Thanks to everyone for all of the input. I wish I could respond to each individually, but that's not really possible. The one thing I keep coming back to is the Detroit study (I think there have actually been several at this point) that analyzed prostates taking during the autopsies of men who died from trauma (and had no diagnosis of prostate cancer). They found that 10% of men in their 20s, 30% of men in their 30s, 40% of men in their 40s, 45% of men in their 50s, 70% of men in their 60s had prostate cancer. Obviously, those numbers are far less than the numbers of men who are diagnosed and treated. My doctors tell me I should have my prostate removed. But if I should do that, then so should 40% of all men in their 40s, so I wonder if that's really the answer.
Of course, the difference is that I know about
mine, and most other men in their 40s with prostate cancer don't know. AS seems like what I should do, unless a more serious PC is found down the line. But I understand the psychological reasons for getting it cut out. Also, you never know until they do the post op pathology what you really had. Surgery brings SE, but it can bring comfort and does reduce risk of dying from PC, even if that risk wasn't high to being with. So there are valid reasons for someone like me to get surgery, and I may yet do it. But right now, I'm leaning away from surgery.
AS is probably what logic dictates I should do, but I've had issues with biopsies and I don't really want one a year for the next 20 to 30 years. I did not have any infections with the two I've had so far, but I've read accounts about
how bad those are, and that's a significant factor. Also, I just don't know if I can handle doing nothing about
this for the rest of my life, even though it's certainly logical to take that course. Plus, there is some risk is not treating. I am young, have a wife and a 3 year old, and if I do AS to some extent I am putting the risk of SE ahead of risk of dying. If it were just me and no family, I'd have an easier time doing AS.
I am still looking into TFT, and I am leaning towards taking that first step, a mapping biopsy, in the near future. I think that would be of significant benefit as a diagnostic tool even I don't end up doing the TFT. Aside from Ziggy, who I have already heard from on this, has anyone else had a mapping biopsy? What was your experience? My Dr in Dallas (and would be surgeon, if I go that route) is concerned that the scar tissue from it could hinder surgery if that is done later. The folks in Colorado who do the mapping biopsy and the TFT are not concerned about
that. Really, like true downside of it seems to be the time, expense, pain in the ***, and a catheter for several days. I should mention that I've had an MRI with an endorectal coil (not fun), but I'm told the mapping biopsy would tell me a lot more than the MRI. Does anyone who's had a mapping biopsy have any thoughts on this?
Apparently, I made a wrong assumption regarding radiation. I assumed that since the prostate is left in place, even if my original PC is eradicated, another PC could pop up in the future and I wouldn't have the surgery option to deal with it. However, I have now been told that there is no evidence that a new cancer can arise in a radiated prostate. If that's true, is it true for both external beam and seeds? And if it's true, radiation (particularly seeds) seems like possibly a good option for me. I know there is some risk of secondary cancer, but it's very, very small, right? And I've heard that SEs (particularly ED) are much better with radiation than surgery. Is that true in everyone's experience? What are the pros and cons of seeds versus external beam? I am a little new to the radiation idea, and have not met with a radiologist yet. Tudpock (Jim), have you not had any permanant SEs from seeds?
Post Edited (JRK) : 5/14/2014 2:21:42 PM (GMT-6)