Somebody said...
Statistically speaking, we can see not just from this document, but from many that indicate few of us have yet to encounter a situation that indicates that we may have actually altered the course of our disease, and if we do get to that point it's likely a situation that indicates that we in fact did not do so adequately enough.

VeteranMember said...
....... they are giving the details that should be what your doctor tells you, but generally does not. ............ My doctor was fairly complete in this respect, but only if I listen to the recording I made of that session. It helps to see it in writing. The "educated" patient must understand all those possible nightmares, and that will only happen if they understand what they hear as well as simply listen.

How many of us can relate to this:-  

(U-Doc )   "....I have to tell you that you have prostate cancer..  Now - you should not be too concerned, because most men with what you have, are more likely to die under a bus, than from the CANCER itself.....  There are options ......, and you need to understand them all before seeking a solution... "

I choose to suggest the comment  on "Under the bus with them" is a parody of what WE were told as new cancer patients, by Doctors keen on allaying our instant dread of a possible death-sentence.
 
One of the problems with the PC-Industry is lack of information.. 
Having said that, there must be a real dilemma for the average U-Doc as to just how much information is given and how fast it is given.
We men seem to enter the sausage factory, and are processed in the same order..  Each specialist lines up, and informs us of what THEY can do to help..  Each is limited by their "Professional Indemnity" in what advice they can give.

Could I speculate , that we here on HW, are just a snapshot of reality..  A snapshot of what is happening out there, and our confusion reflects a glint of what must exist for those without the Internet. 
I know men who just turn-off and don't want to know anything about their ailment or possible treatment, and then I know men craving information, and willing to make an informed decision

I could suggest that I was nearly a  "Lorenzo Q. Squarf", were it not for the family and friends who impressed upon me that they had more to lose from my bravado and belief, that I could DIY my own cure.

 
I might have done so,  but then I think of the doctor referenced earlier, who on his death bed declared  "perhaps I left it too long"... and fear for  someone with Bone-Mets, after declining treatment.

To be offered a statistically significant guarantee of full cure, or be left to nature, is not a real choice  IMHO..

{not all treatments are successful and not all treatments are failures .... }

But delayed treatments are almost guaranteed to be less successful (to varying degrees) than early intervention, except that with early-intervention, the patient will NEVER know what might have been..

Whilst this thread has proved contentious, I can't help thinking that it has done nothing to harm HW, and has shown that we men can think a little more distant than 10inches (???) from our navels..

I cannot accept that knowledge of the disease has had anything but a positive impact on the lives of every man that I know with PC..    I am not saying that they welcome the Dx and the prognosis..

For anyone to suggest that it's likely better to not know, than to know and show concern for what we will do, is a strange indictment of Male mentality. 

Oh, how I wish that I could roll over in the night and love my wife in the way I have for the past 40 years.

Oh, how she wishes that was still the case (occasionally), but there is more to LIFE..

Whilst we can observe that with BCa there is an image-issue that can colour the female-concerns,  I have to say that as a male, the suggestion that I might not have sex as WE have know it for the past 40 years, ever again, would seem to be FAR more relevant and daunting than a concern over disfigurement..  That's the male in me thinking that way ! 
Few women of age 60 would consider that going topless is of high priority in their lives, and for their husbands, their appearance would not change despite any surgical disfigurement.

I have to respectfully say that for those who wish to remain blissfully unaware, enjoy your life !
AND - to those who seek information and treatment - Go for it, and God willing, you will do fine.
AND - to those of the bureaucracy who think we are statistically not worth the Government dollars spent on possible cures, find something REAL that money can be saved on..   --  Like planning for pre-obsolete Internet networking.

AND - to those who agree with the Govt. that more die from falling out of bed, or from ladders, than those directly of PCa --  "under the bus with them"..
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Agreed.... !

I was reviewing these threads and realised how far Off-Thread we were to "The Book", which contains INFORMATION, good information, and we all crave is just that.

Generally the O-T issue seems to come from the misinterpretation of how this book might be viewed.

Surely we are all either seeking rational information to seek a cure, or seeking information on what to do to recover what was lost (if appropriate) after or during the cure procedd..   Our little angers are best aimed at the System, and not the support.

{Debating controversial subjects should be taken elsewhere. }

I do suggest that this 'Rule' is somewhat open to interpretation as so very much of the Medical Issues are themselves - Contraversial, and hence to limit discussion to Non-Contraversial issue, is shutting a great many doors

Thanks, JamesC

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TinFoilHat:  Use the metaphor or analogy all you want.  It has probably been used by someone else on this site.  I know I didn't invent it, but yeah, it seems pretty descriptive.  I also like the signature on this site that says, in effect, "I beat up this disease and took its lunch money."  I think it's TC-Las Vegas.  That's what we all hope to do.

Good article. Once we are in this boat, we need to check for leaks.

Fairwind,

NO, NO, NO

And understand I don't care about the politics of the book (they were not evident to me, and reading it again, I still don't see a recommendation). The summary information was great.

I do not agree with your comments on the surgery section.

As having been once part of the legal community, I would also say that encouraging that a specific part of any community be thrown under a bus (therefore violence) violates rule number 1.

IMHO == and for those who have not read the book ---

Having sat down and read the book from cover to cover, (rather than the previous sampling) , I have to say that the book seems a very good resource and presents facts without making any real recommendations. 

My regret is that it might be used as the basis for Health-Care planning in Australia.

Aspects in the book are repeated in a number of ways.
The book does repeatedly stress the statistics suggesting that wide-scale screening is pointless and a potentially wasteful public expense

Section SIX is a must read for anyone interested in learning about the technology and the terminology of the ailment.

Some of the interesting comments

{The surgery will have been unnecessary because .strange as this idea may seem . the cancer would have never caused problems in many of these men's lives. This is an absolutely central point that is at the heart of this book.}

{The other core point we will make is that medical science is today unable to predict with any precision which early discovered prostate cancers will turn out to be those that kill,}

{Prostate cancer is the second most common cause of cancer death in Australian men (after lung cancer..............) the large majority of men who die from the disease die late in life close to when they would have in all probability have died from another cause anyway.}

{The surgery will have been unnecessary because strange as this idea may seem . the cancer would have never caused problems in many of these men's lives.

This is an absolutely central point that is at the heart of this book.}

{Some of these men, and others who are not impotent, also have ongoing incontinence problems. These are not problems that you wear on your sleeve, or announce to the world. They are typically endured privately and rationalised by the very powerful idea that these problems were small prices to have to pay to remain alive.}

Of interest to ME as one who was Dx'ed with cancer , subsequently shown to be a potential killer.....
{Prostate cancer is the cause of death in only about 4% of men. Since it occurs in up to 50% of men, we therefore know that in many, many men it is not life threatening}

So - if 50% of ALL men will develop PCa, and 4% of ALL men die from it, then this says that 8% of men with PCa will die from it.
ie.  nearly 1 on 10 chance that IF you have PC, then you may die from it !

To me, the relevance is that if one is detected as having PCa, then you have a near 1 in 10 chance that it MAY have actually killed you, had you not reacted to control it.

Of men who died "Un-naturally"
{Among men aged 50.59, 23% had incidental prostate cancer and among those aged 60.69, 35% (approximately one in three) had incidental prostate cancer. In the oldest group (aged 70.81) 46% of men were harbouring the disease}

Cancer site     Number      Per cent of total cancer     Crude rate per 100,000     Risk to age 85
All cancers      59,058      100.0                                                 584.6                          1 in 2
Prostate         17,444       29.5                                                  170.0                          1 in 5

Conflicting Stats...  ???     by age 85,    1 in 2 men will have problems with CANCER, and 1 in 5 will find that it's Prostate Cancer !

{Because people have to die of some cause, reductions in some causes of death inevitably mean that more men will die from other causes instead.}
Suggesting that as improvements in treatment for other cancers, reduces their death-rates, so, proportionally, PCa becomes more statistically serious..

{Dr Richard Ablin, the scientist who discovered the Prostate Specific Antigen in 1970, wrote forcefully about it (PSA Tests) in March 2010 in The New York Times, describing the test's popularity as "a hugely expensive public health disaster".  He continued the test is hardly more effective than a coin toss.
As I've been trying to make clear for many years now, P.S.A. testing can't detect prostate cancer and, more important, it can't distinguish between the two types of prostate cancer . the one that will kill you and the one that won't.}

One of the most fascinating statements, reports on the extensive use of the DaVinci robot and it's poor results..
{The JAMA study of 1938 men followed for five years reported that, compared to routine "retropubic" radical prostatectomy, minimally invasive prostatectomy performed via robotic surgery "was associated with an increased risk of genitourinary complications (4.7% versus 2.1%) and diagnoses of incontinence (15.9% versus 12.2%) and erectile dysfunction (26.8 versus 19.2 per 100 person-years)".}

This was the reason used by my Uro, to insist that only RRP be used for Prostate Removal.. 

Also interestingly, Australia's top (DaVinci) RLRP Surgeon reports that it takes 2000 operations before a Surgeon can be consider as least risk prone.  Ouch - for the first 1900 patients...

It is contrary to the personal beliefs held prior to the RRP, where the impression was that "Some have problems".

When I conduct personal investigations, I find that THIS finding above is far more likely the rule, than was suggested pre-RRP..

{Make your own choice: weighing up the benefits and harmful effects of prostate cancer}

Post Edited (BuiDoi) : 11/18/2010 10:57:16 PM (GMT-7)