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So, if I am diagnosed with cancer and don't seek treatment, is that the same as doing your self in?

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  • Posted

    There's no simple answer to your question. An key consideration is how aggressive your cancer is - and that is the purpose of the Gleason score. These days, a low score might lead to a recommendation to simply monitor the cancer. A high score implies that the cancer will very likely spread outside the prostate - most commonly to the bones - at which point treatment often focuses on extending life and reducing pain. That's what happened to my father, who died of prostate cancer.

    Both my brother and I have had prostate cancer and both of us elected surgery - in his case, over two decades ago, in my case, only six months ago. These days one can recover from surgery fairly quickly. Radiation & hormone treatment takes more time but is equally effective.

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  • Posted

    it would actually depend on the staging of your diagnosis. Many patients choose not to treat immediately depending on clinical staging

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  • Posted

    As winn says, many patients choose to do nothing. It is an informed choice and certainly not the same as 'doing yourself in'. Much depends on the staging, your Gleason score and your PSA history.

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  • Posted

    Thanks for your thoughts. I posted that while feeling a little down.

    I had a successful procedure done 3 years ago which took care of my BPH symptoms and my cancer without removing my prostate. Unfortunately, my last PSA score went up 3 points in just 3 months. So i had a T3 MRI and everything still looks good but the urologist still wants to do a biopsy because the MRI is only 80 percent accurate. If the cancer comes back, I do want to know but not sure I will take any steps to fight it. I feel like the only reason I would is for my family. If the cancer comes back I'm not interested in a Prostatectomy because of all the bad side effects that come with it. I'm not afraid of death but also don't want to put my family through unnecessary grief or set a bad example by not fighting the cancer.

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    • Posted

      You might consider re-looking at the side effects of Prostatectomy. Both my brother and I had nerve-sparing surgery, meaning we regained normal continence and the ability to have sex. The one drawback is dry ejaculation. In my case, laparoscropic surgery meant the bulk of my recovery took less than two weeks. Continence recovery takes longer - up to two years for some men -- but the bulk of us, including me, are back to normal in less than a year; less than six months in my case.

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    • Posted

      its yoir choice. i couldnt have surgery mine is advanced. if i could have had it sparing the nerves i would have. family is important and so is your quality of life.

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    • Posted

      Thanks rkwnyc,

      Would you please let me know who did your procedure? I know results are contingent on skill level of the surgeon. Any other recommendations from other men on here are also welcome.

      Thanks.

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    • Posted

      There is another aspect to getting a positive test for cancer and choosing to not treat it - anxiety. I had a positive biopsy in 2012, and went on active surveillance for a year and a half before getting a second biopsy. That showed "progression" so I decided to have the cancer radiated. During the year and a half I felt continuous anxiety about the cancer and spent a huge amount of time thinking about it, reading books and publications about prostate cancer, and basically put my life on hold. Once I got my radiation the anxiety went away and I was able to get my life back. Not treating cancer IS a form of treatment. If you get a positive for cancer, get the RRP. That will take care of both the cancer AND the BPH symptoms - a two for one. My radiation took care of the cancer but I have been suffering for five years with BPH symptoms. If I had it to do all over again I would have had my prostate removed.

      Tom

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    • Posted

      Dr. Goh at Memorial Sloan Kettering. However, my internist told me that basically any doctor in any Manhattan hospital was going to be excellent - so I just decided to go with MSK because they had been more responsive to some of my research queries. I asked the administrator I'd been dealing with to recommend someone, she sent me Goh's profile. I looked at his profile and was impressed. However, to be honest, I think that any teaching hospital in a major city is going to have top-quality laparoscopic surgeons these days. My brother got excellent nerve-sparing surgery in Denver over 2 decades ago - before robotic laparocoptic surgery was an option. The difference was that he has a large scar and took several weeks longer to get through the first phase of recovery. The key, I believe, is to go with a surgeon who specializes in prostatectomies.

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    • Posted

      The surgical results are mostly related to the surgeon's experience. A surgeon with little experience will generally not give you a good result in respect of continence and tumor removal.

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    • Posted

      Glad to hear that you received a good replies to your research queries. I did not when I approached MSK. My guess is that some doctors are more focused on patient care than others.

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    • Posted

      I agree if the surgeon's experience is specifically the procedure you need. A lot of unrelated experience, IMO, doesn't mean as a much. Also, robot-assisted laparoscopic surgery is actually more of a team effort, at least based on the number of people that were in my operating room who introduced themselves before I was anesthetized. Also, given that MSK is also a teaching hospital, it is quite likely that my doctor was actually just supervising the work of the staff performing the surgery rather than actually doing it himself - so the actual surgeon for me might have been relatively inexperienced. This is how teaching hospitals work and for both me and my brother, the results were excellent.

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    • Posted

      You write:

      Also, given that MSK is also a teaching hospital, it is quite likely that my doctor was actually just supervising the work of the staff performing the surgery rather than actually doing it himself - so the actual surgeon for me might have been relatively inexperienced.

      I agree. Scary to think a patient opts for a 55yo experienced surgeon and ends up with a 28yo inexperienced one supervised by the 55yo!

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    • Posted

      The track record of leading teaching hospitals is so good that I wasn't scared as long as the guy ultimately responsible for my treatment was a proven expert - someone like that isn't going to let a junior surgeon make mistakes.

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    • Posted

      Quality of life is #1 for many. Sorry to hear your PCa was too advanced for surgery.

      I had surgery and RT and ADT. I am very much alive but sex will never be on the menu again. I am 50.

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