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Re: Might Negative Second Biopsy Procedures Indicate Spontaneous Regression?
Thanks for your detailed points, Terry. It was the Oppenheimer blog that I had not remembered.
It's true as you say that " . . . the word “cancer” still has the power to push men into inappropriate treatment, helped by doctors who should know better." I held off treatment for 8 months but was persuaded by a leading surgeon that if he put my prostate in a jar I would be able to put all this behind me and live the rest of my life without worrying if the PCa would develop.
As I have reported before, because of scar tissue I had from a previous TURP, he actually left 6 grams of the gland behind the bladder neck. This means that I am still doing the AS I was doing for 8 months before the op, only now I do AS with all the morbidities that follow a prostatectomy! (The musician Andrew Lloyd Weber is now in this position. Only his surgeon apparently blames scar tissue from an appendectomy at age 3!)
But in any case all men do AS after their ops and radiation anyway. The PSA tyranny never really goes away. You once said that men often choose surgery because if it fails you can move on to HIFU, for example, and if that fails you can go to radiation and if that fails on to ADT, etc.. You then speculated that it might be better to cut out all the procedures in the middle and simply keep an eye on things until, if necessary, go straight to ADT and the other palliatives.
It seems that for most men, with insignificant prostate "cancer", the survival outcomes are the same whatever you do or don't do. But at least by not storming in with heroic intervention too early, the patient will avoid all the morbidities of surgery or radiation.
Although the uro I see now is a HIFU expert, he tries to keep intervention to a minimum. He is helping me do AS. My PSA over the 2 years since my op, from my remaining 6 grams, has been up and down from as high as 1.62 (post op!) down through 0.81 to as low as 0.13 and most recently 0.61. In his last letter he said although there has been "quite a bit of fluctuation . . . I think it's fair to say there is no obvious progressive rise. I am reassured by this."
So am I. But even if there is a progressive rise, I shall now think very carefully, and slowly, before I allow him to unleash the Sonablate or whatever.
Re: Might Negative Second Biopsy Procedures Indicate Spontaneous Regression?
Terry I guess it just depends on one's perspective. Most health professionals can readily recall cases that defy existing medial knowledge. Health professionals use the term spontaneous regression, some patients see it as divine intervention. No doubt science will provide explanations over time, particularly when therapies are able to attack identified rogue cells.
It refers to a study in Norway – those darned Scandanavians!! – and it says in part ….new study, to be published Tuesday in The Archives of Internal Medicine, suggests that even invasive cancers may sometimes go away without treatment and in larger numbers than anyone ever believed. Well, perhaps no one other than me – and the dozens of men who chose not to have immediate conventional treatment for an insignificant tumour.
I know this isn’t any proof positive of anything, but it should be food for thought for those with an open mind.
