Utterly confused

Hi David

Yes, I noticed that paradox too. I am not a statistician. However the statistics say nothing about me, just about an historical population of which we know almost nothing. My choice of treatment is about favouring the chances of being in or moving into my preferred group. With my first diagnosis of advanced local prostate cancer, I do not wish to be hastened into the T4 group / smaller group that do not make that encouraging ten year figure. Plus, there is the hope that a cure or a very long remission may gained in my case. In practical terms that might be as good as a cure. I rationalised it by linking it to the statistic that 75% of men diagnosed with prostate cancer die of some other cause. I would prefer to be in that 75 % group. We are not told the outcomes of that 75% group beyond the ten year figure. We have no breakdown of the state of health or the first diagnoses of that population. For me the decision on treatment came down to focusing solely on my own case.

I feel for you very much. I am not a gambling man. It goes strongly against the grain for me to make a decision on such slender data and with horrendous potential consequences set against a potential excellent outcome. But decide we must and live with the results as best we may.

I wish for you an inspired decision with an excellent outcome.  

Thank you very much for responding. I guess I will go for the biopsy, then do whatever is recommended. I just feel that despite the strong emphasis on patient choice these days, almost everyone seems to end up going down the same path. I note also that almost all urologists are also surgeons (or strongly connected to them) so I cannot help thinking that they are not entirely unbiased in their decisions. One final observation I have made is that individuals will nearly always recommend the path they have chosen - cognitive dissonance is extremely powerful. Thanking you again for your advice; I wish you well.

Hello David,

I am am sorry to hear about your confusion.  

An  PSA  increase of 0.9% within five months IS a cause for concern.  

Some P C can be quite aggressive and In view of your Famiy History,  it would seem inadvisable to theorise about treatment protocols,  when any investigative postponement and/or treatment delay might allow a relatively unthreatening situation to develop into something more sinister.

Your Urologist has seen it all before.  And whereas His demeanour might seem relaxed and unalarming do not be deluded into thinking your situation is more a theoretical exercise,  than a practical one. 

I would recommend mend you have the biopsy and know what you are dealing with.

 

The biopsy will come to you in specific grades. the agression of the cancer is measured on the gleeson scale of 1-9 one being the least agressive.and stage from 1 - 4 4 being spread from the prostrate.

Various degrees of cancer some early stages cuable thus the need for biopsy.

Mine was already 8 stage 3 when i was diagnosed in 2010 its now 4 and terminal.so its importance is very clear.

good luck.