Prostate Cancer Survivors






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Re: Re: A hyperinflated disease


I do agree with many of things Terry has said. However, as grossly imperfect as it is, the PSA test is unfortunately what we have. If I am understanding your position, we should not do anything (as imperfect as it may be) to try early diagnosis of PCa. You seem to be advocating waiting until it metastasizes to check whether you have it or not and then start some sort of treatment. If this is wrong, please correct me.

There definitely needs to be a better test for PCa, as well as better imaging of the prostate. More money needs to be funneled into research in these and other areas and men need to get together and demand more funds be allocated to prostate research. Breast cancer receives significantly more funds for research for a form of cancer that is diagnosed just as often and results in about the same number of deaths. I do not advocate taking funds from Breast cancer research, but for adding additional funds for Prostate cancer research.

However until new tests come along,we have to use the tools we have. Again it is what we do with the information once we receive it. There should be more education regarding what is considered low grade possibly indolent PCa. I cringe when I read the posts of someone who has been diagnosed with a Gleason 6 with very small amounts of "cancer" one month and the next month has the prostate removed or fried. I agree totally that it is over treated and AS or WW should be advocated to patients by the doctors not just mentioned dismissively by most. I would also like to see an elephant fly but unfortunately I don't think either will happen.


Re: A hyperinflated disease

To Fred B.

The point is that depending on
the autopsy study 30 to 70% of
men older than 40 walk around
with PCa, but only 3% of them
die of it mostly at old age.

The PSA test and follow up work,
cannot capture and pinpoint these
3%, hence it's useless.

The only thing that makes sense
is to wait for symptoms and treat
these symptoms. Symptoms need not
to be directly metastasis, miction
problems will be the first sign
in the majority of cases. This
was the situation until the ninetees
before the advent of PSA.

The only alternative would be
to remove prostates preventively
at say the age of 40 in all men.
However even this would not work
either since micrometastatic
disease will be present in some
individuals that cannot be
pinpointed in advance.

The proof for this that in RP
specimina pathologically graded
as pT2, the best case scenario
("we got it all"), still some
3 to 10% progress depending
on the study you believe.

I hope this helps,
best regards,

Henk Scholten
The Netherlands

Re: A hyperinflated disease

pT2 failure is even higher than I posted above. 5% in Johns Hopkins and 32% in Mayo Clinic (PSA progression at 10 years)

Best regards,
Henk Scholten
The Netherlands

Re: Re: A hyperinflated disease


I still must disagree. It is not the knowledge that causes problems, it is what you do with it. If you know you have a rising PSA, you can be checked for other urinary tract problems, if you find from biopsy you have PCa you can undertake certain lifestyle changes to arrest its progression with out undergoing anything radical. If you know you do not have to wait for symptoms to make beneficial changes. I have cut down on red meat, added vitamins, drink pomegranate juice, and am losing weight. If these work(some say yes some say no-only time will tell) the fact that I knew there was a problem and could take corrective action could either stop further symptoms or delay them.

The failure rate of RP is too high whether it is 5% or 35%, if people would take a deep breath after a Dx and study and learn, then I firmly believe that knowing is power. I have the power to make changes to possibly avert further symptoms, metastases, complications etc because I know.

Thanks for the debate.

Fred B