The Unending PSA Controversy

The first and third are my opinion and I stand by them. My opinion shouldn't piss you off.

In the second one, please notice the pronoun "I", as in me, and I was referencing the fact that my PSA had dropped down to .5 and yes, I think I would be nuts to have a radical procedure at this point.

Really, you need to take it down a notch and not take everything so personally.

No, I would not. I would tell them that I respect their opinions and that we should agree to disagree. Life, death and cancer evoke strong feelings and strong passions. I fault no one for whatever conclusions they have come to and understand their passion.

Have a good day, I believe we're done here.

Ed (F8):

You made a comment just before I left work to head home and make supper, eat it, walk the dog, etc., etc., etc. and now the conversation has moved on. But, with your permission I'd like to revisit your "can't tell if you were overtreated" thing. I have an analogy that might help those confused.

Suppose there was a proposal to implement a lottery in your state and you were trying to figure out who would benefit and who would be hurt by it. For simplicity sake let's limit our thinking to the actual winnings and loss and ignore such things as the program the lottery might fund or whether non-players are free-riding on the system.

So, if you vote against the lottery and it doesn't pass, who is helped? The guys who would have played the lottery and lost. And who is hurt? The ones who would have played and won.

From the experience of similar states that have passed a lottery you can estimate how many people would play. From the design of the game you can work out the odds -- you can know how many winners and losers there would be. Assuming that you know that you are the kind of guy who would play a lottery if there was one, then based on self interest and the information above, can you know for sure whether you would or wouldn't be hurt by voting against the lottery?

Without a time machine there is no way to point at anyone and say "this guy would have won ten million dollars so he was hurt by the lottery not passing." But some state lotteries start at 10 mil for the grand prize and go up, so you can know that guy is out there... someone, somewhere didn't get that ten million bucks but you don't know who he is nor does he.

The guys who are overtreated for prostate cancer are the guys who would have won the gamble if they had chosen not to be treated. Statistically, you can show that they are out there but there is no way for them to know that they would have won.

Comments deleted for Rule 3 violation

ed

Post Edited By Moderator (Tudpock18) : 8/15/2014 5:01:56 AM (GMT-6)

Hi guys, this thread has reached 4 pages and we finally had to do an edit for a Rule 3 violation. As was expressed earlier in this thread, we can and should address each other without resorting to pejorative comments. This is a serious subject that evokes strong feelings but PLEASE address each other respectfully and in the spirit of our forum. Agreeing to disagree is ok.

Thanks,

Jim

Temporary lock at the request of the OP

hi, I would be considered a newbie, I was diagnosed with pc a year ago and had a random biopsy my psa at the time was 6.3 and I believe my gleason score was 3.5, ten out of 12 cores came back negative two positive. my urologist sent me to see a robotic surgeon and he was adamant that I undergo radical robotic surgery, I then went to see an oncologist and between he and my uro they told me with my numbers I had a lot of options but it was their suggestion that I should watch and wait. my uro said why get aggressive with it if it wasn't getting aggressive with me and have another random biopsy in a year, i underwent another biopsy a month ago. 8 cores came back negative 4 positive psa 2.3 gleason score 6 now my uro is pushing me towards radical robotic surgery. if everything i read about this with my new numbers i am still considered low risk. i have read about mri guided laser ablations and i believe this is the way to go unfortunately there are only a few places that perform this procedure and although they are fda approved most insurance companies are not covering them as of yet. so i guess if i am in fact low risk would i have time to watch and wait in hopes of this procedure is approved. your thoughts please

truckdriver52 - from my poor understanding of PCa I'd say it is hard to say what to do. Many men who opt for surgery later have their Gleason scores upgraded/downgraded. If it were me I'd do something about it before you get a "random" biopsy that comes back as a G7 or higher.