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I want to honor Terry's memory (and his determination to promote AS for the right individuals) by asking you to explain where you stand on the subject.
Hi Alan,
Thanks for the question and a good one it is.
Alan, buried within the archive of this forum you will fine a plethora of exchanges twixt Terry and myself contrasting our perspectives on AS, and one or two other issues as well. I think those threads will provide you with insight into our juxtaposition.
Furthermore Alan, as a former dabbler in matters academic myself, it was never my desire to hand feed students. Do your research Alan, and by all means come back with issues that you feel need clarification. I would be happy to expand on any statements that I have made in relation to AS or any other matter that you may wish to canvass. To find both Terry's and my old posts, simply click on our username and a list of threads in chronological order will be displayed. They do go back quite a long way though, but riveting reading none the less, and for the most part, still salient today. It will be interesting to revisit what we said then. Get cracking Alan, there could be another doctoral dissertation buried in there.
In terms of honouring Terry's memory, you will not hear any disparaging words from me. True, Terry and I engaged in a bit of sabre rattling from time to time, but at the time of his passing, I, like most others on here, paid homage to both the "grand old PCa warrior" and "gentleman" that he was. I trust that whatever you seek to address through your research, will be sensitive to what I have just written. With all that being said, go to it Alan. Let's see if we can make a reasonable Horace Rumpole out of you.
best wishes
john
p.s. oops sorry Alan, droopy eyes this way, I thought the question was from Andrew the student. My apology, but the general gist of what I had to say still applies. Ask and I will endeavour to respond.
The tone of your reply initially came across as condescending, until I read your P.S.
Listen, I am not your student, and am I not writing my thesis on the writings of John Bonneville. I just wanted a no beat-around-the bush answer to my question** to gauge your open mind. Lastly, FWIW, I have been reading your posts right along since you "popped back up" some time ago after a long absence. In that time, while I may be remembering wrong, I do not remember any pro AS musings until your post following Terry's passing.
**A simple "I believe that AS is an appropriate strategy for men that meet the following conditions...", or "I think AS is not a wise and well thought out decision under any circumstances because..." would have sufficed. Short and to the point!
Alan I am not adverse to the use of AS in the management of PCa in suitable candidates. Below is an extract of the criteria for AS applicable in Australia, which I happen to agree with;
"Patients with low risk disease: men with low volume malignancy (one of four cores positive or less) of Gleason score 3+3 with a PSA of less than 10 ng/mL on presentation and either a non-palpable tumour on DRE or a small tumour occupying less than half of one lobe (stage T1c–T2a)"
Needless to say, we are talking about very early stage low risk disease.
The other indicator for AS in my view is a life expectancy of less than 10 years. Co-morbidity is of course another mitigating factor.
I trust this clarifies my position for AS for you.
