But it's true that by not having radiation leaves it as a secondary treatment if necessary but most gloss over the fact it only has a 30% success rate.
As a relative newbie, do I assume that you are saying that RADIATION only has a 30% Success rate.. A very good reason for NOT considering it as a first step, if it means that surgery is pretty much OUT after Radiation, and Radiation only starts the problems of Incontinence and ED, which I understand, creep up over the next few years..
[Quote]Many here who have had surgery, find themselves soon after with systemic PCa, or lifelong effects.
Could I suggest that there should be a special qualification to that comment.. Most Folk hanging out here have a problem. By far the greater number of those who have surgery, never come back here.. The general statistics suggest that 95% can be guaranteed a normal life after an RP. That may be questioned by the percentage, for whom Incontinence and ED are an issue, but they still know that there is only a 5% chance of Systemic PCa.
[quote]For those with low risk PCa, many rather just worry about possiblities than have to wonder about incontinence that worse case scenario may never get better and likely long lasting ED and it's effect on relationships. All of a sudden 15 years of AS looks like a pretty good option IMHO over those.
Yes - that is the whole problem.. How does one define QOL... Sleeping well in the belief that I have a 5% chance of failure, or stressing the heart with the fear that the PSA will JUMP just after my next PSA test and that it might have escaped, by the time I have another.
Still - JohnT's observations are reassuring that given the RIGHT circumstances, AS can be a positive thing, if the patient has a positive attitude..It's normal for many here to justify their treatment by condemning others or especially AS. Those most vocal about it for some reason are many who have not been at this site long and soon are mass posting after treatment. I do hope your side effects get better but you shouldn't condemn those who aren't in a rush to experience and can live with PCa.
I suppose that many could be hurt by being criticised for their treatment decision (or lack of it ), by those who are convinced that statistically, the risk is NOT there in the first place, and that AS is the way to go. It's a two way street !
I would have thought that each is likely trying to justify their choice, and that NEITHER is critical of the other... Just trying to ensure that a third-part, sitting back and observing, is aware of ALL the issues..
Like folk talking about
Radiation, and how minimal invasive it is and how few the side effects are, but omit to mention that once irradiated, the goose is cooked and it's pretty much down hill from there until after three years, you are pretty much where the RP chap starts with lots of hope.. ( or that's at least as I have been told by Professors of Radiation - DON'T have radiation ! except ...... )
I would have been OK with AS, but ED would have been an absolute certainty, after castration by the bride, if I did not get cut and, after the Onc. told us of the prognosis.. Now, ED is a 50/50 thing, and I still have the family jewels !
Where there are Jewels - there's hope !
NO - I would hate to think that ANYONE reads discussion as criticism of personal choice.
Many of us Newbies might be just trying to convince ourselves that WE made the best choice for our situation.. Just as the Oldbies are convinced that they are right, whilst they await that NEXT PSA...
Nov 2009 = First-PSA 5.3 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-'10 = TRUS Bx DX - AC T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May-'10 = RRP-Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
MI(xtensive) Post, Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED -85%, Cont -5%
+17W First 'DRY' day. ED -90%
+26W ED -60%