What brought this on? Another email exchange between me and my radiation oncologist.
Over the weekend, a few more questions popped into my head and I wanted to get his response. Yesterday, I fired off an email asking if any advances in radiation delivery technology or methods in the last 10-15 years improved the side effect outcomes over the studies he shared with me. In short, the answer was no—there were no appreciable changes.
Of greater interest to me was his interpretation of the Freedland study, which shows that I can do nothing and have a 94% chance of being around 15 years from now. His response:
I am familiar with the study you included, and it is one of many retrospective reviews on this subject. The authors preformed a retrospective review on a total 379 patients over period of 18 years from 1982 – 2000. Therefore, although the data are valuable and contribute to the literature, I consider it (as well as the many other studies on this subject) thought provoking.
Perhaps I’m reading too much between the lines, but his last sentence translates into “skeptical of the study” to me. He continued:
The bottom line is that you have a biochemical recurrence with a low, slowly rising PSA. Do you need radiation treatment now, sometime in the future or never? I don’t have a definitive answer to that question, but there are data to suggest “the earlier the better” and other data to suggest treatment might not be needed at all. It depends on your point of view…
Am I upset by that response? Not really. It’s pretty much what I expected it to be, and that tells me that my research has been quite thorough. He and I both landed at the same place.
Will it make deciding my course of action any easier? Hell no. But it does reinforce that it’s my decision, and my decision alone.
Now where did I put those Eisenhower dollar coins again???