Dr Strum's best advice for beating PC is is faily simple:
1. Know the biology of your individalu cancer
2. Fit the treatment option to your cancer's biology
3. Find the best artist to perform the treatment.
I think that this is excellent advice for anyone hoping to beat this disease and a good strategy to follow. I have a military background and military history is my hobby, So I like to think of fighting PC as fighting a war. As as we were taught, Hope is not a strategy, and you have to have a good strategy to win. It does not guarentee winning, but it results in the probability of a favorable outcome.
Know the biology of your cancer. To me this means knowing how your enemy operates, his tactics and his strengths and weakness. All PC is not alike. There is very slow growing and indolant PC; PC that is growing at a rate that will eventually hurt you given enough time and PC that is very dangerous, and must be delt with in the most timely and severe manner. Also as long as PC is fully contained in the prostate it will not hurt you. Once it escapes, it grows locally in the prostate bed or surrounding tissues, then it goes to the pelvic lymphnodes, then to all the lymphnodes and then to the bones. It feeds on testosorone and insulin. It expresses itself in rising psa and pathological gleason grading, and you can tell a lot by these two metrics. PSA doubling time is usually a good indicator of how fast the cancer is growing and is genetic to the cancer, which means that it doesn't usually change over time. Multiple psa readings over time will usually give a good indication of how the cancer is behaving.
Multiple scans, color doppler or MRIS can also tell you a lot about your enemy; is he growing and how fast and is he near any critical areas, such as the margin, seminal vessicles, nerves ect. PSA3 can indicate its agressiveness and PAP can indicate if it has escaped the prostate. Only after you have good indications of its agressiveness, growth rate and location can you develop a strategy to defeat it. Going in blind usually results in failure and losses.
Find the treatment option that best fits you cancer's biology. If it is very slow growing and fully contained and not near any critical areas there is no need to attack; you will only suffer losses and be in the same place you sarted. You can watch it for any signs of increasing strength as in this stage it can't harm you. If it is growing to the point that sometime in the future it may become dangerous then you can deal with it. If you don't know the exact location or the size of your enemy your attack may fail. If you can identify it's location, size and strength then you can remove it choosing an option that least damages your own body and eliminates the threat. If it is strong and moving fast you have to hit it hard with all you have before you are overwhelmed. This may include surgery, RT and HT all in combination. Your best chance is the first chance and piecemealing your resources may not be the best strategy.
Choosing the best artist to perform the treatment. You want your most experienced and best general in the fight, not some newcomer. Skill and experience does matter.
I see a lot of patients make decisions based upon just one psa, one gleason reading and one doctor's recommendation; most of the time it's just not enough information to base a life changing decision on. As in most things, including fighting a war, you need information, a strategy based upon that information and a good general to implement it.