British Study
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From: Robbie on 3 Jun 2006 13:27 I read a recent news article about a study at the Institute of Cancer Research in England where they conclude that maybe its not always a good idea to use aggressive treatment of PC. They base their opinion on a long term study where patients with low grade cancer have about a 1% chance of dying of PC with or without treatment over a 15 year study period. Anyone else see the article and have an opinion. I had an RRP in 2000 and the side effects have been intolerable at times. Robbie
From: judamd on 3 Jun 2006 14:13 I haven't seen this study but when I was diagnosed in 2003, I saw graphs showing what I could expect if I left my cancer untreated. I had a 20% chance of dying from PCa in 15 years with a Gleason 6 and PSA 4.9. That also doesn't include those still alive at 15 years but with metastatic disease who whould die in the next few years. The graphs of those with Gleason 4 were closer to the low percents in the British study so I suspect the study was referring to these low Gleasons, not those in the intermediate and higher ranges. Dave Perry Robbie wrote: > I read a recent news article about a study at the Institute > of Cancer Research in England where they conclude that > maybe its not always a good idea to use aggressive treatment of PC. > They base their opinion on a long term > study where patients with low grade cancer have about > a 1% chance of dying of PC with or without treatment over a 15 year study > period. > > Anyone else see the article and have an opinion. > > I had an RRP in 2000 and the side effects have been intolerable at times. > > Robbie
From: Alex on 3 Jun 2006 14:35 "Robbie" <alrobinson_1705(a)yahoo.com> wrote in message news:LDjgg.1$ow1.0(a)fe09.lga... >I read a recent news article about a study at the Institute > of Cancer Research in England where they conclude that > maybe its not always a good idea to use aggressive treatment of PC. > They base their opinion on a long term > study where patients with low grade cancer have about > a 1% chance of dying of PC with or without treatment over a 15 year study > period. > > Anyone else see the article and have an opinion. > > I had an RRP in 2000 and the side effects have been intolerable at times. > > Robbie Robbie, I posted a link to this study a week or two ago, and it stimulated quite a discussion. Essentially the study's authors said their findings show little to no benefit from aggressive treatment of prostate cancer for men with Gleason scores of 6 or below during the 15 years after diagnosis. For those with more aggressive cancers (higher Gleason scores), aggressive treatment did seem to pay off in terms of decreased mortality. The data also found that low-Gleason prostate cancer is much less likely to cause death (during the 15-year period after diagnosis) than other risks, such as other diseases, accidents, etc. These non-PCa risks took the lives of about 30 percent of those studied. For those with Gleason of 6 or less who are actively watched by a competent physician and get their PSA checked regularly, the findings SUGGEST that this course may be a reasonable alternative to surgery, radiation, etc. (Full disclosure: that category includes me, which is why I found the article so interesting.) These men need to carefully weigh the near-certainty of experiencing some side effects of active treatment against the relatively low apparent benefit (a 1% or less decrease in mortality over a 15-year period) and the relatively high likelihood that, even after treatment, they have a 1-in-3 chance of dying from some unrelated cause (heart attack, car crash, getting shot by angry husband of girlfriend, etc.) Those who disagreed with this point of view noted that it is just one study (actually a study based on findings of many other studies, but still just one group's point of view.) They also noted that it is based on findings in Britain, where the National Health System has an incentive to hold down costs, and that American treatment strategies may differ. Also, the study had to use data from men diagnosed up to 15 years ago. In the interim, some posters noted, there have been major advances in treatment. (However, the flip side of this criticism is that the very low risk means that even improvement in treatment can produce little real benefit for men who would not die of PCa anyway. In addition, men electing "active surveillance" of a low-risk cancer may in the next few years benefit from one of the many new treatments being developed by researchers.) Many guys, justifiably, don't want to play the odds, and "want it out." They feel more comfortable taking aggressive measures against a potentially deadly disease. Also, several posters noted that Gleason scores in biopsies are not always correct; many a man has gone under the knife with a Gleason 6 diagnosis, only to be told that pathologists who dissected the entire removed prostate found cancer with a higher Gleason score. In short, it is an interesting study, but not likely to change many minds here. Alex
From: Robbie on 4 Jun 2006 00:12 Thanks for the responses. I don't follow this newsgroup as carefully as I did when I was first treated. My numbers (Gleason 5 - before and after, PSA 5.2) probably would have put me in the category where I could opt for watchful waiting. Given what I know now about side effects and finally some movement on more targeted treatments - I might be willing to wait awhile. Robbie "Alex" <tuchasoffentisch@_NO_SPAM_gmail.com> wrote in message news:eEkgg.45653$Lm5.5237(a)newssvr12.news.prodigy.com... > "Robbie" <alrobinson_1705(a)yahoo.com> wrote in message > news:LDjgg.1$ow1.0(a)fe09.lga... >>I read a recent news article about a study at the Institute >> of Cancer Research in England where they conclude that >> maybe its not always a good idea to use aggressive treatment of PC. >> They base their opinion on a long term >> study where patients with low grade cancer have about >> a 1% chance of dying of PC with or without treatment over a 15 year study >> period. >> >> Anyone else see the article and have an opinion. >> >> I had an RRP in 2000 and the side effects have been intolerable at times. >> >> Robbie > Robbie, I posted a link to this study a week or two ago, and it stimulated > quite a discussion. > Essentially the study's authors said their findings show little to no > benefit from aggressive treatment of prostate cancer for men with Gleason > scores of 6 or below during the 15 years after diagnosis. For those with > more aggressive cancers (higher Gleason scores), aggressive treatment did > seem to pay off in terms of decreased mortality. > The data also found that low-Gleason prostate cancer is much less likely > to cause death (during the 15-year period after diagnosis) than other > risks, such as other diseases, accidents, etc. These non-PCa risks took > the lives of about 30 percent of those studied. > For those with Gleason of 6 or less who are actively watched by a > competent physician and get their PSA checked regularly, the findings > SUGGEST that this course may be a reasonable alternative to surgery, > radiation, etc. (Full disclosure: that category includes me, which is why > I found the article so interesting.) > These men need to carefully weigh the near-certainty of experiencing some > side effects of active treatment against the relatively low apparent > benefit (a 1% or less decrease in mortality over a 15-year period) and the > relatively high likelihood that, even after treatment, they have a 1-in-3 > chance of dying from some unrelated cause (heart attack, car crash, > getting shot by angry husband of girlfriend, etc.) > Those who disagreed with this point of view noted that it is just one > study (actually a study based on findings of many other studies, but still > just one group's point of view.) They also noted that it is based on > findings in Britain, where the National Health System has an incentive to > hold down costs, and that American treatment strategies may differ. > Also, the study had to use data from men diagnosed up to 15 years ago. In > the interim, some posters noted, there have been major advances in > treatment. (However, the flip side of this criticism is that the very low > risk means that even improvement in treatment can produce little real > benefit for men who would not die of PCa anyway. In addition, men electing > "active surveillance" of a low-risk cancer may in the next few years > benefit from one of the many new treatments being developed by > researchers.) > Many guys, justifiably, don't want to play the odds, and "want it out." > They feel more comfortable taking aggressive measures against a > potentially deadly disease. > Also, several posters noted that Gleason scores in biopsies are not always > correct; many a man has gone under the knife with a Gleason 6 diagnosis, > only to be told that pathologists who dissected the entire removed > prostate found cancer with a higher Gleason score. > In short, it is an interesting study, but not likely to change many minds > here. > > Alex > > > >
From: Alan Meyer on 4 Jun 2006 00:15
Good summary of the discussion Alex. Alan |