Month 22 - Status Quo

Aside from this being Prostate Cancer Awareness Month, there really isn't much that's changed since last month's post.

Things continue to go well on pretty much every front with the exception of the sexual function.  That's still only running at the 50% - 60% level and I think it's time that I retry the Cialis again.  (Readers of this blog may recall that I had problems with my vision shortly after starting it after the catheter was removed, so I stopped taking it.  I thought eyesite was more important than an erection.)

I did find that there's a local prostate cancer support group in my area that I may get involved with, mainly to share my experience with guys who are newly diagnosed.  I'll have to do some research on it...

So that's about it.  A short post this month.

September is Prostate Cancer Awareness Month

All of the recent and confusing headlines about prostate cancer may cause guys to just abandon the idea of getting screened altogether. Don't ignore it! Burying your head in the sand would be a mistake.

Now, more than ever, it's important to educate yourself about prostate cancer, the associated research, and its treatment options. Remember that one in six men are diagnosed with this disease each year, so knowledge is power should you happen to be that one in six.

My cancer was discovered during a routine physical with a digital rectal exam (DRE). My physician felt a mass, ordered the PSA, and that led to a biopsy and confirmation of cancer. Thirty seconds of discomfort led me to ultimately being cancer-free. So I have to ask:

Have you had your prostate poked lately??

 

If not, schedule an appointment with your doctor. Now.

 

Month 21 - Undetectable PSA & Surgery Study

My PSA was undetectable (<0.01) at the 18 month mark--still cancer-free!

I'll have to admit that I'm getting better at being less emotional about these PSA tests.  Again, whatever the results are, there's nothing I can do to control them, I can only control my reaction to them. 

*    *     *

On 19 July 2012, the New England Journal of Medicine published another study that yet again increases the confusion about the treatment of prostate cancer:

Radical Prostatectomy versus Observation for Localized Prostate Cancer

The study followed 731 men over 10 years (mean age: 67; median PSA: 7.8) in two groups: one that had a radical prostatectomy and the other that went through observation.

Over the course of the 10 years, 47% of the men with prostatectomies died and 49.9% of the men just being observed died.  That was statistically insignificant.  Of the men who had had prostatectomies, 5.8% died from prostate cancer or its treatment, while 8.4% of the men in the observation group died from prostate cancer.  Again, not a significant difference in outcomes.

In a related article in the San Francisco Chronicle, Otis Brawley, chief medical officer for the American Cancer Society said, "There is no question in my mind that what we have been doing in the United States for the last 20 years has hurt a lot of men needlessly."

SF Chronicle: Prostate Surgery Fails to Save Lives

So what are us poor schmucks diagnosed with prostate cancer supposed to do?

I'm an analytical kind of guy, and I have to admit that these statistics--while cold, hard, unemotional numbers--are beginning to make me wonder if having had the surgery--with all of its lasting side effects--was the right course of action.

Then the emotional side of me kicks in and the peace of mind knowing that my PSA is still undetectable at 18 months makes me say, yes, I made the right choice. 

Would I have made a different choice had this information been available when I was first diagnosed nearly two years ago?  I don't know.  Really.  Besides, there's nothing I can do to change it now.

We can only make the best decision we can with the information available to us at that point in time.

Until there's a test that can accurately determine whether a guy has the "lazy" prostate cancer that he can live with or the really aggressive prostate cancer that will likely kill him, this will be an ongoing debate, source of confusion, and perhaps unnecessary treatment.   

So if you're recently diagnosed and wondering what to do next, all I can say is research, research, research, and make a decision that fits your own needs and comfort level.