In the study you referred to most of the patients had moderatly differeniated PC and not low risk PC. It is not valid in evaluating AS, which has strict criteria relating to low risk PC only.
How do you explain the Hopkins studies that show there is no difference in cure rates of those low risk patients receiving deferred treatment vs those treated immediately. If being on AS was a dangerous as you infer there should be a vast difference in the BCFS in the deferred treatment group to the immediate treatment group.
The argument about
the long term benefits of screening vs the long term benefits of treating low risk PC are not apples to apples. Screening finds high risk PC and this is what kills you. In all of the studies I have seen, progression of low risk PC (if it does progress) usually occurrs within 3 to 5 years and free of progression usually remains stable after that, so if you go 5 years without progresssion the chances of a later progression is very low; that's why it's called indolant.
I also agree that too much emphsis is put on long term results as the vast majority of reoccurrances occur within 5 years and the longer you are cancer free the less chance of a reoccurranc regardless of the treatment recieved. Yes there are some reoccurrances after 15 years, and these occur with all treatments, but these are rare and your chances of developing an unrelated cancer is much greater.
64 years old.
PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.
2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.
Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.
Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.
25 treatments of IMRT 6 weeks after seed implants. No side affects at all.
PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.