Life expectancy
Through my research I have seen more than once that life expectancy is very similar for those who have been treated for prostate cancer and those who have chosen no treatment. If this is at all true then I can’t imagine putting myself through the hell of treatment and am considering just getting on with my life without treatment. Anyone else? Any thoughts?
A lot of it depends on how aggressive the cancer is. I find that there are two types of patients when it comes down to this question. The first guy wants to eradicate the cancer cells. The second guy wants to manage a life that includes the knowledge that cancer is within him. There is no right or wrong answer. You know your body. This is a good question. Thanks for asking it! I have many questions for my doctor next week before making any decisions. The first doctor talked soooo fast and gave us way more info in a very short amount of time than we could process. We’ll see. I am glad to hear that you are going to ask these questions. I encourage you to write them down. And don't let that doctor leave your treatment room until they are answered! Best of luck
First off, much depends on the specifics of your diagnosis. What is your NCCN Risk Group? Second, assuming that it is Low or Very Low, it seems to me that a watch and wait strategy might be an appropriate consideration. Anything above that I think is where it gets tricky. I think factors like age, other health considerations, life expectancy, etc., then come into play. In my case, with an Unfavorable Intermediate diagnosis, watch and wait is not an option. One oncologist commented that although I have time to make my decision as to approach (RP or IMRT/ADT), she would not want to see me delay treatment unnecessarily, certainly not for a year. Had my diagnosis been lower, e.g. Low, or maybe Favorable Intermediate with few positive samples, I might have pursued FLA subject to additionat input and personal research. Good luck, and for sure do plenty of research, and ask lots of questions. 
Hi
. and summed up a lot of considerations that go into the decision process. As a stats person, I can tell you that those who cite the life expectancy numbers as evidence that treatment doesn't make a difference don't understand/take into consideration all of the variables that are not being controlled for. Those who are treated early have a very high success rate and life expectancy basically reverts to the norm. Those who are not treated tend to have a variety of reasons for this - from having a low grade/slow growing cancer, age, to other conditions ... all of which have the potential to not change their life expectancy. Another factor is those who die from some other condition and it is then discovered that they had prostate cancer. They become an untreated case, but something else was the cause of death and the PCa didn't change life expectancy. Another, often overlooked, variable is the fact that those who do die from prostate cancer (over 33,000 men in the U.S. per annum) get folded into the death statistics and therefore impact life expectancy numbers and it is impossible to know what the number would be without those 33,000 PCa deaths. All of this is a long-winded way of pointing out that every case is individual and the patient will have his unique circumstances that should drive treatment decisions. Trying to extrapolate what is best for you, as an individual, from any statement on overall population life expectancy numbers is mathematically dubious and would do the patient a disservice. Best, Richard (ProstateCancer.net Team) Two treatments now in last twenty years. My PSA was taking off like a jet, so yes, side effects but treatment has worked well.
