Saw surgeon today who would operate (i.e. perform the radical(?) prostatectomy) on me if that was the option we decided to take. Adding his opinion into the mix, we get the updated leader board (except its not – and this isn’t strictly come dancing, aka dancing with the stars) as follows:
| AS | S | EB | B | |
| 1 | Y | Y | Y | - |
| 2 | - | Y | Y | - |
| 3 | Y | Y | Y | Y |
| 4 | - | Y | Y | Y |
| 5 | Y | Y | Y | Y |
Thinking about active surveillance as an option (and the preferred option for low risk prostate cancer according to NICE – apart from my age – and whether or not you agree with the NICE guidelines like dK) I can see the following pros and cons to waiting:
- it might avoid treatment altogether – although the Royal Marsden study suggests the chance of unnecessary treatment is likely to be less than 30%
- it would allow us to schedule treatment for a more convenient time – but when would that be and what’s more important than your health?
- the delay might allow the development of new treatments with less bad side effects – although what treatments would these be? I guess HIFU and cryotherapy may become more accepted but we have not seen/heard positive reports on these treatments
- by delaying treatment, would this push back the time when the cancer might reoccur – but this is a rubbish argument as I am sure if I live to 75, what difference would it make if cancer reoccurred at 55 versus 65 – and this assumes a 10 year wait before treatment
All in all, while I am not in a hurry to treat, I am coming round to the view that the some treatment is much more likely to be needed than not. Who knows what the chance of avoiding treatment altogether is, but I am sure it is a lot less than the chance of having side effect free treament, particularly given the Sheffield and Malmo studies. Tried to talk about these studies with dB today but he didn’t seem that interested and like dO and dB seemed to be relying more on gut instinct. But if it works for them …
Still need to decide if formal second opinion (from outside the MDT) would be a good idea and then what kind of treatment to go for. But this is something for after Xmas I think.
