Wednesday, November 21, 2012

Prostate Cancer

I've got it.  I've known for about a year and a half.  Here are some facts.

Most forms of PC are very slow growing.
There are a handful of ways to measure the severity or threat of PC and in my case all such measures are low.
In the last year or so the medical community has, to say the least, lost enthusiasm for  a common screening test and some authorities now discourage routine testing. It is considered most likely that a person will die with the disease rather than from it.
There are several treatments options available in addition to simply monitoring the cancer.
I know a number of guys who have had success with seed implantation and I have available to me a radiologist with a lot of experience and apparent competence.
All options carry a risk of  negative side effects including urinary and/or bowel incontinence, and impotency.  These are of variable severity and duration.  If your luck is bad you could be permanently affected.
Death from PC is painful.
If one has radioactive seed implantation and later the cancer returns, neither surgical removal of the prostate or another application of seeds is possible.  I believe you just have to go down with the disease.
I am 74 years old and prideful regarding my good health.
My grandfather, (the one who didn't get hit by a streetcar while in a state of uncertain sobriety) lived into his 90's as did my father and aunt.
My mother ended her life virtually comatose for a long time with Alzheimer's.

In the light of these facts I am faced with deciding what to do,  Should I get some seeds or should I just monitor the situation and see what develops? The first insight that came to me as I began to consider these choices was just how much I have been expecting, planning and wanting to live into my mid 90's.  At the same time I worry about ending like my mom.

One can think of a number of reasons for delaying treatment.  The more the delay, the less time after treatment for a new cancer to appear. (The cause(s) of PC is (are) apparently unknown.)  The situation is full of uncertainties.  I think I need some additional information even though some of it is only of a probabilistic nature.    What are the chances of a recurrence of the disease if it is successfully treated?  Does delaying treatment decrease the chance of success and if so how does the chance of success relate to age, tumor size, and general health?  Does the probability of serious side effects increase with age?  Are there better treatments on the horizon?  Since I think dying from cancer is much better than lingering with dementia, if dementia is in my future, I'll be glad I have the cancer.  It will save me the trouble of blowing my brains out.

No comments:

Post a Comment