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News bulletin this morning

User
Posted 15 Sep 2016 at 07:04

 

I wonder if anyone else woke at 5.30 this morning to a news report that research has shown surgery for prostate cancer to be unnecessary in 90% of cases.  90% of men who chose watchful waiting are alive 10 years later - the same % as those who had radical surgery.

Great timing considering I am having surgery 2 weeks today.  Time off from work, from clients etc is all set up and I am/was quite decided that at 62 this is what I have to do.  The surgeon told me yesterday that having had a TURP 9 years ago recovery may well not be simple.

I am ready for this but I do want to feel it is necessary and the correct route to take.  As so often with medical issues it seems noone can give you definite advice.

User
Posted 15 Sep 2016 at 11:32
I think the key words to this report are " small" and "early stage"

The trouble is that whenever a journalist gets hold of a report they tend to over simplify them . It's an interesting study but I doubt it will have an impact on current medical practices, especially where the patient is identified as having a large, aggressive or invasive tumour

User
Posted 15 Sep 2016 at 16:39

Hi John

Hope all goes well. I've not looked back, my wife and I were not willing to leave things to grow further (from biopsy to op mine had changed from T2 to T3).  The decision had been RT or  RP  as I didn't know about Brachy.    I had zero symptoms

I try and keep things as simple as possible   :  My logic was/is   

Early detection is key 

Get as much current info/facts as you can, as I'm sure you have done, and balance with don't rush. Make an informed  decision.     ie if you want to leave alone then that is one's choice.    Unfortunately many men are presenting late to GP and as you know the PSA test is very 'poor although a very good indicator post treatment.  Again I know a colleague who ignored symptoms and for some reason didn't go to GP at all (I guess very similar to my dad - see my profile).

You still have time to re think, eh ?

    

There was about 10 minutes discussion on Jeremy Vine  -  about the first 15 mins if you follow link.   It's entitled Nick Clegg and the Badgers !  

I've only skimmed report  - see thread  (thanks to Andrew who posted links)

I need to re-read, it does have some useful data within.   Maybe others can  help  with this :  - I'm not sure how many of the 530's (ie 33% of the pool) who started with AS went onto RP / RT or other  if at all and when.   Are we talking 6 years or 10 years ?  In my opinion the outcome of survival seems to be improving every year, and a very real positive for any one who is diagnosed at whatever stage. Hopefully education and funding increases, we can all do our part.

Moving on ..         

Extract :    (I bolded) - copied as 'fair use'  

Although many active-surveillance programs were developed during the ProtecT trial
period, there remains little consensus on inclusion criteria or monitoring and intervention
strategies.      The active-monitoring policy in the ProtecT trial had less selective inclusion criteria
than do many active-surveillance programs, and follow-up did not include scheduled repeat biopsies
or magnetic resonance imaging; however, the rate of men in the active-monitoring group
in the ProtecT trial who changed treatment  strategies was similar to that in other studies.

I read this and still not quite comprehend what it actually means ! lol

 

 In my case, did I have RP too late or too early.  I presented early thanks to my dad , ie I asked for PSA tests, I kept informed.  The only regret is maybe I could have forced GP a little more - ie 12 months earlier as PSA just started to creep up.  In many ways I was on AS, simply looking at PSA values.  My hardest decision was actually do I have a biopsy or not. ?  I was 59, fit , no other health issues at all and life was rosy.  The future :  I found RP and recovery fine, operation quite painless, no incontinence after catheter out.  Life is still rosy.

There's some interesting data on ED in the report.    Reading posts on here and my own experience, obviously surgery with or without nerve sparing physically traumatises the whole network of nerves in the area. No ejaculate with RP, maybe RT less damage,  which does take a bit of getting used to.   Nature given time does heal I feel and nerves can recover albeit very slowly.  It will be down to the skill of the surgeon at the end of the day.  I've been lucky I guess.      

Have you posted your PSA values/history or biospy result(s) on here, as can assist others showing your journey over the last few years. ?

All the very best..  

 

 
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