tag:blogger.com,1999:blog-3114833974012757165.post9116902294101502315..comments2023-04-18T01:19:13.256-07:00Comments on Prostate Snatchers: Active Surveillance for Men with Intermediate Risk Prostate Cancer Prostate Oncology Specialistshttp://www.blogger.com/profile/12308174937988133133noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-3114833974012757165.post-18286175950980256552015-07-09T12:21:14.509-07:002015-07-09T12:21:14.509-07:00He doesn't mention surgery for any treatmentHe doesn't mention surgery for any treatmentAnonymoushttps://www.blogger.com/profile/04305208882411936185noreply@blogger.comtag:blogger.com,1999:blog-3114833974012757165.post-37026540872216943672015-07-08T14:56:02.347-07:002015-07-08T14:56:02.347-07:00Having recently been diagnosed (Gleason 3+4) and h...Having recently been diagnosed (Gleason 3+4) and having undergone HDR (used in this study), this abstract was interesting, but raised many questions (perhaps answered in the full text).<br /><br />Isn't it a rather large leap to conclude that because the prostate cancer mortality was similar between the low and favorable intermediate-risk groups <b>undergoing treatment</b> that they would behave the same without treatment? The cancer mortality was very low in both groups (less than 1%). So was the treatment effective in the favorable intermediate risk group and just overkill in the low risk group?<br /><br />They mention "high dose radiation therapy and androgen deprivation therapy <b>as appropriate</b>. Does that mean the groups were treated differently? How much differently? Did everyone get ADT? I got HDR as monotherapy because of my favorable risk status, and I've heard that ADT isn't all that helpful when combined with radiation for intermediate risk patients, but I'm not sure this was the case at the beginning of the study back in 1997.<br /><br />Also, how much of the similar behavior in the two lowest risk categories is because most (or all) of the biopsies were random and missed some Gleason 7's in the low risk group?<br /><br />I guess with today's imaging, active surveillance means something different that it did just a few years ago. I'm not sure I would be brave enough to trust that my slightly more aggressive (than Gleason 6) cancer didn't microscopically spread outside my prostate while watching it. I had 9 of 9 cores with Gleason 7 (MRI directed--3 each in 3 lesions), so I'm pretty sure I really have Gleason 7, but this study wouldn't be giving me the courage to do AS. <br /><br />Then again, not so long ago, and I'm sure even today, Urologists were/are ripping out Gleason 6 prostates and telling their patients they don't have time for a second opinion.<br /><br />This will be interesting to watch. Hopefully some genetic typing can provide further clues.Anonymousnoreply@blogger.com