Re: surgery vs seeds vs waiting

[Guest guest]

> It appears that most people or many that post on this site

> seem to favor the surgery. Most of the people that I have

> spoken with personally favor 'the seeds'. ...

The question of which treatment to get, surgery or radiation,

and which form of treatment, open or laparoscopic for surgery,

seeds or beam for radiation, x-rays or protons for radiation,

HDR or LDR seeds, etc. etc. are highly contested.

At one time I thought I could pick the best treatment. Now I

don't think so. I personally picked radiation and came through

pretty well. However I know some people who picked surgery who

are now continent, potent, and cancer free and others who picked

radiation who have complications and are not cancer free. And

of course vice versa.

There are strong arguments for and against each course of

action. The only hard and fast conclusion I've come to is that

it's not possible for me to give anyone hard and fast advice on

which treatment they should get.

There is one other conclusion I've come to and that is that,

whatever treatment you get, get the best, most experienced, most

committed, most caring doctor you can find to administer it.

That, together with a good helping of luck, may make more

difference than which treatment you pick.

Alan

[Guest guest]

> It appears that most people or many that post on this site

> seem to favor the surgery. Most of the people that I have

> spoken with personally favor 'the seeds'. ...

The question of which treatment to get, surgery or radiation,

and which form of treatment, open or laparoscopic for surgery,

seeds or beam for radiation, x-rays or protons for radiation,

HDR or LDR seeds, etc. etc. are highly contested.

At one time I thought I could pick the best treatment. Now I

don't think so. I personally picked radiation and came through

pretty well. However I know some people who picked surgery who

are now continent, potent, and cancer free and others who picked

radiation who have complications and are not cancer free. And

of course vice versa.

There are strong arguments for and against each course of

action. The only hard and fast conclusion I've come to is that

it's not possible for me to give anyone hard and fast advice on

which treatment they should get.

There is one other conclusion I've come to and that is that,

whatever treatment you get, get the best, most experienced, most

committed, most caring doctor you can find to administer it.

That, together with a good helping of luck, may make more

difference than which treatment you pick.

Alan

[Guest guest]

> It appears that most people or many that post on this site

> seem to favor the surgery. Most of the people that I have

> spoken with personally favor 'the seeds'. ...

The question of which treatment to get, surgery or radiation,

and which form of treatment, open or laparoscopic for surgery,

seeds or beam for radiation, x-rays or protons for radiation,

HDR or LDR seeds, etc. etc. are highly contested.

At one time I thought I could pick the best treatment. Now I

don't think so. I personally picked radiation and came through

pretty well. However I know some people who picked surgery who

are now continent, potent, and cancer free and others who picked

radiation who have complications and are not cancer free. And

of course vice versa.

There are strong arguments for and against each course of

action. The only hard and fast conclusion I've come to is that

it's not possible for me to give anyone hard and fast advice on

which treatment they should get.

There is one other conclusion I've come to and that is that,

whatever treatment you get, get the best, most experienced, most

committed, most caring doctor you can find to administer it.

That, together with a good helping of luck, may make more

difference than which treatment you pick.

Alan

[Guest guest]

Dan,I opted for the surgery for several personal reasons. Dad had PCa and they did IMRT and literally burned his rectum and bladder. He was an Alzheimer's patient and Mom had him treated because the doctor said that he needed it. She regretted the treatment. I spoke with a radiation oncologist and she advised me personally against brachytherapy because of my family history and the recurrence within the family (2 of Dad's brothers and 1 of Mom's had it as well and 2 of them recurred within 5 years of the brachytherapy). Know your family history. My problem came from the initial problem of blood in the urine and an elevated PSA (went from 1.3 to 2.5 to 3.8 in about 18 months). I had back surgery 2 months before the PSA of 2.5 and blood. I could have gone through the AS (waiting)

because I had 1 of 12 positive and a Gleason 6 (3+3). With the surgery, there can be a complication if the catheter loses any pressure (as mine did) of nerve damage. Five months post-op and I am just now regaining most continence and the ED is terrible. Thankfully I have an understanding wife.Steve S in ArkansasTo: ProstateCancerSupport Sent: Friday, January 9, 2009 1:33:01 PMSubject:

surgery vs seeds vs waiting

It appears that most people or many that post on this site seem to

favor the surgery. Most of the people that I have spoken with

personally favor 'the seeds'. The people I do know that have had

surgery are slow to recover and for the most part have had ''life'

changing adjustments. It seems that many people want to 'rid'

themselves of cancer and in all reality, in this day and age, whether

it is active or not, I believe everyone in this part of the world has

some type of 'infected' or cancerous cell in their body.

A person I work with is going back to Mayo after 1 year to fix a

leaky 'faucet'. Another person that I know still can not golf 1 year

later due to leakage. I am not sure if I am being influenced

incorrectly or just hearing what I want to hear..

I imagine it all depends on the severity or 'scores'. I know I am

painting with a pretty broad brush but thought I would throw this out

there.

Dan

>

> > Men who receive radiotherapy for localized prostate cancer

> > have an increased risk of bladder cancer compared to patients

> > undergoing radical prostatectomy and compared to the general

> > population. The risk of rectal cancer is increased in patients

> > who receive external beam radiotherapy compared to radical

> > prostatectomy.

> ...

>

> http://www.ncbi. nlm.nih.gov/ pubmed/18801517

>

> This abstract cited by contains some numbers for

> "relative risk" and for "standardized incidence ratio". Are

> there any statistical sophisticates in our group who can

> interpret for me what those mean?

>

> As is so often the case in medical research studies, the numbers

> are confusing even apart from trying to figure out what they

> mean. The "standardized incidence ratios" for rectal cancer

> developing after surgery, external beam, brachytherapy, and

> external+brachyther apy were: 0.91, 0.99, 0.68 and 0.86

> respectively.

>

> That makes it look like patients receiving either form of

> brachytherapy had *less* rectal cancer than patients receiving

> surgery - which is not what the title of the article says nor

> what we would expect.

>

> Any and all insights are invited.

>

> Thanks.

>

> Alan

>

[Guest guest]

Dan,I opted for the surgery for several personal reasons. Dad had PCa and they did IMRT and literally burned his rectum and bladder. He was an Alzheimer's patient and Mom had him treated because the doctor said that he needed it. She regretted the treatment. I spoke with a radiation oncologist and she advised me personally against brachytherapy because of my family history and the recurrence within the family (2 of Dad's brothers and 1 of Mom's had it as well and 2 of them recurred within 5 years of the brachytherapy). Know your family history. My problem came from the initial problem of blood in the urine and an elevated PSA (went from 1.3 to 2.5 to 3.8 in about 18 months). I had back surgery 2 months before the PSA of 2.5 and blood. I could have gone through the AS (waiting)

because I had 1 of 12 positive and a Gleason 6 (3+3). With the surgery, there can be a complication if the catheter loses any pressure (as mine did) of nerve damage. Five months post-op and I am just now regaining most continence and the ED is terrible. Thankfully I have an understanding wife.Steve S in ArkansasTo: ProstateCancerSupport Sent: Friday, January 9, 2009 1:33:01 PMSubject:

surgery vs seeds vs waiting

It appears that most people or many that post on this site seem to

favor the surgery. Most of the people that I have spoken with

personally favor 'the seeds'. The people I do know that have had

surgery are slow to recover and for the most part have had ''life'

changing adjustments. It seems that many people want to 'rid'

themselves of cancer and in all reality, in this day and age, whether

it is active or not, I believe everyone in this part of the world has

some type of 'infected' or cancerous cell in their body.

A person I work with is going back to Mayo after 1 year to fix a

leaky 'faucet'. Another person that I know still can not golf 1 year

later due to leakage. I am not sure if I am being influenced

incorrectly or just hearing what I want to hear..

I imagine it all depends on the severity or 'scores'. I know I am

painting with a pretty broad brush but thought I would throw this out

there.

Dan

>

> > Men who receive radiotherapy for localized prostate cancer

> > have an increased risk of bladder cancer compared to patients

> > undergoing radical prostatectomy and compared to the general

> > population. The risk of rectal cancer is increased in patients

> > who receive external beam radiotherapy compared to radical

> > prostatectomy.

> ...

>

> http://www.ncbi. nlm.nih.gov/ pubmed/18801517

>

> This abstract cited by contains some numbers for

> "relative risk" and for "standardized incidence ratio". Are

> there any statistical sophisticates in our group who can

> interpret for me what those mean?

>

> As is so often the case in medical research studies, the numbers

> are confusing even apart from trying to figure out what they

> mean. The "standardized incidence ratios" for rectal cancer

> developing after surgery, external beam, brachytherapy, and

> external+brachyther apy were: 0.91, 0.99, 0.68 and 0.86

> respectively.

>

> That makes it look like patients receiving either form of

> brachytherapy had *less* rectal cancer than patients receiving

> surgery - which is not what the title of the article says nor

> what we would expect.

>

> Any and all insights are invited.

>

> Thanks.

>

> Alan

>

[Guest guest]

Dan and all,

Allan’s post sums up the position

well and clearly. There is simply no way of establishing with any certainty

which path is THE BEST. And that is because there is no good evidence to guide

us, so we just have to make up our minds to do what ‘feels’ right

for us. To get a good feel for this unfortunate state of affairs have a look at

the report that Jon posted in February last year entitled 2008 Comparison of

Treatments. You can find that by clicking on the Files link on this site.

Good luck to you whatever your path.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of buckeyedan73

Sent: Saturday, 10 January 2009

6:33 AM

To: ProstateCancerSupport

Subject:

surgery vs seeds vs waiting

It appears that most people or many that post on this

site seem to

favor the surgery. Most of the people that I have spoken with

personally favor 'the seeds'. The people I do know that have had

surgery are slow to recover and for the most part have had ''life'

changing adjustments. It seems that many people want to 'rid'

themselves of cancer and in all reality, in this day and age, whether

it is active or not, I believe everyone in this part of the world has

some type of 'infected' or cancerous cell in their body.

A person I work with is going back to Mayo after 1 year to fix a

leaky 'faucet'. Another person that I know still can not golf 1 year

later due to leakage. I am not sure if I am being influenced

incorrectly or just hearing what I want to hear..

I imagine it all depends on the severity or 'scores'. I know I am

painting with a pretty broad brush but thought I would throw this out

there.

Dan

>

> > Men who receive radiotherapy for localized prostate cancer

> > have an increased risk of bladder cancer compared to patients

> > undergoing radical prostatectomy and compared to the general

> > population. The risk of rectal cancer is increased in patients

> > who receive external beam radiotherapy compared to radical

> > prostatectomy.

> ...

>

> http://www.ncbi.nlm.nih.gov/pubmed/18801517

>

> This abstract cited by contains some numbers for

> " relative risk " and for " standardized incidence

ratio " . Are

> there any statistical sophisticates in our group who can

> interpret for me what those mean?

>

> As is so often the case in medical research studies, the numbers

> are confusing even apart from trying to figure out what they

> mean. The " standardized incidence ratios " for rectal cancer

> developing after surgery, external beam, brachytherapy, and

> external+brachytherapy were: 0.91, 0.99, 0.68 and 0.86

> respectively.

>

> That makes it look like patients receiving either form of

> brachytherapy had *less* rectal cancer than patients receiving

> surgery - which is not what the title of the article says nor

> what we would expect.

>

> Any and all insights are invited.

>

> Thanks.

>

> Alan

>

[Guest guest]

Dan and all,

Allan’s post sums up the position

well and clearly. There is simply no way of establishing with any certainty

which path is THE BEST. And that is because there is no good evidence to guide

us, so we just have to make up our minds to do what ‘feels’ right

for us. To get a good feel for this unfortunate state of affairs have a look at

the report that Jon posted in February last year entitled 2008 Comparison of

Treatments. You can find that by clicking on the Files link on this site.

Good luck to you whatever your path.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of buckeyedan73

Sent: Saturday, 10 January 2009

6:33 AM

To: ProstateCancerSupport

Subject:

surgery vs seeds vs waiting

It appears that most people or many that post on this

site seem to

favor the surgery. Most of the people that I have spoken with

personally favor 'the seeds'. The people I do know that have had

surgery are slow to recover and for the most part have had ''life'

changing adjustments. It seems that many people want to 'rid'

themselves of cancer and in all reality, in this day and age, whether

it is active or not, I believe everyone in this part of the world has

some type of 'infected' or cancerous cell in their body.

A person I work with is going back to Mayo after 1 year to fix a

leaky 'faucet'. Another person that I know still can not golf 1 year

later due to leakage. I am not sure if I am being influenced

incorrectly or just hearing what I want to hear..

I imagine it all depends on the severity or 'scores'. I know I am

painting with a pretty broad brush but thought I would throw this out

there.

Dan

>

> > Men who receive radiotherapy for localized prostate cancer

> > have an increased risk of bladder cancer compared to patients

> > undergoing radical prostatectomy and compared to the general

> > population. The risk of rectal cancer is increased in patients

> > who receive external beam radiotherapy compared to radical

> > prostatectomy.

> ...

>

> http://www.ncbi.nlm.nih.gov/pubmed/18801517

>

> This abstract cited by contains some numbers for

> " relative risk " and for " standardized incidence

ratio " . Are

> there any statistical sophisticates in our group who can

> interpret for me what those mean?

>

> As is so often the case in medical research studies, the numbers

> are confusing even apart from trying to figure out what they

> mean. The " standardized incidence ratios " for rectal cancer

> developing after surgery, external beam, brachytherapy, and

> external+brachytherapy were: 0.91, 0.99, 0.68 and 0.86

> respectively.

>

> That makes it look like patients receiving either form of

> brachytherapy had *less* rectal cancer than patients receiving

> surgery - which is not what the title of the article says nor

> what we would expect.

>

> Any and all insights are invited.

>

> Thanks.

>

> Alan

>