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:

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.”

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.

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