Ignoring Prostate Cancer Entirely

Exactly….
https://grok.com/share/bGVnYWN5_71b03503-9df2-4e1f-adcc-785f67d88dd5

My thinking on this topic —> What one does for asymptomatic (or even symptomatic) prostate cancer depends on a number of factors.
> when I was diagnosed with prostate cancer at 56y (in 2012), my decision on treatment will be different from my oldest brother who recently was diagnosed (at 78y). His time horizon is much shorter and might even warrant doing nothing depending on the aggressiveness.
> This is a personal call. Yes, the people who love you will also be impacted by whatever decision you make. In my case, at diagnosis my prostate cancer was low-grade, localized, and in my opinion warranted active surveillance; my wife (& my urologist) wanted me to have surgery. Her’s was an emotion-driven opinion; he was a surgeon; mine was a data-driven decision. Here we are now 13 years later, (4 years after having proton radiation treatment) and I’m fine - it’s as if this journey never happened. My wife now understands that the treatment decision must be appropriate for the diagnosis.
> Also (as mentioned in that article), yes prostate cancer does rank as the second most frequent type of cancer in men. However, prostate cancer has only 1/10th the deaths compared to cardiovascular disease. All these numbers must be kept in appropriate context.

Make an informed decision; become a “student of prostate cancer.” Don’t think prostate cancer = death; it usually doesn’t. Be sure to know yourself and what best treats the cancer and maintains the quality of life you want to have. There is no “rolling of dice” if a truly informed decision is being made.

Most of the data points mentioned in that UroToday paper somehow track back in some way to looking at mortality (between patients managed with active monitoring versus radical treatment).

Beyond looking at mortality, quality of life is of great importance. For just a Gleason 6, radical treatment can often be worse than the possible cancer itself.

In the early 2000s, so many men were opting for radical treatment for a G6 (usually surgery) when it wasn’t medically necessary, that in 2012 the United States Preventive Services Task Force (USPSTF) recommended against routine prostate cancer screening (assigning the screening a “D” recommendation: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening-2012).

As it turned out, that knee-jerk reaction had bad downstream consequences. But, it was as a result of so many unnecessary radical treatments for G6 and the adverse quality of life impacts they caused.

Sir , what you say about loved ones around you is an important decision . Also , a commitment to yourself - to never give up and to strive to get better . When I was diagnosed 4 years ago at a early stage ( at 57) I said to myself - "for my sake and the people around me , I will get better and live . I am only 57 and have a lot of living and sharing to do ! " . God Bless Sir .

I've watched several loved ones go through cancer, all of them died from it. My mother was the most impactful of all of them, breast cancer that was in remission for about ten years and then her life was out of a nightmare nobody wants. She was almost totally comatose for the last three years of her life and there was zero quality of life for her.

I swore I would never let myself get to that. My mother swore that too, after watching her best friend die from it. It's funny that, in the heat of the moment, we grasp at everything we can to keep kicking.

I told my wife ages ago, even before my first cancer, that I would go one round of treatment no matter what. And, to me, surgery isn't yet treatment (even if it's defined as such). After that round I would start skydiving every day with the company with the worst track record and let God take the wheel. I still feel that way, I may not when the that day comes, but I have to try treatment to see if it cures me.

Before the prostate cancer mess I was told there was an anomaly on my remaining kidney. Having survived a very rare kidney cancer and told, at that time, that if it came back it was lights out, this was obviously a concern. After MRI's, CT's and ultrasounds, they dismissed it as a likely nothing-burger, but my urologist just told me a couple days ago that it was only a pause and they now want to start checking that again to be sure. It feels like I'm in a constant state of crap-sandwich instead of nothing-burger, but I will, again, try treating it at least once before anything else.

All of this isn't just for me, it's for my family too. My dad lost his wife to cancer, it's breaking his heart that his son has fought the battle twice.

Brian, thank you so much for that very necessary history lesson; unfortunately, most if us live in the “right now” forgetting the painful lessons of the past.

It’s really tough to live with cancer - and the impending doom that it’s going to come back. To have more than one type is truly overwhelming.
But I really have a problem with those who have none of it and boast “They’ll NEVER do that to me!” Or “I’ll just die before I get THAT poison shot into me!” How little they know…
They assume they’re untouchable, but as Mike Tyson said, “Everyone has a game plan - until they get punched in the face.”
Keep on surviving, Bro….cause once we stop trying we’re toast. Best,
Phil

I've seen it represented various ways, the attached chart is probably as good a representation as another...Lifespan versus Healthspan.

No one wants to be "average" on this chart. Even if one finds themselves having to take potentially quality of life reduction medical treatments, due to incurable prostate cancer, the implementation of "massive action", regarding exercise (and to a lesser extent diet) lifestyle changes, will push out one's "Healthspan".

I've heard it said that exercise is better than any drug ever administered, when it comes to addressing the negative effects of chronic disease. Since we all must die of something, the most effective thing we have some control over, regarding our health during the last decade of our life, is how much we exercise.

Obviously one could be hit by a bus tomorrow morning, but making regular, vigorous exercise a routine part of our lives...for as long as we our physically able...is the best way to ensure a long "Healthspan".

Yeah. I haven't seen the worst that cancer can do (by a long shot), but 3 1/2 months on my back in a hospital bed, unable even to use the toilet or even wipe myself for most of that time, and being transferred from bed to stretcher like a sack of potatoes, gave me a small taste of what life's *actually* like if you let cancer progress.

Fortunately for me, thanks to a very skilled surgical team and world-class oncologists here in Ontario, I'm getting a second chance to walk, garden, bicycle, play classical guitar, go on trips, and generally live my life. I didn't know I had cancer until I could barely walk; anyone who thinks they'll just wait and let it happen is either expecting to die soon (e.g. elderly or serious co-morbidities) and ready to end their life in hospice — which is an entirely-reasonable choice in that situation — or really doesn't understand what "it" is.

(Note again that I'm not talking about Active Surveillance, which *is* a very common early cancer treatment; I'm talking about just closing your eyes and pretending it will go away.)

Totally, North, you really did get a preview of how devastating any cancer can be - and this one is no different. The simple things in life you describe truly must feel like heaven when you are totally bedridden, in pain and uncertain what the future will bring. Best
Phil