The Story So Far

So first of all, “PC” doesn’t mean “personal computer.”  I’m not trying to keep this a secret.  But neither am I trying to broadcast it to the world.

In April I had my annual physical examination.  One of the tests I always have is a PSA (prostate specific antigen) test.  The results were not high, but they were higher than the previous years.  This is considered a warning sign for prostate cancer, although this (and the use of PSA tests in general) is controversial–too many false positives.

To make a long story short, I ended up getting a biopsy and prostate cancer was found.  My doctor then ordered additional tests — a bone scan and a CT (computerized tomography) scan to determine if the cancer has spread.

Luckily those tests came back negative.  This means there is no sign of the cancer spreading to other parts of my body.  That is very good news, because if it had spread, it would be incurable.

So now I need to get the cancer treated so that it won’t spread.

I’m in the process of interviewing doctors, each of whom has their treatment to tout.

There are four standard treatments for prostate cancer:

  1. “Active surveillance”, previously known as “watchful waiting”.  The theory behind this technique is that prostate cancer is often slow growing and no treatment is necessary, especially in older men (in their 70s).  However I am not that old, and my cancer is not expected to be slow growing and so it needs a more active treatment.
  2. Surgery.  Removing the prostrate removes the primary tumor.  If it hasn’t spread then you’re done.
  3. Beam Radiation.  This is a traditional treatment for cancer;  in this case the beam is focused on the immediate area so the usual side effects are largely absent.
  4. “Seeds.”  This is another form of radiation therapy.  In this form, small pellets (“seeds”) of radioactive cesium are implanted directly into the prostate.
All of these latter three treatments are available to me.  They all have approximately equal cure rates, but they all have (different) nasty side effects.  

So, as I said, I’ve consulted with three doctors, each of whom advocates one of the three latter treatments above.  None of them advocate active surveillance for the reasons already mentioned.

“My” doctor–the one who is assigned to treat me at present–is a surgeon and not surprisingly recommends surgery.

I have a friend who is going through the same process and he has lots of doctor friends.  They recommend against “my” doctor because he is young and inexperienced.  So I have an appointment with another surgeon who is very well known (and very thorough).  The only problem is that he is booked until September 15.

So I’m thinking, reading, and waiting.

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