1. Advice/recommendations for older people (over 70 and up) won't always work for us, young.
2) Age is one factor in cancer control strategy that must be taken into account. Now the main question is: what other advantages do we, young people, have, and what can we use before we die

Well, I beg to disagree

I was diagnosed at age 57, high risk, one daughter in high school, another starting college, eight years until "65" and "retirement, though I finally retired at 70.". Treatment choices were binary, surgery, brachytherapy. I chose surgery, maybe I'm an outlier, no incontinence, erectile function returned and within a month I was travelling, exercising...

Alas, it was not a cure, 12+ years later, SRT, Triplet Therapy and Doublet Therapy.

Yet here I am.

A lot of living has gone on in those 12+ years, vacations, graduations, anniversaries, birthdays...more to come

How have I "managed my PCa at 57 versus 70...? Not any differently.

I control the things I can:

Diet
Exercise
Managing stress

I choose my medical team well, it's a privilege to be on my medical team, not a right.

I also have rules for myself and my medical team...

Once I make an informed decision and carried it out, I never look back. Well, that is not entirely true, I look for lessons learned from that decision. The path is always forward: I continue to learn about PCa and always look ahead. What counts is today and what lies in the future.

Yesterday is gone, so forget it, well, learn from it.

I educate myself as completely as possible and took the time I needed, I always know that no matter the outcome of a particular choice, I made the best possible decision. That knowledge that I have thought my decisions through carefully is what is really important—and may be more important than the decision itself.

I am in charge. Not my doctor. They need to be consulted and their opinions and ideas should carry weight as I make my decisions. But I never forget: it is my life, my today, and my future. I have made the best possible, fully educated decisions that makes sense for me, with the focus on long life.

Don’t Walk In Cold to an Appointment. To make sure I do the best thing for my individual prostate cancer, I need to educate myself.

Knowledge will empower my BS detector. When several urologists told me ADT monotherapy is what I needed and did not want to talk about imagining and combining other therapies such as radiation and chemotherapy, I didn’t just have to accept their advice on faith.

I walk in the door ready to start the conversation at a different level. I don’t have to spend time talking about the basics, things like Gleason grade and clinical stage and what they mean. I already know. I can have an intelligent discussion about the merits of a particularly treatment for my cancer, my likelihood of being cured, and risk of side effects.

I won’t blindly accept the opinion of a non-specialist – I know that my cancer requires a team approach.

Rules for my Medical Team

Know your stuff. As part of my medical team, you must have a thorough knowledge of my cancer and of the latest developments in research, and be ready to formulate a plan of attack. If what I ask about based on my research is not familiar with you, then admit it, say you will look into it and discuss on my next consult. Better yet, you will call me!

Do your homework. I expect you to have reviewed my medical records prior to my appointment, talked with other doctors I have seen that day.... You’ve looked at my x-rays; you have my pathology report, labs. I can tell when you're looking at my clinical data from tests for the first time !

Respect my point of view. Listen to all sides thoughtfully before reaching a conclusion. With patience and finesse, I’m sure you can help me to feel confident about the plan you and I have shaped for me.

Don’t close your mind to new hypotheses and don’t ignore clues that might lead you toward the best results. Rid yourself of the temptation to make your day easier by delivering perfunctory care.

When it’s decision time, please decide! Care for me with a dogged determination to get me healthy

Follow up on promises and follow through on tasks. I can tell you with absolute certainty that there is no greater disappointment than realizing that you cannot rely on your doctor.

Please talk to me. I need your advice, comfort, and expertise; I am scared and discouraged—are you willing to take a seat, look me in the face, and answer my questions?

And yes, the front desk is key, sets the tone, pleasant, efficient on check in and scheduling on the way out...a kind word, smile...and don't call me "honey." You have my records, I am ok with you calling me by my first name or Mr.___

Yes, I am fortunate, of these 12 years, three have been on treatment, the rest off. While on treatment, was life any different? Yes, I experience the side effects, fatigue, muscle and joint stiffness, genitalia shrinkage, weight gain...But, didn't change my life, only how I felt doing it. I went skiing with friends in Colorado, did the Bataan Memorial March with my sister, travelled the Ring Road in Iceland with my wife, attended my daughter's college graduation, went to a Willie Nelson concert with my wife...I continued working, often travelling, my colleagues knew when I was on treatment and had no issues with my work,

My original treatment decision was curative, since then, treatment decision have been about managing my PCa, knowing a cure is no longer possible. I make my decision in concert with my medical team. We have decision criteria in doing so, we treat for defined periods using hybrid decisions that combine the guidelines from NCCN, AUA, with results emerging from clinical trials into mainstream clinical practice and my clinical data. We have decision criteria for de-intensification.

So, from my perspective, the underlying concepts and principles behind managing one's PCa at younger versus older may not be different. The mind is a powerful X factor in this. Yeah, when I got the call, it floored me, I had my pity party, then picked myself up off the floor and set about he business of living.

Kevin