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Profile picture for northoftheborder @northoftheborder

@jimbo12 That sounds really tough. Once a patient is in their 80s, a lot of practitioners will recommend against more-extreme measures like ADT or radiation, on the assumption that quality of life matters more than quantity of life at that stage.

The problem is that there's an idea that the same applies to younger prostate-cancer patients, which it most certainly does not. When I was diagnosed with stage-4 prostate cancer at age 56, I'd had potentially decades of life ahead of me, and wanted to fight — HARD — to try to win them back.

The moral is that there's not just one situation called "prostate cancer", and people (even doctors) who go around making blanket statements like "Prostate cancer is slow developing" or "You're more likely to die with prostate cancer than of it" are conflating too many different things.

With the aggressive prostate cancer that strikes young (in your 40s, 50s, or early 60s) and spreads fast, you're *far* more likely to die of it than with it, unless you take drastic measures quickly. That's what killed famous people like Johnny Ramone (55), Frank Zappa (52), Dan Fogelberg (56), Bill Bixby (59), James Michael Tyler (59), Gary Cooper (60), and Jack Layton (61). It's only in the past few years that this type of cancer has become manageable after it metastasises, so instead of just palliative care, we have the option of new treatments that can (in many cases) keep us alive for years while treating advanced prostate cancer as a chronic disease.

But the aggressive treatment that made sense for me with fast-moving PCa at age 56 might not have made sense for you with slow-moving PCa around age 82–3. It's not as likely that you had the extra strength and health reserves to tolerate the side-effects of ADT or radiation the way I did in my 50s, and I'm so sorry that things worked out badly for you. It's also ridiculous that you have to live in a society that will make you pay for an expensive-but-essential medical test if it comes out negative, but that's a separate thread. 😠

My point is just that we need to be clear that we're not always talking about the same thing when we say "prostate cancer". That's why we need to ignore the quacks on YouTube — they oversimplify to get followers and likes, because that's how they make money or advance their careers. (I don't mean the legit researchers, like some of the Mayo practitioners, who aren't afraid to talk about the nuances and complexity.)

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Replies to "@jimbo12 That sounds really tough. Once a patient is in their 80s, a lot of practitioners..."

@northoftheborder

I'm inclined to believe that factors such as finances, a person's character, and their support network influence success in the fight against cancer.

Finances make various treatment methods available; if one doesn't work, another is used. Many poor people are doomed by definition because they don't have access to advanced treatments.

A person's character influences how they respond to help. A complex character makes it difficult to make informed decisions.

Finally, those around a person determine their motivation and determination. In some cases, if a person is poor but has friends and relatives with financial means, this also offers an additional chance.

Of course, these three factors, in various combinations, must be in harmony. For example, Steve Jobs had a lot of money and was surrounded by people who motivated him, but he didn't listen to doctors or his family.

In other words, these three factors must work together.

If we take celebrities as examples, there are many who had overly large egos and often didn't listen to anyone, so I don't think it's rational to use them as examples.

My uncle died of lung cancer. He lived for many years as an outcast, with no money, no connections to his family, and a nasty temper.

In my opinion, the fight against cancer begins with the three factors I listed above, followed by other, secondary factors, such as the doctors' competence, the body's response, and others.

And most importantly, primary factors (finances, character, support from those around you) are inextricably linked with secondary factors. If there's disharmony, everything will collapse. Of course, this isn't an absolute statement, but rather something that increases the likelihood of survival.

I've read many books about how famous athletes, writers, and others recovered from cancer, but they were saved more by the opportunities available to them. Think of that champion cyclist, I don't remember his name. I highly doubt he would have beaten cancer without the help of America's best doctors. Ordinary people don't have such opportunities!

I think my point is clear, right?

Thank you!