It's getting a little one-sided here. What fun is that? I'm going to change teams.
I was the first one to point out that AS is an option you should consider. But it won't break my heart if you pick a different option. It's up to you and it's not an easy choice to make.
If you look at my signature you may notice that I was a candidate for AS before I had my surgery. I talked to two different surgeons and both of them recommended it. But my wife's dad died of prostate cancer and if you added her level of anxiety to mine it seemed like AS wouldn't be much fun for us. My surgeon was sort of surprised when I told him I wanted to go ahead with the surgery. And then when he opened my up he found lots more cancer, and more aggressive cancer than any of my four biopsies had shown. So, as it turned out, it was a good thing for me that I was such a nervous Nelly. When I choose to rattle my chains I can easily play the Ghost of Active Surveillance Anxiety.
I saw one study recently that predicted the difference between enrolling in an AS program vs immediate radical prostatectomy. I seem to remember if was Johns Hopkins program but I could be wrong. I do remember that they predicted that the men who had the immediate surgery would live, on average, 1.8 months longer but the men who enrolled in the AS program would get an extra 6 years, on average, of normal no-side-effect life before they needed treatment. They then did some sort of calculation of quality-of-life adjusted survival and decided that the guys on AS had more good years and they won, even though they didn't live quite as long. OK, fine. Although I might well have been one of those few guys who brought down the average "real" survival by those 1.8 months.
I saw another study about selecting men who were candidates for AS. One of the criteria they were proposing was to eliminate men who were prone to be anxious -- maybe some of them NKenney's gloomy Scandinavians -- to avoid compliance problems with the program.
So AS is an option that all low-risk guys should consider. But it's not for everybody. It wasn't right for me and it might not be right for you.
But then again...
Very interesting post, PDA.
BTW, I forgot to say in my last post: though I have not been happy with my SEs which many other men seem to get as bad or even much worse- and get them whether or not they get a "cure"- still there are a fair number who seem to have virtually no SEs at all at least after a few months to 2 years. So I'm thinking most of these guys are probably pretty happy with their choice of surgery, I probably would be too. I just can't see how anyone can predict in advance which group they are going to be in. Also, my impression is that the majority of these men are G6s/not terrible PSA/OK DRE with no need to cut wide and able to have full nerve sparing. Not all in that group will get a trifecta, but most trifectas are in that group, seems to me. Of course, most of those guys are also the good prospects for AS.
Anyway, back to PDAs post. PDA, do you recall if the predictions in the study were for the AS guys to die 1.8 months earlier from PC?
Or was this all cause death? I ask because statistically, aren't the solid majority of G6s(or heck, even a lot of higher Gs, but for sure G6s) going to die from other than PC? Well, either way, 1.8 months
of extra life vs an extra 6 years SE free? Well, people will vary, but I know which I would choose based on those #s. And while going with the AS, (or possibly BT or something with really low %SEs) I would be hoping for less traumatic cures to come along and pursuing some of the more natural approaches. But I understand some folks would just have to have it out, possible/likely SEs be danged.
PSA 10.9 ~112013
Bx on 112013 at age 64 yrs 11 months, with 5 of 12 pos with one G9(5+4), 1 PNI, T2B.
RALP with lymph nodes at Vanderbilt 021914. (nodes clear, but SV+, still G9 but down graded to 4+5, cut wide, but 1 tiny foci right at the edge of margin ) Pros. 106.7 gms!
At 15 months, not wearing a pad most days, mostly dry
PSA <.1 on 4/7,
PSA <.01 on 6/11, 8/20/14 and 3/4/15
Post Edited (BillyBob@388) : 8/13/2015 9:17:00 PM (GMT-6)