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Subscribe to RSSNew research strongly reinforces the notion that prostate cancer is vastly overtreated with often dire results.
A study out Wednesday in the New England Journal of Medicine focused on treatment side effects, following a group of 3,533 men for 15 years after they got either surgery (called prostatectomy) or radiation for cancer that had not spread beyond the prostate. Radiation produced fewer side effects -- especially in the first years after treatments-- but both groups experienced huge impacts.
“This paper tells you that if you get treatment there are a lot of side effects regardless of the therapy you chose,” the senior author Dr. David Penson, professor of urologic surgery at Vanderbilt University Medical Center, said in an interview.
Most men were in their sixties when they were first treated. Two years after treatment 60.8 percent of the men who had undergone radiation had erectile dysfunction, compared to 78.8 percent of those who chose surgery. By 15 years, the numbers became 87 percent and 93.9 percent. Many men also suffered urinary and bowel problems and those, too, grew worse with time.
A rational argument is that such side effects are acceptable if the treatment is saving lives. But the paper raises serious doubts.
“So many of these men have low-risk disease that probably doesn't need to be treated,” Penson said.
Men typically undergo needle biopsies because they have elevated levels of the blood test called prostate-specific antigen (PSA). If the needle finds cancer cells, a pathologist measures their severity, resulting in what is called a combined Gleason score that ranges from 1-- the least severe-- to 10. Most prostate cancers score between 6-7. Several top urologists at university medical centers agreed that prostate cancer below a score of 6 should be watched, but not treated. Yet in this latest study, which is a reliable cross-section of how medicine is actually practiced, about 60 percent of the men who underwent treatment had scores of 2 to 4.
The findings prove that “a staggering percentage of men with totally inconsequential prostate cancer got treated and suffered the consequences,” says oncologist Dr. Marc Garnick of Beth Israel Deaconess Medical Center and Harvard Medical School, who was not involved the study.
Undoubtedly, prostate cancer can be deadly. Estimates are that it will kill almost 30,000 men in the United States this year, second only to lung disease as the major cause of cancer deaths in men. But the problem is, there are at least two kinds of prostate cancer.
The common form appears in the majority of men over age 50, grows slowly, and never presents a health threat. The other form spreads rapidly and can lead to a horribly painful death, usually from malignant cells invading the bones. Doctors cannot tell the difference between the dangerous and harmless cancers. Researchers are looking for genetic markers that would make the critical distinction, but they have yet to find them.
Meanwhile, increasing numbers of prostate cancer specialists argue that the sensible path is for men with lower combined Gleason scores to undergo active surveillance (formerly called watchful waiting), come back for future tests and forgo treatment until it is indicated. Often they will never need treatment.
That doesn’t happen, however. Penson said recent surveys show that fewer than one in four men who are candidates gets active surveillance. The majority get surgery or radiation.
One reason for the intervention is “incentives for the facility and for the providers” -- in other words, money for hospitals and doctors. “Also,” he adds, “patients don't like to hear 'I have cancer and I'm just going to watch it.’” But patients should demand and doctors should educate that “just watching it” is perfectly safe in many cases.
Learning that lesson could spare an enormous amount of misery and money.
Related:
Erectile dysfunction may increase heart risks
Shorter penis alarms some men after prostate treatment
Caffeine linked to leaky bladder in men
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My stepfather had prostate cancer.He had radiation.It was cured and he's still alive 15 years later and now he suffers from Alzheimer's.His once brilliant mind is gone.Getting old is no picnic in the park.
Like almost everything else in medicine, it all comes down to money. You have doctors who own interests in the treatment facilities and they are compromising their medical judgement in order to drive more profits. They push guys who should never have been treated into unnecessary procedures that end up causing long term, extremely negative side effects. These doctors should not only be sued for malpractice, but they should also have their licenses to practice medicine revoked. A law needs to be passed banning doctors from owning an interest in treatment facilities, or at a minimum barring them from referring any of their patients to any facility they hold an interest in. This is the only way to stop these profit driven medical recommendations.
Already is such a law.
Then it should be enforced!!
I knew someone once that had prostate cancer, it was treated to a degree, he had diabetes, it was treated to a degree, then he had Alzheimer's and it was treated, now that he is 98 he wants to know why medicine can't provide cures.
Last year I had a PSA of 8 (at the time I didn't even know the doc was doing PSAs on me.) Then it went to 12 and 14. I was sent to a urologist who told me of the horrors of watching someone with metastasized prostate cancer and assured me that I need the Da Vinci surgery. He said that side effects were temporary and "minimal" and that the da Vinci surgery was "nerve-sparing" and seldom had any side effects.
Luckily my wife is a PhD research gerontologist. After diving into the literature with a little help, I found the following:
1) Virtually all PSAs are incorrectly administered. A proper PSA requires that the patient not ejaculate for 2-3 days prior to the test. If the person has had a previous vascetomy, then it is 7-10 days. I doubt that there were any PSAs done on me in which I had not ejacualted in 10 days. In this case the manufactuer's tip sheet says that the resulting test in completely invalid. This is the major reason for lots of false positives that result in bioipsies.
2) Biopsies can cause the same side effects as prostate surgery. (Duh! It is also surgery.) This is more prevalent these days because urologists have gone from 6 sticks to as many as 30. This means that more men have worse side effects.
3) There is an increasing body of evidence that biopsies are involved with the fast-growing (clinical) type of prostate cancer. Microscopic examinations of removed prostates are finding the fast-growing cancer cells along the path of of the biopsy needle and only the slow-growing type elsewhere in the prostate. The reason is unknown.
4) Several major studies of thousands of men over many years conclude that 19 out of 20 men with prostate cancer are non-clinical, meaning that they have the slow-growing type of prostate cancer and likely will require NO treatment. In men who actually have treatment (surgery, chemotherapy, radiation, hormones, etc) it is 3 out of 4 who have non-clinical prostate cancer.
5) These studies also concluded that all the PSAs, biopsies and treatments in the world do not extend lives by even a single day. Apparently the treatment takes away about as much lifespan as it adds. This applied to both deaths from all causes and deaths from prostate cancer alone.
6) A Gleason score cannot predict whether a cancer is fast-growing or slow-growing. It can only indicate how many clumps of cancer cells were hit by the biopsy needles and has only 50/50 reliability --- about the same as a coin toss, but without the side effects.
7) The US Preventive Services Tack force has recommended that PSA's not be given to men without other risk factors or indications of prostate cancer.
8) There have been a number of studies like this one that show that the side effects are far more serious and far more likely to be permanent that urologists tell patients.
9) The urologists have a lot to protect. The average course of treatment for prostate cancer runs around $300,000. This is a major chunk of urologists' revenue stream. That's why you are seeing so many strange news articles about prostate surgery --- they have a lot to lose, along with hospitals and clinics.
My wife summed it up pretty succinctly: "You can choose to have your heart attack playing volleyball or have your heart attack shopping for Depends."
I am now in the "watchful waiting" crew and have already outlived the urologist's estimate. My family doc treats me as some sort of wierdo hippy alternative medicine crazy person. I treat my family doc as someone in over his head. He classified the USPS Task Force report on PSA screening as "Obamacare" that would kill millions of men. In fact, it was a GW Bush initiative and is unrelated to Obama. Here is a link to the report: http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm
The money grab in health care began when laws were modified and health was allowed to become a publicly traded commodity. The fiduciary (meaning highest) responsibility was then diverted to the shareholders rather than the patient. Executives, the money makers, are in a more important position than the health care professional. Get health care off the stock market.
If your urologist recommends that your prostate be removed, you should consider asking him to provide a post-surgical microscopic study to confirm that the cancer was indeed clinical (the fast-growing type.) In 3 out of 4 men who have their prostates removed, the cancer was non-clinical, meaning that it required no treatment at all.
I had radiation treatment 10 years ago at 55 and the side effects their speaking of do get worse in time . They told me the Gleason count was close to 10 and was the most likely the more aggressive form because it left the prostate. The last Doctor I saw at Sloan Kettering in New York said he didn't think it went on tour but he wouldn't bet a nickle on it ,but here I am years later !! Who really knows for sure that's why all Doctors are just practicing medicine !!
Good luck to you Jimi......great photo!
So, while you are doing the wait and see thing, should you go out and get all the sex you can while you still can ?
That would be a good idea
Most are treated because the doctors make money from procedures.
Well, it is always the patients choice whether they want to pursue the treatment recommended. Each person should research the cancer they have and the treatment options and then make their own decision. Whether you chose wisely or not is all dependent on how you want it to go. Some men would prefer to live a longer life.....while others would think having ED is the end of their life. Each to his own.
not all men develop ED as a result of the prostatectomy, and also some have ED before the procedure is even done
@Mike,
Nowhere in the article did they state that all men get ED and if you had pre-existing ED, you cannot "develop" ED as a result of the surgery. If you do a little quick math and see how many people could not develop ED because they already had ED, then the percentage that do get ED is nearly 100%.
Its better than death. Doing nothing isnt an answer. If in doubt, lop em off. The good news is, you wont really miss them.
Great point!! One of the better solutions is just removal of the prostate later in life.
I thought the discussion was about the postrate gland. What are you talking about, "lop em off" ?
The article states, "The findings prove that “a staggering percentage of men with totally inconsequential prostate cancer got treated and suffered the consequences,” says oncologist Dr. Marc Granick of Beth Israel Deaconess Medical Center and Harvard Medical School, who was not involved the study." The face is that for that staggering percentage (around 19 out of 20 men) "doing nothing" is the correct answer. It is called "watchful waiting." For those 19 men, biopsies and treatments are a violation of the Hippocratic Oath's first stricture: "I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone."
Most men have no idea what the prostate even does. I am recently diagnosed with prostate cancer and was given all the options by my urologist. The thought of having biopsies every 6 months was a factor. Not pleasant I assure you. I have no interest in having a cancer in me that can spread. I'm 65 and it's "get it out of there for me". Lots of options for sex too.
I have had a PSA blood test every 6 months for about 17 years. I have also undergone 5 biopsies during this time and they have not found any cancer cells and have taken as many as 20 samples. I am presently taking Avodart to help with the enlarged prostate. Even with the medicine my PSA is 11.4 and without it has been about 23. Some men just have high PSA readings and from the research that I have done a lot has to do with the size of your prostate. If so, mine has to be the size of Alaska and the Bering sea. I am now 75 and still in good health and believe that even if they find cancer that I WILL NOT have my prostate removed. I believe that mine was caused in my 40's as I was taking Dimetap for sinus problems and I got a prostate infection and it left my prostate scarred. My doctor, at the time, told me that that was the worst thing I could have taken. Men OF ANY AGE, if the over the counter medicine says DO NOT TAKE IF YOU HAVE PROSTATE PROBLEMS, DO NOT TAKE IT AS IT CAN CAUSE PROBLEMS AS YOU AGE.
My father had prostate cancer that metastasized to one lymph node. He had a very high PSA at the time of his radical prostatectomy & lymph node removal. It has been almost 3 years, and his PSA level has not gone up. He is currently in good health, and we are very thankful for the treatment provided to him. If he had not been treated, the prostate cancer may be all through his bones by now.
It really, really frustrates me when these studies come out basically advocating against treatment of prostate cancer or against early detection of breast cancer. If anything there should be more treatment--nobody wants to have metastatic prostate cancer throughout their bones--I know I'd take treatment over metastatic cancer any day of the week.
Are you reading the same article as me. You say your Dad had a very high PSA. This article is talking about people being treated when they have a low PSA. In other words Doctors performing procedures not needed merely for capital gain. I'm glad your father is doing good. I don't think his situation is the same as the article. My father was told he had prostate cancer in 2005. He didn't accept his first diagnosis and scheduled an appointment at Emory Hospital in Atlanta, Ga. It was determined that he had an infection. He was treated with antibiotics. He has continued with testing ever since. No cancer. Good thing he didn't let them operate. Just saying get a second opinion. Doctors are like car mechanics some are great and some suck.
Cancer is very individual. Just because your father's case was a certain way doesn't mean that it will be the same for another person including you.
That's why you get several opinions on what to do and make a decision then. Treatment is also a risk and may make things worse.
There is not a shred of evidence that all the PSA's, biopsies, and treatment in the world extends the lives of men with prostate cancer by even a single day. This included both deaths from all causes and deaths from just prostate cancer. For this reason, the current protocol is no PSA screening for men who are otherwise healthy and have no serious risk factors or signs or prostate cancer such as bleeding into the urine or semen.
The issue is that all the PSA's and needless biopsies and needless surgery waste finite medical dollars while transferring an average of $300,000 a patient into the pockets of urologists, drug and test manufacturers, hospitals and clinics. The medical system is convincing hundreds of thousands of men that they are "cancer survivors" when, in fact, they had a form of cancer thet was never life-threatening in the first place. They would be more aptly called "malpractice survivors."
That's a very important point that some people are ignoring.
The money is what keeps the HIFU treatment out of the US,a treatment that is more affordable, less invasive and has less side effects and seeing that the research has been done in Europe and in the US its seems that the politics of money is really the hold up.Surgeons not being able to make as much money seems to be the only foot blocking the door.FDA open up the door for this treatment state side.I have early stsge prostate cancer and I dont want standard surgery options only.PLEASE
us
Very good points. The Focal HIFU tratment offers real hope for a successful outcome. It should clearly be the first choice over the other options refered to in this article. It's a shame that the politics of "big money" often promote the wrong treatment at the expense of Americans who suffer as a result. As they say, it is the root of all evil.
Really? What possible qualifications do you have to make such statements? I personally know people that have spent their lives researching cancer and developing treatments for cancer and they don't make such statements!
@Bigdoc,
Wouldn't it be better to first find out why there is no evidence that prostate cancer interventions do not extend the lives of men by even a single day --- for both deaths from all causes and deaths from prostate cancer? We are essentially looking at interventions that are not needed for 3 out of 4 men who have them. But for whom the side effects are serious and long-term or permanent.
If you do have "early stage" prostate cancer (an impossible claim to make except from thin-slide analysis of a removed prostate) then you need to do some reading on "watchful waiting." The interesting thing about watchful waiting is that your sex life, bowel and uninary control, and risks of infection are "normal."
A close friend had prostate surgery and radiation several years ago, and while ED is a side effect the biggest problem he faces is lack of urinary control. He is a good sport and jokes about and when you ask how he's doing his standard answer is, "it depends."
I have a good friend that I worked with for over 40 years. He was told the same thing but Dan was never one to take anyone at their word so he did his own investigation and found that surgery and radiation are only used as a last resort in Europe. In the early stages of prostrate cancer hormones are used. Dan choose to do hormones. That was over thirty years ago. He has no cancer and no side effects is in his eighties. Any questions? If you are reading this you have a computer. Do your home work. Dan did and he is doing great.
And what hormones are you talking about? Estrogen?
Yeah and what if the insurance decides not to renew for me next year?
My dad died in March from this and he refused any treatment other than Chelation,vitamins and 3 times a week Vitamin blood transfusions,they caught it in 2006 just when his levels started to go up,and so they played it by ear,he did not want surgery or radiation,so I don't know ...I think had he had it takin out when it was early he would be here for his 6 grandkids but he worried so much about how much Dr.'s make and how radiation kills,but shoulda thought,hey Vitamins and chelation cost loads of money too,And if the "naturalpathic" way had the cure with vitamins,would they not be screaming it from mountain tops??I have no problem with natural but use both,.. modern medicine too,I lost my Dad because they told him diet,vitamins/chelation should cure you,The mainstream Meds will kill you,he was so very healthy and strong I thought he would out live me...plz guys get checked and do your research,your family's need and love you.
Vitamins and chelation won't cure prostate cancer, and if any paid practitioner told him otherwise, you should sue them. Certain botanicals may inhibit its development, but they won't be miracle cures either. However, you should know that for the few prostate cancers that are very aggressive and really life-threatening, early surgical treatment also often is not curative. A large study published recently followed men who had chosen watchful waiting or radical prostatectomy after early-stage diagnoses. After 15 years, 8% of the watchful waiting group had died of prostate cancer. But so had 6% of the immediate surgery group. In other words, if you were a person who was going to die of it without treatment, there was only a 25% chance that you'd avoid death by getting treatment, and a 75% chance that you were doomed no matter what you did. Your dad's choice may have been ill-advised, but the odds are that it didn't cause his death, so you don't have to feel that he was responsible for your loss.
As a prostate cancer survivor of 2 years now, I always get frustrated when I see articles like this.
The analytical side of me can look at the numbers and see where physicians and researchers are coming from, but your perspective really changes when a doctor utters those three little words: You have cancer.
I did my research and opted for a radical prostatectomy as what I thought was the best option for me and my circumstances. I'm lucky in that I have full control of my bladder ("dry") but the ED issue is a problem that's improving slowly with time.
Until researchers can isolate the really agressive cancers from the more slow-growing cancers, it's a crap shoot for any prostate cancer patient no matter how you slice it. Do the active surveillances and pray that it doesn't metastasize, or treat it and risk significant side effects.
I wish that prostate cancer awareness and research received half the attention that breast cancer awareness and research does. Heck, we even had the NFL dressed in pink the entire month of October for Breast Cancer Awareness month, but I didn't see a single word about prostate cancer or a single blue ribbon for Prostate Cancer Awareness Month in September. The sad thing is that about 10 men on each NFL team will be diagnosed with prostate cancer.
Don't get me wrong. Breast cancer is a terrible disease and has a higher mortality rate than prostate cancer, but more men (1 in 6) will be affected by prostate cancer than women (1 in 8) will be affected by breast cancer.
Far more prostate cancer research is needed to allow patients to make better treatment decisions.
So true!
I also had a radical prostatectomy about a year and a half ago. One of the deciding factors was my large medical deductible which made the watchful waiting too financially debilitating. Next best route for me was the one I took. I am still healing, but cancer free. My father had it and my brother had it and it kills about 28,000 men in the U.S. annually. As IN47006 said, more needs to be done in order to make better decisions. We need to educate ourselves and be self-advocating to make the best decision we can.
Breast cancer is also a horrible disease that kills about 39,000 women in the U.S. annually. The mortality rate is being lowered by research and improvements in treatment for many cancers. Let's keep the research going and maybe we will be able to eradicate these diseases as we have been able to do before.
I feel the same way about most of the attention and donations going to one cancer, when there are so many of them that deserve the same research and treatment. Right now the fastest increasing cancer diagnosis is that of head and neck cancer, largely because of the HPV virus. This virus has always been ubiquitous, without causing too many cancers until lately. Researchers aren't sure why, but it doesn't take a rocket scientist to generalize that there is usually more than one cause involved in any incidence of cancer, and that the standard treatments of surgery, radiation, and chemo are very harsh with long-term side effects (one of which is the occurance of cancer due to the treatment, especially with radiation).
Whatever happened to "informed consent" and "do no harm"--MONEY!
Don't post about things you have no idea about.
Like you're in any position to judge my ideas. Who appointed you the comment police?
I had a very high PSA 17.4 enlareged after 5 biopsies they found the cancer, gleason was a 9 , i was not going thur radiation or chemo, talked to my Dr and decided to have it removed, it was in 2008 had the da Vinci robotics surgery and removed 39 lymph nodes, after 6 to 8 months ED made the visit, no urinary control problems, have blood test every 3 month just to be safe, to this day i can say i didn't even know i had the surgery other than that damn catheter for 2 weeks, was home in 18 hrs and walking definitely recommend the da Vinci robotics surgery if necessary just my opinion
Google the New England Journal of Medicine to see the truth and stop believing everything NBC publishes. This research was only on localized prostate that under went surgery or radiation beam treatment and did not include brachytherapy and the doctors quoted in this article were not part of the research. Nor did it differentiate between the types of prostate cancer in the research. If you check the VA's research, they have found that prostate cancer due to Agent Orange was more aggressive and if caught early and sent into remission, still had a tendency to come back with a vengeance depending on the PSA level at the time of treatment. The biggest risk the patient should be told about is the possibility of an increase in heart attacks after treatment. So the wait and see approach is not applicable in all cases. Even if you were never in the military (Viet Nam), does not mean that there is no possibility you were exposed to Agent Orange. You need to check out the U.S. maps where the chemicals were stored or used in test fields to see if you lived near an exposed area during the designated times.
After a full cardiac workup (tread mill & nuclear stress test) patient given clean bill of heart health. Six months later found to have elevated PSA above normal range. Follow up weeks later showed greater PSA increase. After biopsy, PSA increased even more. After brachytherapy, PSA at highest level and patient left with ED without resolution to date most likely due to the bone being hit during implant. It took almost two full years for PSA to return to normal range (the norm is usually 1 year) and well over a year for urinary continence to return without the assistance of medication. However, one month after brachytherapy, patient experienced first major heart attack with 100% and 60% occlusion and urologist contacted from emergency room, because patient told seeds can dislodge and travel. Second heart attack occurred a little over 13 months later, because doctors only repaired one blockage out of the two after 1st heart attack.
So bottom line prostate cancer that is a carcinoma aided by Agent Orange acts very much like sarcoma, which needs a whole different control group when looking for genetic bio-markers that may have been damaged by chemical exposure. This patient is living proof and I disagree with the blanket statement of "wait and see" or "claims of over treatment" when carcinoma combined with other factors can mimicked the more aggressive sarcoma. Each patient is different and needs to be treated as such.
Getting old sucks, but not getting old sucks more.
Exactly!
Getting old sucks, but not getting old sucks more.
My husband was diagnosed with prostate cancer at age 46 and was dead less than 3 years later. He did have a high PSA and a very aggressive cancer that had already metastasized when it was diagnosed, and he did die a painful death in which cancer actually ate away some of the vertebrae in his spine, as well as spreading throughout his bones and lymph nodes, and eventually to his kidneys and brain. I hate that people refer to prostate cancer as a "good" cancer or a less serious cancer. Even if you have the slow kind of cancer anything that impacts your sexual function or urinary continence is devastating! Yet when you have the aggressive prostate cancer, you lose sexual function totally due to the testosterone suppression that is required to try to slow the cancer down, and you feel you'd gladly trade both your sexual functioning and your continence, if you could only be around to watch your kids grow into adults, meet your future grandchildren some day, not abandon your wife to widowhod, and not leave your elderly parents to mourn your loss. Prostate Cancer is horrible regardless of what kind you have and it seems like people don't really care. The money raised for Prostate Cancer research is small compared to that raised for Breast Cancer. We need to care equally about men and women who are victims of cancer.
Widow... My sympathies.
I am a prostate cancer survivor and it did spread outside the margins so I was diagnosed with STG 3.
I credit the PSA test with saving my life. People need to understand that sometimes a trade-off with side effects are always better than dying. I understand the positions of the two camps in this argument. However in my opinion, playing roullette with one's life rarely turns out well.
This looks like they are trying to recouperate after a government panel of Doctors last year came out and said that the Blood PSA test caused more harm than good. This article also fails to mention that there is two PSA tests one done with blood and the other done with urine and according to the gov. panel both is useless. Both PSA tests cannot determine whether you have the aggressive or non-aggressive form of cancer or even BPH. Doctors also don't tell the patients that they can get a staph infection from a biopsy. They also don't tell you that any kind of infection in the urinary track like a bladder infection or a kidney stone can cause an extremely high PSA, and they diffently will not tell you that having any kind of sex before giving blood for a PSA test is a big no no. For the person that mentioned HIFU, there is another safe treatment with lower side effects and it is the Green Laser. I know of 3 cases of prostate cancer in my family. I had 3 uncles that had prostate cancer, each one of them contacted the cancer causing material when they were making bombs for our army aircorp in WW11. All 3 of them died of pneumonia and not the cancer and they were in their late 80s and early 90s when they died. These articles also fail to mention how many of all kinds of cancer patients actually die of pneumonia and not the cancer. If I could suggest anything, use the computer you will be amazed at all you can find.
No problem here ... under the law of obamacare, treatment such as this and mant more (especially for men) will become a thing of the past and the healthy ones, although still paying for health insurance, will find the cost coming down. It cost very little to do "nothing." However, I suspect that at some point in the near future, with death rates rising from the lower costs of obamacare, we will all be required to buy government funeral insurance in order to control the rising costs of funerals. See ... it is all good.
Gunner, that post is so much tripe...
The AHA expands coverage, it does not contract coverage. PSA tests are currently covered by the vast majority of insurances and there is no indicvation that they will cease to provide certain preventative tests.
Just another phoney opportunity to take a cheap shot. Pretty transparent of you...
How will Obamacare cause death rates to rise? treatments such as this and mant more? Is there government funeral insurance?
takenaka...
I suspect we're dealing with a troll here...
I hope they are studying surgical treatments which involve the temporary removal of the cancerous organ for external irradiation (including Boron Neutron Capture Therapy (BNCT)), after which the irradiated organ (temporarily on ice) would be surgically returned to the patient's body. - Rick Carter
I was seeing a urologist for several years and he knew that I was under the "watchful waiting" program and had been for 10 years or so. Then their group bought one of those new pieces of equipment that required a new building of its own and many more staffers and doctors. It promised a 95% chance of wiping out your cancer if they get it before it leaves the prostate. Over a few months my PSA had gone up by a few points so my urologist suggested I might consider this. I visited their facility and came under the influence of a very pushy doctor who obviously needed patients to pay off and justify this huge new investment. I said no and he kept pursuing me. After a few months he told me I "owed it to my family", etc., etc. I finally gave in. It was 45 procedures, one every day except weekends, 7 minutes each. It was supposed to zero in on the prostate only and not touch any other parts of your body. A couple of months after the procedure I started getting problems related to my bowels and they continue today. The doctor won't take my calls anymore. I changed urologists. Is my experience out of the norm? I guess you have to be the judge.
You're talking radiation.
Your experience is not "out of the norm", but that depends on how you define "the norm". I had the non-robotic, open surgery ten years or so ago, because my Gleason Score was a 7 on the biopsy. It worked out to be a 9 when they took out the entire organ and did the pathology, with some slight "extra capsular extension" but no lymph node or seminal vesicle involvement. My doctor told me I was at high risk for recurrence, so I did a course of anti-androgen therapy for a year. My PSA remained undetectable for six years, and then slowly began to rise, so the doctors told me I needed to try radiation therapy, which I did for 39 sessions. No help.
The problem with the radiation is that it does not hit just the prostate and prostate bed, but it also hits the bladder, and the rectum, to name a few. The side effects often do not begin to show for years and years, but when they do, they need to be treated quickly, before you wind up with a colostomy. I'm three years out from the radiation, and so far, so good, but I am keeping an eye on things, as is my oncologist. I hope you can get your condition treated successfully, and quite frankly, a urologist is not the best choice for treatment, and going to a nationally recognized prostate cancer center like Sloan Kettering in NYC, or Dana Farber in Boston, or M. D. Anderson in Houston would probably be a good idea to get started with.