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What Your Doctors Won't Tell You

From PPML:

Date: Mon, 24 Nov 1997 09:25:36 -0600
From: Scott M <realty@EXCEL.NET>
Subject: Note to Scott Eauslin

Here's what his doctors won't tell him:

There is currently no treatment available that has been proven capable of providing a cure, capable of extending life, or of doing more good than harm. In addition, all treatments have undesirable side effects that can seriously detract from the patient's quality of life for the rest of his days.

In the United States, only one of every eight men diagnosed is forecast to die from the disease. The indication is that seven of the eight men would not benefit from treatment. Unfortunately, it is not possible today to determine which one of the eight men requires treatment and there is no assurance that currently available treatments could cure him if he could be identified. Source: http://rattler.cameron.edu/ww/wwopt.htm

"Because the primary goal of the urologist is to "cure" prostate cancer and prolong life, the concept of surveillance therapy seems to be quite inappropriate; however, few other diseases have treatments that can so negatively impact on a man's daily quality of life. In addition, the natural history of this cancer, in contrast to many others, does not invariably lead to metastasis or death during the normal life span of most patients. Therefore, in contrast to physicians, many men may wish to maximize their quality of life rather than their duration of survival. This choice depends on the probability of good and bad outcomes that are possible with each treatment option. Ultimately, it is the patient's choice to make with help and unbiased guidance from the physician."
from "Defining the Role of Surveillance in the Management of Localized Prostate Cancer" by Jeffrey S. Palmer, MD from the Department of Surgery, University of Chicago Pritzker School of Medicine; and Gerald W. Chodak, MD from the Prostate/Urology Center at Weiss Memorial Hospital, Chicago. The article can be found in the Nov., 1996 issue of The Urologic Clinics of North America, pages 551 thru 556.

Also, once PSA has passed 10, the reappearance of cancer after RP is at least 62% within 10 years, and that's 10 unpleasant years.

Scott