Orbach, from the reports, never had surgery.  I've seen reports that he
has had prostate cancer for 10 years, but I don't know if they are
accurate.  It does seem strange that he would die suddenly of prostate
cancer without an extended downhill course, which is more typical of
advanced prostate cancer.  But it is really pointless to conjecture
without the facts.

I have two friends besides myself who had early detection and aggressive
treatment to try to cure prostate cancer.  The prognoses in these cases
were fairly positive, varying somewhat among the three cases.  So far,
all of us are doing fine.  I don't know anyone personally who fits the
description you give.  So, the "we all know" statement doesn't apply to
me.

Through prostate cancer forums,  I have seen a few cases like what you
describe, but the number is not large.   The informal anecdotal
experience of these men, when you consider that the sample is biased by
selection, is consistent with the results on studies of the success of
early aggressive treatment treatment.   Whether you like it or not,
modern methods of treatment for early prostate cancer have been shown to
be very effective by several solid studies, but of course it is not
universally effective.  That is not really in serious doubt.  What is in
doubt is whether it is more effective than the alternative, which would
be doing nothing until clincial symptoms of advanced prostate cancer
develop, if they ever do, and then treating the patient with hormone
therapy.  It is pretty clear that some patients with early prostate
cancer would develop metastatic cancer were it not for the treatment, so
they definitely benefit from the treatment.  Of course in some cases
early treatment fails in the sense that the cancer eventually recurs.
It is also fairly clear that some patients who receive such treatment
would never be bothered by their cancers during their lifetimes.  What
we don't currently have a good fix on is the percentage in the third
category, and how that percentage varies with the specific details of
the diagnosis.  It is to be hoped that further research, some of which
is being done now, will lead to a way to distinguish definitively those
cases which will metastatize if not treated from those that never will.
 Now the best that can be done is to use diagnostic criteria like PSA
value, rate of increase, Gleason score, and staging.  Age also plays a
significant role.  Few older men will benefit from early aggressive
treatment because they are not likely to live long enough.  But these
tools are not precise enough.