A 5 Year Study helping men make informed decisions about prostate cancer treatments completed...

[NPfisherman]

Hello Wanderers,

When we start this journey, there are decisions to be made regarding RP, radiation treatments and no one can accurately tell us the likelihood of ED, urinary incontinence, etc... A recent study of 5 year follow up post treatments is now available...and while this is not the science I keep touting as coming...It is helpful....and for those having issues, it may give some insight into what could possibly happen over time....

sciencedaily.com/releases/2...

and the completed study....

jamanetwork.com/journals/ja...

Sexual function declines occurred even in the "Watchful Waiting" crowd, which I can only attribute to aging...

This Science came, but it gave me NO HOPE !!!........ROFL...

Don Pescado

[cesces]

Findings In this prospective, population-based study of 1386 men with favorable-risk prostate cancer and 619 men with unfavorable-risk prostate cancer, most functional differences, measured with Expanded Prostate Cancer Index Composite scores, associated with treatments (favorable-risk disease: active surveillance, nerve-sparing prostatectomy, external beam radiation therapy, or low-dose-rate brachytherapy; unfavorable-risk disease: prostatectomy or external beam radiation therapy with androgen deprivation therapy) attenuated over time with no clinically meaningful bowel or hormonal functional differences at 5 years. However, prostatectomy was associated with worse incontinence over 5 years (adjusted mean difference of –10.9 for favorable-risk disease and −23.2 for unfavorable-risk disease) and worse sexual function at 5 years for unfavorable-risk disease (adjusted mean difference, −12.5).

[cujoe]

Thanks for the article, Fish.

Based on my own knowledge, the equalizing of short- vs long-term effects of many treatments over 5 years sounds about right to me. As for ED with PCa patients and older men in general, here is an article that indicates it is much more prevalent than most would like (or are willing) to admit:

What Fraction of Men Develop Erectile Dysfunction, Really?

No one knows the prevalence of ED. But with time, the proportion keeps growing.

Psychology Today - Dec 15, 2017

psychologytoday.com/us/blog...

Be Well - K9

[NPfisherman in reply to cujoe]

Thanks for the reply, I do wonder what my treatment algorithm would be if I could choose again based on my knowledge base, but I really have no complaints because of how I am doing currently....If it ain't broke as we say in the WV... People usually don't choose anyway....It is the Urologist, MO, etc who decides the treatment regimen and determine what is offered...

Fish

[cujoe in reply to NPfisherman]

And then you got the guys like me, who ended up in a treatment regime (or current lack there of) because his MO was out of the country and the decision to continue/stop ADT after 3 mos was made by moi. Still off treatment with sub 0.1 PSA and normal T levels 2 years and counting. Hoped for benefit is to have preserved effectiveness of SOC ADT when I need it in the future. A roll of the dice for sure, but one this 72 year old is happy to make.

Minor benefits (to us) for looking back. If I had known what I know now, I doubt I would have gotten PCa in the first place - and I definitely would have tested T, gotten a second opinion, and taken action early enough to keep my cancer organ-confined. But, as we are where we are, we can only go forward. Most of us who frequent these forums at least have the benefit of making much better decisions as we go in that direction.

Thanks, as always, for you contributions. Be Well - K9

[NPfisherman in reply to cujoe]

K9 Caped Crusader,

Thanks for your reply. Indeed, the treatment options are changing and rapidly...It is why I believe we will be at Chronic Disease State within a few years with a 5 year OS for Stage 4 greater than 50%... I think one of the things that Dr Maha Hussain of Northwestern said in regards to treatment is that shamefully, too many patients are just being offered Lupron at initiation of treatment when they needed more...She estimated 70%...Would changing that alone bring 5 year OS to greater than 50% for Stage 4?? I believe so...

This is why it is so important to get an MO that specializes in PCa...

Have a great day...

Fish

[marnieg46]

Thanks npfisherman for this interesting study. As mentioned the outcomes do enable clinicans to better inform patients when making choices and this is a good thing. You'll be very glad to know I didn't need you to interpret the science for me this time.

[NPfisherman in reply to marnieg46]

I am always happy to help.... it is good that MD's can tell patients about their odds for fecal and urinary incontinence and ED.... I believe the odds have been under reported previously especially on ED... When you get on this hell ship, it is good to know what your odds are for certain things... Now, if the ACS would get busy and update the OS rates since those still seem outdated...

Fish

[marnieg46 in reply to NPfisherman]

Yes you're always very helpful - keeping across all the developments from a scientific perspective and making sure you include those items that recognise the QOL issues.

[cujoe in reply to NPfisherman]

Did you say something about someone being "odd"? I represent that statement, my good man! :o)

[NPfisherman in reply to cujoe]

You are on the island of banned toys so you are no more odd than the rest of the banished ones....LOL...

Fish

[cujoe in reply to NPfisherman]

Our own little Treasure Island, I'd say.

[marnieg46 in reply to cujoe]

Think I nearly found myself there for interrupting D’s dinner! Desert island looking quite good and I’d be in such good company too!

[NPfisherman in reply to marnieg46]

I think of us as more like an island oasis where people can get a different point of view ...

Fish

[NPfisherman in reply to marnieg46]

We'd be the ones in good company with you...Let's see ....we'll get a pistol for you to wear on the hip, a cutlass for the other side, and a dirk to slip into your boot... we are a dangerous lot.... Pirates of the Forbidden Forum...

Salty Fish

[marnieg46 in reply to NPfisherman]

Shall I draw up the Code? You know all pirates need to have a code or Articles . Hope the Captain's boat is seaworthy or at least has lots of life jackets. Sounds like you're going to make sure I'm well equipped at least for whatever dangers comes my way. I'm a better shot with a double barrel though if you're going to need me to defend you. The outfit doesn't sound too glamorous. Not at all like the women on Survival. I'll need some of the jewels/booty to add a bit of glitz. I hope you're in charge of fishing for dinner because if it's up to me we'd definitely starve. I could cook though. So when do we sail.... M

[NPfisherman in reply to marnieg46]

Sailing time is up to Captain Greybeard....as for the Code--this should be good for a start--we can expand on it...:

edu.pe.ca/springpark/pirate...

I will definitely do the fishing....A taut sail and a stiff breeze and all that...

Salty Fish

[NPfisherman in reply to marnieg46]

We'll see that you get glitz and booty ...sometimes a girl just needs a shiny bauble...I got one for the Lady M...

Fish

[NPfisherman in reply to cujoe]

Are you Long John Silver??

Fish

[cujoe in reply to NPfisherman]

Arrrrggghhh, Matey. Shiver me timbers! Afraid I'm just an old hand of Davy Jones - and just trying my best to avoid his locker. Always keep a keen eye on the weather & Be Well - Captain Graybeard

[NPfisherman in reply to cujoe]

Captain Greybeard,

I could be your First Mate and they can refer to me as Salty Fish fore and aft...or Salty Fish and Chips with a side of tartar sauce and a bit of ketchup.... for and aft...when does Long John's close?? I could go with a Fish and Chips and some hush puppies....

The Salty One...

[NPfisherman in reply to cujoe]

Next time we meet, will you have a parrot on your shoulder, a black doo rag, and an eye patch?? Perhaps a saber strapped on at the hip to give it the full pirate look.... Work on saying, " Arrgh, matey..."

Fish

[cujoe in reply to NPfisherman]

Beat you to it, Brother Fishman

[addicted2cycling in reply to cujoe]

Treasure Island implies a plethora of jewels so I vacated that location 5 years ago following my orchiectomy. As for an Oasis, that implies free flowing water and I sure have been seeking that for some time also; HOWEVER, I have been on Oasis of the Seas for some great cruising.

My land locked Dessert location would be anytime I'm riding my bicycles in comfort thanks to my banishment from Treasure Island. ;0) Had 75 miles of crank spinning-wheels rotating-tires humming isolation on my own Desert Island yesterday.

[cujoe in reply to addicted2cycling]

Wet or dry, it appears you have learned to make the very best of each situation - jewels or no jewels. Spinning Wheels Got To Go "Round

youtube.com/watch?v=SFEewD4...(Not working as expected?)

Be Well - Captain K9

[addicted2cycling in reply to cujoe]

youtube.com/watch?v=GugsCdL...(Not working as expected?)

[NPfisherman in reply to addicted2cycling]

Keep up the cycling.....exercise is shown to be beneficial in our disease....interval training especially... I am interested in what kind of immunotherapy injection you got at the start of this journey...would you expound on that information?

Fish

[addicted2cycling in reply to NPfisherman]

I was offered an option to have a 3 drug combination in addition to my unorthodox treatment procedure that had not yet received approval as a combo but on their own each one had obtained successful results with other cancers. Only 5 years into this experiment and Dr. wishes I do not mention the drugs used. Thanks for asking. Will be happy to reveal if I come out on top of this Gleason 10 wrestling match.

[NPfisherman in reply to addicted2cycling]

Understood.... Best of luck....

Don Pescado

[Hidden]

We are stuck

In the mudd !