doctor (woman) said that it is difficult. I believe this. We people are such, that we do not willingly admit difficulties. Who could ask somebody who makes the definitions with microscope? Somewhere in Internet is photos about the cells seen through microscope, I have seen them, I do not remember the address. Certainly there is possibility that I am wrong. But _I_ _have_ _no_ _symptoms_. An d I am not a psychiatric patient :-) I believe that most of us believe that Gleason score can develop. It may become greater or lower. Also Gleason number is not exact. Or better to say the number is exact, but its interpretation is statistical. Same is with Psa. And further I believe that changes between individuals exist too. there is no information about this. Also there is no information about making business round the prostate. At least Finnish doctors have not said even a word about this. How is it over there in the Usa? For example Psa:s alarm- border was earlier 10, now it is about 3-4. You have at least some tens of thousands patients over there. How many tens of thousand patients more came within medical cure by lowing the limit of Psa. I am sorry I try to be polite, but my english is limited. We must also keep in mind that we are talking about things that concern life and death. It is true I am obstinate on my mind. Sometimes it is good, sometimes bad. I am learning to separate these in right situations. ------- I have a friend with prostate cancer too. We met in meetings of patients of prostate cancer. His Psa is now 54. The diagnosis was done 14 years ago. No treatments. =3D=3D=3D=3D> he's lucky to live so long, but his time is going to run outin a few years. you will see his psa start to double a lot faster in this time frame. We all are living so that we know some day is the last. I have been in many meeting where prostate cancer patient talk about their experiences. ----- I think in all western countries together are thousands prostate cancer patients with "watchful waiting". How could I get contact to each other? =3D=3D=3D> check with yahoo newsgroups. there is a newsgroup that does watchful waiting. Thanks of information, but I do not find it by that. Is there some more exact info about address? I would be _very_ thankful of it. I am very thankful to all of you who have written here about "watchful waiting". It is good that we are of different opinion. So the truth comes visible. ------- ------ > you feel healthy and that's the problem. No. That is a great delight, gladness, joy pleasure. (Those were the words I found in dictionary :) >if you psa is under 10, normally, you have a >very good chance for a >cure from prostate cancer. Yes. But if it is not a sickness at all in my case? Especially why for example Gleason numbers 2- 5 are called sickness? In the world are at least tens of thousands of men who have Gleason 2-5 and high Psa, but they do not know anything of it and die one day without knowing it. >even though you say that you aren't afraid >of dying, why do you wish to speed it up by >ignoring the fact that this >cancer is going to kill you? for example, if >your natural age would >have been 85 or 90, would you want to settle on >the age of 70 for dying >because you refused to get treatment because you >didn't trust the >medical system? >i've tried to be very plain in explaining this to you. >i hope this has helped. Thanks to you Curtis. I am very delighted about your thoughts. I have read them sharp. I wish you and all of us the best possible continuing in life. And for us who try to believe in God: God will bless us. Here happens not our will but God s. >Curtis >ps. and yes, you have a beautiful country over >there. Yes, Finland is famous for its thousands of lakes and its archipelago and Lapland beyond the polar circle. Now I live (only a little) outside Finland , in Estonia. >knowledge is power - growing old is mandatory - >growing wise is optional That is very well said. One day at a time. First things first. Sisu If someone want to contact me personally, my address is: ankkurit at hotmail dot com (I'd be very delighted of it) >So we can say centimetre in one laboratory is 11 millimeters and in >another 9 millimeters. I'm sure this is true Sisu but I disagree strongly with your conclusion below. A margin of error of 10% is just not enough to get excited about - certainly nothing like enough to justify condemning the results. If all other indicators were more or less equal, I would put 2 patients, one with PSA 5 and the other with PSA 5.5 in the same ball park regarding treatment and prospects. (Likewise, at the lower end of the scale. I would associate risks at PSA 0.1 as comparable with those at 0.11 or 0.12, come to that.) It is because such inconsistencies can occur that one should pay much more attention to PSA dynamics - the rate at which your PSA values are changing - rather than being overly critical about a single isolated result. Looking at the example above, if these 2 patients (psa 5 and 5.5) were gleason(3+3) and had opted for watchful waiting - those were 'precisely' my circumstances just over a year ago and prior to my second biopsy - the picture would look vastly different if 6 months later the psa 5 had jumped to 10, while the psa 5.5 had moved to 6. Clearly, its a good idea to stick with one lab if you can. >May I say, that is not medicine. That is something else. >That is one reason, why I hesitate to start treatments. I think that is entirely wrong. It's perfectly sound science in the absence of an 'absolute zero' to establish benchmarks and to calibrate. That is more or less what you are doing in staying with one laboratory and examining your PSA *dynamics*. Do it every 3 months, same lab, and check the curve. > Hello from Estonia again! > We have a sunny snowy, wonderful day. Temperature is about -10 in Celsius > degrees. In Cincinnati, Ohio (a little east of center of the United States) we have snow for the first time this winter. We have had heavy snow as early as October 14 in the past (and as late as April), but Sunday was the first time this winter we awoke to snow and it was only three inches. Our temperatures have been between -6 and 0 Celsius, but during December they hit 21!! >>=3D=3D=3D=3D=3D> it means that the cancer is >growing faster and your > doubling time >>will get shorter each time frame. for example, >it might take you two > years to double your psa, >then, 18 months, then, 1 year, then, 8 >>months, etc, etc, etc,. it is not linear. >that is what you have to >>understand about the doubling rate. While doubling time can decrease, I believe the the term actually means the length of time it takes to double. Therefore, if your PSA is 2 now and you have a 12-month doubling time, it will be 4 next January (2008), 8 in 2009, 16 in 2010, etc. And, of course, that is assuming no treatment. > So we can say centimetre in one laboratory is 11 millimeters and in > another 9 millimeters. > > May I say, that is not medicine. That is something else. > That is one reason, why I hesitate to start treatments. The are testing for nanograms -- millionths of a gram! And comparing it to how many millionths of a gram occur in 2 liters of liquid. That is a very hard thing to keep absolute. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05, 2/06, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 PSA <0.04 Non Illegitimi Carborundum > Certainly there is possibility that I am wrong. But _I_ _have_ _no_ > _symptoms_. Nor do those being slowly killed by high blood pressure, or early diabetes, or cardiovascular disease, or many other deadly diseases. > It is true I am obstinate on my mind. Sometimes it is good, sometimes bad. We noticed that, and consider it being bad, maybe unnecessarily fatal, in this case. > I am learning to separate these in right situations. We question that, in this case. > I have a friend with prostate cancer too. We met in meetings of patients > of prostate cancer. His Psa is now 54. The diagnosis was done 14 years > ago. No treatments. And Steve Irwin was killed not by a 5-meter, 500 kilogram crocodile but by a lazy, mild-mannered sting ray. Virtually every old alive man has some degree of prostate cancer; I'd guess most of those cases are not Gleason 7 or greater. > We all are living so that we know some day is the last. "All?" YOU are, but most of us are thinking more about years or even decades. > I have been in many meeting where prostate cancer patient talk about their > experiences. Great. Now realize that those experiences mean nothing to you. Your future is most likely to resemble large scale statistics, not Juhani's or Oskari's case. > It is good that we are of different opinion. > So the truth comes visible. The highly visible truth is that you are not being realistic about your prostate cancer. Yes, you may wake up tomorrow with no prostate cancer, or may die by Friday because of your prostate cancer. But far more likely is a horrible and maybe avoidable death from prostate cancer in your early 70s, if not sooner. Best of luck, Sisu. I.P. Maybe Sisu is trying to commit suicide by prostate cancer? If that's the case, watchful waiting at this stage will most certainly do the job. >Maybe Sisu is trying to commit suicide by >prostate cancer? If that's the >case, watchful waiting at this stage will most >certainly do the job. Dear friend there faraway. Why you say this? Much more willingly, tell your experiences so maybe you can help me or tens of others who read these messages. All the best in your life, Jean Sisu >> Maybe Sisu is trying to commit suicide by >prostate cancer? If that's > the [quoted text clipped - 3 lines] > Much more willingly, tell your experiences so maybe you can help me or > tens of others who read these messages. 1. You're not willing to listen to one fact or opinion we have to offer. Why keep asking for them? 2. The PC experience of a "friend from far away" -- or your brother or father -- tells you nothing about your odds of cure or side effects; it is of no use in that regard. I.P. >1. You're not willing to listen to one fact or >opinion we have to offer. >Why keep asking for them? >2. The PC experience of a "friend from far >away" -- or your brother or >father -- tells you nothing about your odds of >cure or side effects; it >is of no use in that regard. sorry my understanding in english is limited. Will you explain a little? ........ I have never had brother. My father was died over 30 years ago. I appreciate knowledge, but also honest experiences, especially in case of PCa. In meetings i got to know, what happened when men were treated all the best to all of us. sisu Exactly, I.P. Sisu, you keep asking for opinions and facts but when people who are very versed in this subject offer you suggestions and give you examples of what they have been through, all you do is argue with them about the numbers. Obviously, you already have your mind made up what you're going to do and nothing we say will make a difference. So why do you keep asking? All the folks on here who are trying to help you, trying to give you the numbers you ask for, are just wasting their collective breath. Personally, I think you're acting this way on purpose just to see what kind of rise you'll get out of everyone, or as I said before ... you're trying to commit suicide and you just want vilification. Well, you're not going to get it from me. This is my last post to you. Jean >>> Maybe Sisu is trying to commit suicide by >prostate cancer? If that's >> the [quoted text clipped - 12 lines] > > I.P. Dear Sisu, Sisu wrote: .Dear friend there faraway. Why you say this? > Much more willingly, tell your experiences so maybe you can help me or tens of others who >>read these messages. We are not so far away after all. My husband and I stopped in Tallinn when we were on a cruise on the Baltic Sea. I remember that the old city was very nice, cobblestone streets and all. And the entire city was *very clean*. About your situation: I want to give you the addresses of some watchful waiting mailing lists, where you can read messages and also submit questions. prostatepointers.org - mailing lists, select WW prostate-help.org go to "forums". There is one that discusses WW. I don't want to criticize you. We have for years been trying for sick people to have freedom to make decisions and "death with dignity". So, your life is your own, and you can do with it what you want. But think, how will your decision affect your wife and daughters, for example? I know I was very close with my father. He is gone and I miss him very much. If you do nothing, you may end up having a very painful death. (Why do some people here revel in repeating every gruesome detail of this over and over, in an almost masturbatory fashion? Makes me want to jump off the nearest roof.) Also, your family may have a very hard time caring for you, think of that. Anyway, please read this because: 1) It comes from the best prostate hospital in the US 2) It is about a study done on *Scandinavian* men (similar genes?) It is written in difficult English, so if you don't understand something, please ask. Publication of the James Buchanan Brady Urological Institute Johns Hopkins Medical Institutions Volume VI, Winter 2003 Scandinavian Study Shows Surgery Saves Lives SOME of the most exciting news in prostate cancer treatment has come from Scandinavia, where so many men die of this disease. A groundbreaking study, conducted by the *Scandinavian Cancer Group* and published in the September 12, 2002, issue of the New England Journal of Medicine, provides the first concrete evidence that *treating localized disease reduces deaths from prostate cancer*. [In other words, not doing watchful waiting increases lifespan] In the study, involving hospitals from Sweden, Finland, and Iceland, nearly 700 men with localized prostate cancer were randomly assigned to * radical prostatectomy or to watchful waiting, the most common form of treatment in those countries.* [Study compares results for 2 groups of men 1) people who had no treatment, WW, with 2) people who had surgery] [To all of us: some multicultural awareness: this is the most common tx? in Scandinavia. That may well shape this man's attittude.] During the average follow-up of six years, a surprisingly short time, ***twice as many men in the watchful waiting group died of prostate cancer.*** This means, the scientists concluded, that *radical prostatectomy may reduce prostate cancer deaths by about half. * A man's risk of dying from prostate cancer exists for 20 to 25 years after he is diagnosed. In another study from Sweden, 63 percent of men who were treated with watchful waiting, who lived longer than 10 years, eventually died of prostate cancer. [To all of us: the other 37% lived. Not exactly Russian Roulette. Hopefully, they will find ways to distinguish the lucky ones.] In the Scandinavian study, at 8 years, there was an absolute *reduction of 14 percent in the number of men whose cancer had progressed to distant metastases (27 percent of men in the watchful waiting group developed metastases, compared to 13 percent in the surgery group)** [In other words, in the group of people who waited, there was more cancer that had spread to other places in the body] The scientists, noting that the average survival of men with distant metastases is only about two to three years, anticipate that with longer follow-up, the differences in cancer deaths between these two groups will become even more distinct. What about quality of life? The men who had surgery experienced more erectile dysfunction and urinary leakage, and ** less urinary obstruction than the men in the watchful waiting group.** [[This is related to your question: the men who chose WW had more difficulties with urination]] However, in the Scandinavian trial, nerve-sparing surgery was not routinely performed. Also, many men in the trial were over age 65, and thus more likely to experience problems with incontinence and impotence. And 20 percent of these men had received hormonal therapy within five years after being diagnosed with cancer. Any of these three factors, the lack of a standardized, nerve-sparing procedure, older age, and the use of hormonal therapy could explain why there were more complications with radical prostatectomy in this study than if the operation had been performed uniformly, at a center where many of these procedures are done each year. I hope you will let us know what you decide. Best Wishes, Leah P.S. To all of you: Isn't it true that if you've had treatment (e.g. castration) and the ca has spread, you will eventually experience this agonizing death, anyway? Or am I wong. I hope. > About your situation: I want to give you the addresses of some > watchful waiting mailing lists, where you can read messages and also [quoted text clipped - 33 lines] > Scandinavian Study Shows Surgery Saves Lives > <SNIP> It seem to me (in my reading of the above study that you have provided) that the above study compares treatment (surgery in this particular study) to no treatment at all (ever). But denying a patient treatment indefinitely is not watchful waiting. My understanding of watchful waiting is to wait until a certain point where the danger of spreading outside the prostate gets much more likely (such as PSA getting over 10 or Gleason over 3+3). Even if we assumed that watchful waiting can continue until PSA is over 20 or Gleason is over 3+4 until treatment begins, that is vastly different then not ever getting any treatment (as was done in the study). Therefore, I don't think the study provides any statistical validity to the outcomes of what most people thing of when they discuss watchful waiting. Dear James, I believe you are mistaken. I'm quoting verbatim from the Hopkins study. What is misleading in some of the comments I made about "no treatment". That was my mistake. I would think it would be kind of unethical to withhold treaetment from symptomatic men. Just my opinion. Here is the text from the article: nearly 700 men with localized prostate cancer were randomly assigned to * radical prostatectomy or to watchful waiting Leah > > About your situation: I want to give you the addresses of some > > watchful waiting mailing lists, where you can read messages and also [quoted text clipped - 46 lines] > Therefore, I don't think the study provides any statistical validity to the > outcomes of what most people thing of when they discuss watchful waiting.- Hide quoted text -- Show quoted text - >Dear James, > [quoted text clipped - 11 lines] > >Leah Then you need to explain what the exact definition of watchful waiting is that was used in the study. Obviously, treatment was delayed, but for how long? Regarding the ethics, it is quite common to ignore prostate cancer once a patient reaches a certain age, on the assumption that they will likely die of something else before they die of a slowly advancing prostate cancer. > If you do nothing, you may end up having a very painful death. (Why do > some people here revel in repeating every gruesome detail of this over > and over Because the man whose life is threatened by cancer has repeatedly, explicitly, and pointedly asked us to do exactly that. > *radical prostatectomy may reduce prostate cancer deaths by about half. > A man's risk of dying from prostate cancer exists for 20 to 25 years [quoted text clipped - 8 lines] > longer follow-up, the differences in cancer deaths between these two > groups will become even more distinct. Yet you told Surfdog that RP is the treatment of last resort. How do you explain that? I.P. Dear IP, > > If you do nothing, you may end up having a very painful death. (Why do > > some people here revel in repeating every gruesome detail of this over [quoted text clipped - 15 lines] > Yet you told Surfdog that RP is the treatment of last resort. How do you > explain that? That's an opinion. You seem to be having trouble distinguishing between opinion and fact. I know you are concerned about accuracy, and people should be careful when they cite authories, but opinions are different. The people here know that when I or someone else writes them a msg they are not receiving a medical consultation. After all, we are bombarded all day with commercials that "prescribe" one medicine or another, but we are told to ask the doctor if it's right for us. So what people say here, anecdotally, is very valuable. There are things you will hear patient-to-patient that you won't get anywhere else. But ultimately you should make treatment decisons together with your doc. I think people know that. Come on, give them some credit. As far as relying on doctors for statistics. Good Luck. You should read the article on Don Cooley's webite about docs and stats, (also researchers) among other things. Know beforehand that it's a difficult read! You will lose whatever innocence you have left. Now about surgery: I am not pro-anything. But, *and this is extremely unscientific*, I have read hundreds of posts from people who have had RT and all they seem to complain about is burning when they take a leak. And one man complained about "having a sunburn in his butt". Better than impotence or incont. And why is it that I have never read a post by a man saying he developed "fecal incontinence"? Now, surgery is a good thing, it's lifesaving. But all I am asking for is that there be truth in marketing. The docs talk to you about "robotic" or "lap" surgery, and IMO, they do not convey to you that this is a serious operation which requires a long period of recovery, both physical and emotional. That's why a lot of men end up completely floored when they develop symptoms post-op. All of this is speaking from experience. The phrase that keeps on popping into my head is that surgery interferes with the "integrity of the body". Now it's also true that getting yourself incinerated does the same thing. But I think what's disturbing here is the "neighborhood" the doc has to cut in. When my husband got cut up in the chest to remove a melanoma, it was no big deal. The problem here is that they are so perilously close to the genital area, and you will probably have some "relocation" of your privates after surgery. And don't be surprised if the same end up "redesigned".. Just read Scardino. Yes, it's true that I am angry about surgery right now. I have to be honest about it; And why is surgery worse potentially than failling rad? I'm guessing that the recovery period for surgery is much longer, for one thing. However, I do admit that I know nothing about rad. Until recently I thought they just directed x-rays at you for a while. Hmm.. I believe surgery is a good thing if it is done selectively. And we are probably getting to the point where we can better predict who the good candidates are. Your doctor knows that when he operates on a Gleason 7, that there's a significant chance of failure. However, the patient isn't told any of this. So you are not exactly playing Russian Roulette, but you know there's a good chance the surgery won't work. At least, the minimally invasive kinds. Now, I know this may be horribly skewed because of my ignorance of rad, but remember, it's just my impressions and opinions. I'm not purporting to be an expert on rad. And the rad people seem so relaxed. Look at A. Meyer, he is always serene. Best to you. Leah >> Yet you told Surfdog that RP is the treatment of last resort. How do you >> explain that? [quoted text clipped - 3 lines] > and people should be careful when they cite authories, but opinions > are different. How is anyone in any newsgroup, let alone a PC newby, going to distinguish an opinion from a fact when opinions often begin with words such as "will", "is", "FACT", instead of "I think", "I suspect", "IMHO", or "some dude said"? Remember, you're a self-described relative newby to USENET; it has logical customs you may not have recognized yet. One of them is making a clear, explicit distinction between fact and opinion. > The people here know that when I or someone else writes them a msg > they are not receiving a medical consultation. After all, we are [quoted text clipped - 4 lines] > But ultimately you should make treatment decisons together with your > doc. I think people know that. Come on, give them some credit. Can't. Too many people actually believe what they read on the internet, this isn't alt.cookies.baking, and there are too many newbies here. > As far as relying on doctors for statistics. Good Luck. I didn't intend to imply one should. > You should read the article on Don Cooley's webite about docs and > stats, (also researchers) among other things. Know beforehand that [quoted text clipped - 9 lines] > And why is it that I have never read a post by a man saying he > developed "fecal incontinence"? Who cares? Only peer-reviewed, large-scale, properly executed studies mean squat to the benefit and SE odds of the next man in line. You are not qualified to make assumptions or statements -- especially ones opposing the literature based on what dudes on the internet say. (I'm also curious to know where you found hundreds of RT pts.) > Now, surgery is a good thing, it's lifesaving. But all I am asking > for is that there be truth in marketing. The docs talk to you about > "robotic" or "lap" surgery, and IMO, they do not convey to you that > this is a serious operation which requires a long period of recovery, > both physical and emotional. That's why a lot of men end up > completely floored when they develop symptoms post-op. And yet many people whine when I try to present frank SE discussions based on the peer-reviewed literature. Your unfounded opinions, often stated as fact, confuses people even further. > All of this is speaking from experience. Anecdotal evidence = oxymoron. > the patient isn't told any of this. Exactly why we need to be very, very explicit here about the distinctions between fact, personal opinion, professional opinion, and outright personal conjecture and/or feelings. > And the rad people seem so relaxed. Look at A. Meyer, he is always > serene. Leah, that proves only one very specific thing about RT pts: One of them is serene. It is of *zero* use to the next man unless his doctor told him *every* RT pt is a monster. I.P. >> I have a friend with prostate cancer too. We >>met in meetings of patients >> of prostate cancer. His Psa is now 54. The >>diagnosis was done 14*) years >>ago. No treatments. >And Steve Irwin was killed not by a 5-meter, 500 >kilogram crocodile but >by a lazy, mild-mannered sting ray. Virtually >every old alive man has >some degree of prostate cancer; I'd guess most >of those cases are not >Gleason 7 or greater. My friend, I can not pass my friends experiences. That is a fact, my friend is a fact. It makes me think. Now, it is not important, who is right, but what is right _in my case_. >> We all are living so that we know some day is >>the last. >"All?" YOU are, but most of us are thinking more >about years or even decades. We all die one day. >>It is good that we are of different opinion. >> So the truth comes visible. >The highly visible truth is that you are not >being realistic about your >prostate cancer. Maybe everybody does not agree that. I asked my doctor: Is it true that if we operate, the cancer does not appear any more? He answered: no, it may appear. It can spread in both cases, if it is treated or not. If we treat, we do not know how it would go, if we had not treated. (I wish I could explain it) *) Sorry I think the time is 9 years. All the best to you too Sisu > My friend, I can not pass my friends experiences. > That is a fact, my friend is a fact. And about as relevant as the lady in Sylacauga, Alabama, USA who was hit by a meteor. I assume you've read several prostate cancer books. I recommend you read one more book . . . any book . . . on statistics. I.P. > Hello again, greetings from Estonia, Europe. > [quoted text clipped - 14 lines] > > sisu One authority that people often quote is PC. Albertsen, et. al who determined the risk of dying of untreated prostate cancer, graded by Gleason score. According to Peter Scardino, in his book "The Prostate", they found for Gleason 7 that the risk of dying of untreated prostate cancer was about 20 percent within 5 years, 50 percent within 10 years, and 65 percent within 15 years of diagnosis. Some of the data for this study preceded PSA testing. With PSA testing, it is possible that cancer is diagnosed earlier by some number of years, so that would push the risk down some. But it seems clear that men with Gleason 7 cancers face a substatial risk of developing metastatic prostate cancer and eventually dying of it. While there is some question about whether men with Gleason 6 cancers always need to be treated, in the US at least, Gleason 7 cases are usually treated by surgery or radiation, unless the man has a life expectancy of less than 10 years. In that case, the man be followed by watchful waiting followed by hormone therapy if needed. Prostate cancer, when it spreads, can be very painful. It spreads to bones, including the spine, which is very unpleasant. It can also disrupt the urine flow by pressure on the urethra, but that is relatively easy to treat. We are not experts here, just men who are interested in the subject because we have had to deal with prostate cancer in our lives. I had a Gleason 7 with a PSA of 4.5 when diagnosed at age 67. I had a radical prostatectomy and after 6 years I'm still PSA free. The chances that I have been cured completely are quite high. I am continent and not impotent. You really need to find a doctor you trust in these matters rather than relying on information you get from the web. Among other things, such a doctor will consider your age and your general health as well as the fact that your PSA has not been growing very fast. I would doubt that a good doctor would wait until your PSA rose to 50 before doing something. The usual borderline that is considered significant is more like 10. Thanks to you Leonard.This is the best I have read about "watchful waiting". Just this kind of information I want. >According to Peter Scardino, in his book "The >Prostate", >they found for Gleason 7 that the risk of dying >of untreated prostate >cancer was about 20 percent within 5 years, 50 >percent within 10 years, >and 65 percent within 15 years of diagnosis. sisu Hello, Sisu: I.P. Freely mentioned Loreli, and I searched for her messages. Consider reading over the things she and her family went through as her husband died of this disease. The toll this disease takes is not just on us, but also on our families. Please keep that in mind as you contemplate what you're going to do about your cancer. --charlie hi sisu - here's a website that you might find interesting. dr. catalona is THE leading surgeon who is given credit for doing the most RP's in the world. http://www.drcatalona.com/qa.asp ~ 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." http://community.webtv.net/PALMER_ENT/doc Sisu, you might want to check this site, "Arguments Favoring Aggressive Treatment", at http://www.prostatepointers.org/ww/yestreat.htm . Of course, there are other sites arguing for watchful waiting, both sides making valid points. I.P. > Sisu, you might want to check this site, "Arguments Favoring Aggressive > Treatment", at http://www.prostatepointers.org/ww/yestreat.htm . Of > course, there are other sites arguing for watchful waiting, both sides > making valid points. > > I.P. All of those quotes are at least 10 years old. >> Sisu, you might want to check this site, "Arguments Favoring Aggressive >> Treatment", at http://www.prostatepointers.org/ww/yestreat.htm . Of [quoted text clipped - 4 lines] > > All of those quotes are at least 10 years old. Valid point. I'd be interested in critiques of their currency in light of newer studies. I.P. |
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