To treat or not

What's your PSA now??

You don't show your age under your profile that I can see and this is one of several important factors that can have a bearing on the way you consider longevity v QoL. I think you also need to consider what sort of treatment and it's potential side affects you are prepared to tolerate. You also have to consider that dying due to PCa is often a very nasty way to go and advances in treatment may ameliorate later stages. It's a very personal decision and I think it unlikely that at this stage you can obtain a sufficiently meaningful personal forecast of how long you might have without further down the line treatment which in the event might not be as bad as you anticipate. We know that men sometimes confound predictions of clinicians and live far longer than guesstimates and others do far less well. Even without treatment of any kind the majority of men with PCa die of something else so their cancer does not progress at a rate to kill them , whilst others can appear to be cured but their cancer can at some stage accelerate alarmingly. When to stop further treatment becomes a very personal matter but perhaps one best decided after consultation with your oncologist as, when and if your cancer progresses to the stage where another treatment needs to be considered.

As regards future treatment Bri it may seem stupid , even arrogant , but I still can’t get my head around being chemically castrated and Chemo given all my recovery to date. The other option of course is earlier demise but that can’t be avoided ultimately anyway. Very nasty old death whatever and whenever.

I think given your figures Bri you could genuinely have ages yet , and I know you are a worrier. If you want QOL then I suggest you maybe let that tiny psa grow to a reasonable figure then ask for a PET. The PSMA isn’t widely available but the Choline seems free on NHS in many areas

i would be extremely happy to have 15 years but think it’s highly unlikely ☹️. I’d be happy to reach state pension age but not optimistic about that either. Bri

In the next 15 years, it's quite likely some lower side effect treatment will come along that extends this, and it's not impossible there could be a complete cure.

If I read your profile right dx at 50 ten years ago you all think John will hit 75?

Thats happy news!

on the basis that Dad was diagnosed aged 60 over 20 years ago, had nerve sparing when it was still a trial, had his recurrence 7 years ago and has so far refused any treatment, and the urologist is predicting that it will take another 15 years to kill him ... #win #liveyourbestlife 

Such a tough choice Brian and probably one that I will have to consider carefully too. How long is your PSA doubling time?  If it is long you may have much more time to chose . It is likely be a relevant factor in any estimate that your onco may give you. At the end of the day it is a very difficult and personal decision.