Question ?

[Murk]

Can I ask a stupid but obvious question? Forum regulators feel free to alter or delete

I've been participating on the boards here since 2020 and I wanted to ask one question many of us have.

Those individuals who were getting PSA tests early, often, yearly with physicals etc and thus saw their PSA start rising above the magical 4 ng/ml level. They took action with one of the many paths for treatments discussed here. Are they mainly here in this basic PCa forum versus the advanced PCa group?

My question is it proven that these watchful testing, discoveries, and thus the attack plans and kept these individuals in the initial PCa group here and in a more safe area of PCa?

Versus we have a forum here with the serious PCa impacted individuals. Are they mainly individuals who didn't discover their PCa until it was advanced???

Or is the more advanced PCa advanced cases just random or a result of a long drawn out process and failures of the many initial treatments???

Don't mean to be stupid or offend anyone but wanted to ask this question for a while.

[Tall_Allen]

If one is diagnosed while the cancer is still in the prostate, it is curable. Those in the advanced PCa forum were diagnosed either after the cancer had already metastasized, or were treated for localized prostate cancer, but found out later that it had already spread. PSA alone is not a good indicator of whether it is localized or metastasized.

[Murk in reply to Tall_Allen]

Thank you TA, short and right on point.

[Cooolone]

As we may all have a difference of opinion, I will say that there is no cure for cancer, not at this time. While we are more knowledgeable today as to associated and observed reactions and mechanisms, we really still don't know what even causes Cancer!

That said, when diagnosed early, this particular cancer is very treatable with favorable results. Curative in nature, but not truly "cured". Let alone when considering Prostate Cancer (PCa). A good example is when the UK began to not test PSA due to a study showing over treatment, no difference in early or later diagnosis, etc., what then occured was patients being diagnosed with more progressed or advanced disease when they eventually did PSA test. So in a way, there is benefit to being diagnosed early, if you're going to have this PCa. Statistical numbers (general) show some 1/3 of patients will fail first line therapy, and another 1/3 who go on to treat recurrence from that group will fail the 2nd line therapy. So yes, we could say that 2/3 of diagnosed patients receive "One & Done" treatment from 1st line therapy, but "cure" is a funny word. Why would I say that? With PCa being one of the slowest developing cancers, it could take so long for a recurrence, that typically a patient will die "With" the cancer, but not "From" it... Take the average age of diagnosis (65), factor in treatment, average age expectancy and the need to track the progression or lack thereof for a decade or more in order to truly "know" if the disease was completely eradicated, let alone post mortem examination isn't recorded when a patient does from something else that the PCa was present... How do we know the true numbers? Let alone for patients who do not obtain care from Major Cancer Center's that might track patients long term, local facilities and doctors do not. Anyways...

Diagnosis is such a funny thing, not all paths are so clear and evident. Even once diagnosed, the medical community using neat little boxes of risk stratification they place patients into isn't necessarily convenient to the patient. And what I mean by that is everyone's cancer is as individual as the patient, yet you'll get grouped into a risk profile based upon some things observed with testing, such as PSA, PSA history, family history, biopsy, scans... And that works for many (see above). But what about that 1/3 that fails? We're they really given the correct diagnosis, and or was the appropriate care provided? What's the defining line between a Intermediate High Risk stratification, or a Low High Risk? Lol... But that's for another discussion...

So many turns, so many things to consider, but ultimately the main avenue we all drive down while traveling this road is the Diagnosis Blvd! All the above is highly associated and dependent upon diagnosis, the accuracy thereof. So take the numbers for what they're worth. Ultimately, to test, or not test, treat or not treat becomes a personal decision. It can be based upon a great deal of input data for our minds to contemplate and make a decision, ie, family history, personal health, etc.! But once we do treat, there's really no way to back track and say this or that would've been better, 1st, 2nd lines and even when we drove into advanced disease, because unless we start to clone ourselves and try two paths to see which is best, ultimately there's no way to know or predict which one would've worked best!

Good Luck and Best Regards!

[Currumpaw in reply to Cooolone]

No one could have said this better.

Currumpaw

[Cooolone in reply to Cooolone]

Excuse the typos, lol

[Murk in reply to Cooolone]

Thank you for spending time and giving such a thoughtful and thorough answer.

[cpcohen]

>>>

My question is it proven that these watchful testing, discoveries, and thus the attack plans and kept these individuals in the initial PCa group here and in a more safe area of PCa?

>>>

My own story:

When I was diagnosed at age 62 (15 years ago), I had no symptoms, and my PSA was 8. My PSA doubling time was about 18 months, so the tumor wasn't aggressive.

I decided to have surgery, since long-term results for radiation were not available at that time, and my life expectancy was .

Surgery was successful -- my PSA has been 0, since then. So I'm as "cured" as any cancer patient can be.

In return, I have 15 years of experience handling ED and mild incontinence. I'm not happy about that, but I can live with those consequences. My life expectancy hasn't been affected by my cancer, or my treatment.

I would not advise _anyone_ to avoid PSA testing. Without it, the first symptoms of PCa often occur when the disease is well-advanced, and often metastatic. Treatment will probably not be "curative", and life expectancy will be substantially reduced.

So in answer to your question:

. . . I (for one) have been successful (so far) in staying in the "initial PCa" group,

. . . and expect (based on available stats) to remain there until I die.

. Charles

[Murk in reply to cpcohen]

THank you for insight and courteous reply.