Comments added in red
text, then detail provided below.
Certainly this shows AS is not without some risk. [This is not really true* for low-risk PC cases; see details below.]
As somebody above said treatment for prostate cancer is about what kind of gambler or risk taker you are. [As shown below, it's really more about how educated a patient you are, not how much of a gambler you are.]
No easy, certain answers on any choice. [This is absolutely integral to understanding the details below. There are risks to initially low-risk men whether you are treated immediately or not, and the risks are essentially the same...with the one* key noted exception.] This blog is great because it presents the points of view from posters across the whole spectrum of choices, it provides a great service to men seeking information on a difficult choice...
The comments in this post are misleading...please refer to the comments embedded above first. (For additional clarity, let's be sure to specify up-front that we are talking to the limited--but large--set of men initially diagnosed with low-risk PC, verified by an expert pathologist.)
The risks you allude to are the risks of having prostate cancer, not the risks of following Active Surveillance
- There is a risk of progression which exists for ALL men with PC. Men who have immediate (versus deferred) treatment DO sometimes progress; in other words, their treatment "fails" and they need secondary treatments.
- And men who initially follow AS also DO sometimes have to exit AS and seek deferred treatment. And a percentage of those who have sought deferred treatment following do sometimes progress, or "fail" primary treatment, and do need secondary treatment.
- But the percentage of initially low-risk men who progress and need secondary treatment is not higher for those who sought immediate initial treatment than it is for those who sought deferred treatment...the risk of primary treatment failure is the same for the entire cohort. Going on AS does not increase the risk of treatment "failure."
- For added clarity and completeness, men who initially follow AS and then defer treatment are program "successes" because they have successfully sought treatment only when and if treatment is needed...and for close to half of all men in this cohort over extended durations, treatment may never be needed. The only "failures" are those who progress after initial treatment, and again (repeating) the percentage is the same as it is for those who sought immediate treatment.
For those who go on AS, the key incremental risk is "getting on with life" so fully that one forgets to appropriately monitor PC activity and lets things get out of hand leading to an eventually progression "failure" due to ignoring it.