Casey and Ziggy: great replies from both of you. Thanks.
Casey, there's no doubt in my mind, and I think I've expressed this many times, that it's a certainty that many men are treated for prostate cancer who would (or might) never have died from it. I'm not sure that equates to "overtreatment." Yes, it's treatment that (thankfully) turned out to be unnecessary, but we really have no way of knowing that minus an unexpected heart attack or traffic accident, or stroke, or something else, that man might have eventually succumbed to prostate cancer. None of us possesses a working crystal ball, and divine revelation is a rarity.
I've also agreed many times that someone with Gleason 6, low volume prostate cancer should be very cautious about proceeding to radical treatment. At the same time, I would never suggest that I have the right, or the government has the right, or anyone has the right, to tell a man in that situation that he CANNOT make the decision and request treatment. That's a very personal and difficult choice for sure, and medical protocols should be put in place to ensure that these men, once diagnosed, are shown the reasonable courses of action available to them, and the downsides of those various choices.
But, I'm surprised you put yourself in the "overtreated" category. Look where you are in your life: newly married with, hopefully, decades of life ahead of you, with a couple of bright kids whose futures will unfold before your eyes. I truly hope that your cancer surgery will help you stay around through those years.
My situation was a bit worse than yours, with six positive cores (though relatively low percentages), and a palpable tumor, Gleason 3 + 4. But, since I was 65 at the time, I suppose it could be argued that I could have avoided the surgery, and that perhaps some other event might kill me before the cancer ever would. But I don't think that's the way most of us live our lives. We don't tend to avoid taking action today because unforeseen future events might render our current decisions unnecessary. So, I put myself firmly in the "not overtreated" camp.
Good medicine will always involve some degree of "overtreatment." People will undergo serious medical procedures only to learn that the doctors guessed wrong, or that the less than conclusive tests should have been interpreted differently. In a perfect world, none of this would happen, but this world is just not perfect. We've seen a lot of suggestions here on HW for reducing overtreatment. I favor the ones that call for new treatment protocols, new methods of patient education prior to treatment.
The claim of a million men living who have been overtreated seems to me to be a number based entirely on speculation. That's about 25 percent larger than the entire population of Alaska and I have to wonder who came up with it, and how they arrived at it.