More on RP vs RT

[dentaltwin]

Interesting (to me anyway) are the examples given for individual patients with different risk profiles and ages.

jamanetwork.com/journals/ja...

[Tall_Allen]

My first reaction was - what about ProtecT? Then I read: "Our result is inconsistent with the findings from the randomized ProtecT study, and we believe this outcome is due to unmeasured confounders for survival not included in our analyses (at least in part)." This highlights the importance of large, randomized clinical trials, which are, unfortunately, difficult and expensive.

[dentaltwin in reply to Tall_Allen]

Those damned confounders will get you every time.

[Tall_Allen in reply to dentaltwin]

LOL - Confound it!

[Hidden]

This continues to be the challenge. There are more head-to-head studies in the pipeline but as a patient I have to make the best decision I can with the data I have. And then worry about it or choose not to worry about it.

"Act in Haste, Regret in Leisure"

This is part of the treachery of cancer, the fear and the sense that I need to take care of this right now. I wish I had read the Scholz book before I made my decision instead of after having RP. I do not think I would have changed my mind but that first week after I read the chapter on treating of "Azure" CaP I had my moments. There were some "benefits" of RP, specifically that the Gleason on the prostate specimen was judged a 9 instead of the previous 8. But that was a trivial difference.

--I made the best decision I could with the information I had at hand.

-- I cannot put the prostate back in.

-- I knew at the outset that I might need eventual radiation

That said, I counsel everyone I can that they do not need to be in a great hurry to decide. For MOST of us, prostate cancer will not be the cause of death.

[Jeff85705 in reply to Hidden]

Key word is "most." Make an informed decision "at leisure" but based on evidence of tumor, such as increased PSA PLUS biopsy or MRI. It is true that "most" men will not die of "most" prostate cancers, but many will need treatment if the tumor shows evidence of aggressiveness or near-aggressiveness. Fortunately, we have ways to help us determine the best route: PSA, Gleason score, pre-treatment staging. Don't make a hasty decision, but do the research.

[Hidden in reply to Jeff85705]

could not agree more, Jeff85705