Perhaps more of a rant here, but I'd greatly appreciate feedback if I'm being too hard in my evaluation of the care being offered in this disease.
Brief summary: RP 2001, biochemical recurrence in 2015 to salvage radiation 2016, now looking at systemic tx as PSA is rising again (last dt was 4 months, low load) and one mets located at pelvic edge lymph node. Being offered Lupron.
In my analysis, care/tx of prostate cancer has been a little slow in the past. Perhaps because it was viewed as slow growing and a disease of "old men" who are going to die of something else first. My RP was open abd at a good center (Seattle) and at the time told I could get robotic surg in France, but an 8 hr procedure at U of W if I wanted it here. Surgery went well, no real bad results in terms of QOL (very lucky). In 2015 I was told looking for mets before salvage radiation was not a good idea due to low PSA (0.41), but that for salvage radiation, I needed to do it now for best outcome. Completed, nadir of 0.11.
Today I would try and get a better scan option before SR to see if we could locate mets, and many advances in RP since 2001. My understanding is that Lupron has been the SOC "go to" for the past 40 plus years. It works (at least for a time) and sure the side effects are not pleasant, but "do you want to die and miss out on the grand kids", etc). Totally get that, but it seems again that this isn't really the only SOC first step, but rather the "usual" first step. Accept that I've always been a little late in terms of advances and really not all that unhappy about care to date; but it seems that SR and Lupron are pretty blunt instruments and may be better ways to go, without getting to out there in terms of chasing every "new thing" in someone's research or phase 1 testing.
Am I off base here?