Big congrats, buddy! Great news...
And you are the perfect counterpoint as well in this discussion. (Sorry about
that I might add) I don't care how many samples you take, if only one core is positive, it can be peripheral in
location, and it can extending from the prostate. Again, I wasn't discussing which treatment is best, but rather asking how can you be sure intervention isn't a good idea? There is no perfect biopsy or scan for this. In this study, 20% of those who waited had to change the plan at some point. Of those 25% were not expected to be able to remain in remission. Now this is about
13 guys out of 262 (5%). Again these odds increase with larger tumors to the point where watchful waiting is not an option. Who can accurately say where that is?
The nature of prostate cancer makes it tough to make that call. Again, I am not touting one way or the other. Nor a treatment modality. When I get to the panel, and I get asked are we overtreating prostate cancer, my response right now is:
Yes in many cases, but unfortunately it takes hindsight to know for sure when we didn't need to treat it. You can do Active Surveillence based on probabilities, but there are real risks that, even though the cancer can appear to be small, we are not able ascertain with clarity when using Active Surveillence will work and when it won't before making that decision. This is a very personal decision that requires a great deal of thought and understanding of your own cancer.
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
Post Edited (TC-LasVegas) : 3/17/2009 11:56:19 PM (GMT-6)