Hi Dan0, and welcome.
Since your biopsy in August, you undoubtedly have felt like you have begun drinking from a firehose, but I’ve got a suggestion for what I think is some very good information. Memorial Sloan Kettering (MSK) is known as one of the top, if not THE top facility in the world for treating Prostate Cancer…perhaps you already know this. They have an excellent webcast available free online that I have recommended to many newcomers; many found it very useful. Here’s the LINK.
The webcast features three doctors discussing their respective areas of PC treatment specialty, which are (perhaps you’ve already learned) are the three primary modes of aggressive treatment of PC:
· James Eastham, MD, is a surgeon
· Michael Zelfsky, MD, is a radiation oncologist
· Michael Morris, MD, is a medical oncologist (dealing with hormone therapy)
If you spend the roughly hour plus that it takes to listen to this entire webcast, you will learn a tremendous amount about the treatment modes—the pros and the cons—directly from the lips of some of the world’s leading experts…it would be time very well invested.
In fact, pay particularly close attention to the surgeon’s words; Dr Eastham mentions that for patients who present with low risk cases he often recommends a collaborative physician/patient approach of “Let’s see what happens.” The point is that some PC cases don't need aggressive treatment. This is because PC can exist in some men for years or for decades and never cause anyone any problem…and for these patients a careful surveillance program rather than aggressive treatment might be the best approach.
The main advantage of the “active surveillance” (AS) approach is an avoidance (or deferral) of the collateral damage and loss of function that are associated with a decrease in the quality of life as an outcome of the aggressive, invasive treatment modes. But please note that the criteria for entering and staying on a careful and “active” surveillance program is stringent. A good AS program administered by a knowledgeable physician will include a strict diet and exercise regimen…and quite frankly some men just aren’t willing to give up their juicy (fatty) steaks. The criteria is especially stringent for younger men, but the more developed programs do not have age restrictions…but the likelihood of eventually exiting AS is higher for younger men. I wish that the webcast had also included Dr Ballentine Carter and Dr Jonathan Epstein who are in charge of AS at MSK…both are world-renowned (Google them).
While you are pondering possible treatments, you might as well make sure that you are doing everything in your power to possibly avoid the knife, or the beam, or all the invasive treatments. Take a look at this very good article for newly diagnosed men like you published on the website of the Prostate Cancer Institute called “I Have Prostate Cancer, Now What?” I’ll tell you now what one of the very smart, very important first steps is: make immediate lifestyle changes. The article will help tell you how.