Benefits and Risks of Primary Treatments for High-risk

[maley2711]

This 2020 EAU supported study of many studies.....

sci-hub.st/10.1016/j.eururo...

each can take it as he/she wishes.....one particular thing caught my attention...

" not

only treatment, but also classification of patients into

prognostic groups is the key to optimal treatment. A recent

SR on the impact of biochemical recurrence (BCR) after

treatment with curative intent proposed additional risk

stratification (EAU high-risk BCR and EAU low-risk BCR)

based on risk factors for clinical progression and worse

survival (short PSA doubling time and a high final GS after

RP, and a high biopsy GS and a short interval to BCR after

RT). Such a classification system can guide clinical

decisions to initiate salvage treatment. A first validation

of this classification system was performed in a large series

of patients with BCR after RP, showing its potential and

applicability in daily practice [113]. However, further

validation is still mandatory in both post-RP and post-RT

settings. Another rapidly evolving area is the use of (non)

genomic biomarkers and molecular imaging [114–

117]. Such prognostic and predictive tools offer an

alternative way of patient stratification supplementary

to our clinical system and may guide clinicians in the

decision whether to intensify FU and treatment schemes. "

I'm still searching myself as to how I will eventually be able to begin any of these multimodal approaches while knowing I am volunteering for an almost immediate substantial reduction in QOL at age 72? and with ADT, increasing my risk for cardiovascular death and other big negatives.....notwithstanding high risk PCa, CV event remains most probable cause of early death, not PCa!