Guest guest Posted December 21, 2006 Report Share Posted December 21, 2006 Sorry Abe – I incorrectly addressed you as Piers, getting two similar situations mixed up!! All the best, Terry Herbert in Melbourne, Australia Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. November '06 PSA 31.4 My site is at www.yananow.net As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data: Dr “Snuffy” Myers. From: Terry Herbert Sent: Friday, 22 December 2006 11:52 AM To: 'ProstateCancerSupport ' Subject: RE: NYC Update G’day Piers, You say, in part <snip> I have discovered in this whole process that I am not the type of personality that can live with too much uncertainty. <snip> Unfortunately everything to do with PCa involves a good deal of uncertainty as you are finding. I am facing the same kind of problem as you are after 10 years of “watchful waiting”. I had my biennial bone scan earlier this week and there is one spot on my spine, adjacent to an are ‘typical of degenerative damage” which may be suspicious for metastasis. Hmmm. Is this the radiographer being ultra cautious and protecting himself from any kind of legal action in the future: is this the radiologist being ultra conservative: is this the radiographer genuinely believing that I should be warned of a potential metastasic extension of the disease? Or is this just an extension of the degenerative damage? I dunno, but I’ll give it some thought. Of course having treatment doesn’t really remove uncertainty either because there is no guarantee of ‘cure’ no matter what you do. Everyone who has had treatment has to watch their PSA ever after for signs of failure of the treatment. This extract from a recent report (the entire report is in the Files section of the group – click on Files at the bottom of this message and see the file labeled Insights AS article.): <snip> The psychological effects of living for many years with untreated cancer are a potential concern. Does the cumulative effect, year after year, of knowing one is living with untreated cancer lead to depression or other adverse effects? The best data on this comes from a companion study to the Holmberg randomized trial of surgery vs. watchful waiting in Sweden. It found absolutely no significant psychological difference between the two groups be after five years. Worry, anxiety, depression, all were equal between the two arms. While surveillance may be stressful for some men, the reality is that most patients with prostate cancer, whether treated or not, are concerned about the risk of progression. Anxiety about PSA recurrence is common among both treated and untreated patients. It is hoped that with education patients will begin to understand the very indolent natural history of most good-risk prostate cancers and, with the realization that the disease is not life-threatening, may avoid much of this anxiety. <snip> Good luck to you in whatever decision you make. All the best Terry Herbert in Melbourne Australia Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June '04: TURP. Nov '06 PSA 31.4 My site is at www.prostatecancerwatchfulwaiting.co.za It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Abe Sent: Friday, 22 December 2006 3:52 AM To: ProstateCancerSupport Subject: NYC Update hi friends, well, had my follow up consultation with my (surgeon) doc at memorial sloan kettering in nyc. the mri showed some abnormality mainly in the left section. of course, once you go through the process they start telling you that the mri is not 100% accurate and the abnormalities may, or may not be malignant. in any event, the mri results, in addition to my psa going up from 4.3 to 6.3 over the past month was still not enough to " alarm " my doc. he still feels that my pc is still one that can be " watched " for a while with possibly repeating the psa and a more focused biopsy and an mri if called for. i have dicovered in this whole process that i am not the type of personality that can live with too much uncertainty. the idea of repeating tests and thus putting off the probable inevitable is not overly appealing to me. i have looked into the various treatment options and i am inclined to go with the lap surgery - again i guess my personality is kicking in as far as tackling this situation agreesively and definitively, well at least that is the feeling it gives me right or wrong. i guess that something should be said about my doc being a surgeon and not " selling " me on the surgery option. on the other hand when i ask him if its possible that by the wait and see option he might tell me a year down the road that this was not (in hindsight) the best option we could have taken; his (honest) answer is " yes, that could happen " . again i guess my personality is kicking in and taking over. anyway, they took another blood test to see what the psa is doing. in the back of my mind i seem to have decided that if the number shoots up again i am going to opt for the surgery. meanwhile, like many others here, i am going to try and take some time out and enjoy the holiday. to one and all, thanks for your on and off board notes of advice and support. have a great holiday season and a very happy new year. Abe-) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 21, 2006 Report Share Posted December 21, 2006 No worries mate - I am sure all can benefit from your experience. Abe-) > > Sorry Abe - I incorrectly addressed you as Piers, getting two similar > situations mixed up!! > > > > All the best, > > Terry Herbert in Melbourne, Australia > > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. > November '06 PSA 31.4 > > My site is at www.yananow.net <http://www.yananow.net/> > > As a physician, I am painfully aware that most of the decisions we make with > regard to prostate cancer are made with inadequate data: Dr " Snuffy " > Myers. > > > > _____ > > From: Terry Herbert > Sent: Friday, 22 December 2006 11:52 AM > To: 'ProstateCancerSupport ' > Subject: RE: NYC Update > > > > G'day Piers, > > > > You say, in part <snip> I have discovered in this whole process that I am > not the type of personality that can live with too much uncertainty. <snip> > Unfortunately everything to do with PCa involves a good deal of uncertainty > as you are finding. I am facing the same kind of problem as you are after 10 > years of " watchful waiting " . I had my biennial bone scan earlier this week > and there is one spot on my spine, adjacent to an are 'typical of > degenerative damage " which may be suspicious for metastasis. Hmmm. Is this > the radiographer being ultra cautious and protecting himself from any kind > of legal action in the future: is this the radiologist being ultra > conservative: is this the radiographer genuinely believing that I should be > warned of a potential metastasic extension of the disease? Or is this just > an extension of the degenerative damage? I dunno, but I'll give it some > thought. > > > > Of course having treatment doesn't really remove uncertainty either because > there is no guarantee of 'cure' no matter what you do. Everyone who has had > treatment has to watch their PSA ever after for signs of failure of the > treatment. This extract from a recent report (the entire report is in the > Files section of the group - click on Files at the bottom of this message > and see the file labeled Insights AS article.): > > > > <snip> The psychological effects of living for many years with untreated > cancer are a potential concern. Does the cumulative effect, year after year, > of knowing one is living with untreated cancer lead to depression or other > adverse effects? The best data on this comes from a companion study to the > Holmberg randomized trial of surgery vs. watchful waiting in Sweden. It > found absolutely no significant psychological difference between the two > groups be after five years. Worry, anxiety, depression, all were equal > between the two arms. While surveillance may be stressful for some men, the > reality is that most patients with prostate cancer, whether treated or not, > are concerned about the risk of progression. Anxiety about PSA recurrence is > common among both treated and untreated patients. It is hoped that with > education patients will begin to understand the very indolent natural > history of most good-risk prostate cancers and, with the realization that > the disease is not life-threatening, may avoid much of this anxiety. <snip> > > > > Good luck to you in whatever decision you make. > > > > > > All the best > > > > Terry Herbert > > in Melbourne Australia > > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. June > '04: TURP. Nov '06 PSA 31.4 > > My site is at www.prostatecancerwatchfulwaiting.co.za > > It is a tragedy of the world that no one knows what he doesn't know, and the > less a man knows, the more sure he is that he knows everything. Joyce > Carey > > > > _____ > > From: ProstateCancerSupport > [mailto:ProstateCancerSupport ] On Behalf Of Abe > Sent: Friday, 22 December 2006 3:52 AM > To: ProstateCancerSupport > Subject: NYC Update > > > > hi friends, > > well, had my follow up consultation with my (surgeon) doc at > memorial sloan kettering in nyc. > > the mri showed some abnormality mainly in the left section. of > course, once you go through the process they start telling you that > the mri is not 100% accurate and the abnormalities may, or may not > be malignant. in any event, the mri results, in addition to my psa > going up from 4.3 to 6.3 over the past month was still not enough > to " alarm " my doc. he still feels that my pc is still one that can > be " watched " for a while with possibly repeating the psa and a more > focused biopsy and an mri if called for. > > i have dicovered in this whole process that i am not the type of > personality that can live with too much uncertainty. the idea of > repeating tests and thus putting off the probable inevitable is not > overly appealing to me. i have looked into the various treatment > options and i am inclined to go with the lap surgery - again i guess > my personality is kicking in as far as tackling this situation > agreesively and definitively, well at least that is the feeling it > gives me right or wrong. > > i guess that something should be said about my doc being a surgeon > and not " selling " me on the surgery option. on the other hand when i > ask him if its possible that by the wait and see option he might > tell me a year down the road that this was not (in hindsight) the > best option we could have taken; his (honest) answer is " yes, that > could happen " . again i guess my personality is kicking in and taking > over. > > anyway, they took another blood test to see what the psa is doing. > in the back of my mind i seem to have decided that if the number > shoots up again i am going to opt for the surgery. > > meanwhile, like many others here, i am going to try and take some > time out and enjoy the holiday. > > to one and all, thanks for your on and off board notes of advice and > support. have a great holiday season and a very happy new year. > > Abe-) > Quote Link to comment Share on other sites More sharing options...
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