The very understandable problem most people have in accepting this approach is the uncertainty associated with it. What is my cancer going to do? Will it just sit there for years, or will it begin to spread quickly? And, the biggest worry of all, how long have I got to live? Am I going to die soon?
No doctor can answer these questions, because in every man, prostate cancer is different. However, although we don’t know the absolute answers for your specific cancer, we do know some things, and they are reassuring.
We know what generally happens to men in your situation who are followed carefully with watchful waiting: Gradually, over time, the PSA level will go up. At some point, the bone scan will become positive. This is the time to begin hormone therapy. Once hormone treatment is under way, the PSA level almost always falls dramatically and stays low indefinitely—for some men, this can mean many years. However, at some point down the road, if the patient lives long enough, the PSA will begin to rise again, as the hormone-resistant cells start to multiply. This is when both patients and their physicians begin to worry, because if these cells cannot be stopped, a man’s lifespan is generally only one or two years from this point.
Now, having said this, we also add that for men facing this today, there is great hope. Within the next five to ten years, we expect major new advances that will make it possible for us to control these hormone-resistant cells. Monumental research efforts are being focused on finding new and better ways to treat advanced prostate cancer. And it is entirely possible, if and when you ever reach the point where the hormonal therapy is no longer working, that more effective treatments will be there waiting for you.
Therefore, it is impossible to tell any man with prostate cancer how long he will live today because there is great and reasonable hope that he will have a much brighter outlook tomorrow.
So, to sum up: All of this means that if you have positive lymph nodes and embark on a plan of watchful waiting, you will be avoiding unnecessary side effects today from treatments that will not prolong your life; that these treatments will be there tomorrow, if you develop symptoms and need them. And that, in the future, there is a strong likelihood that we will have new treatments available for you that will do a better job of controlling this cancer.
No doctor can answer these questions, because in every man, prostate cancer is different. However, although we don’t know the absolute answers for your specific cancer, we do know some things, and they are reassuring.
We know what generally happens to men in your situation who are followed carefully with watchful waiting: Gradually, over time, the PSA level will go up. At some point, the bone scan will become positive. This is the time to begin hormone therapy. Once hormone treatment is under way, the PSA level almost always falls dramatically and stays low indefinitely—for some men, this can mean many years. However, at some point down the road, if the patient lives long enough, the PSA will begin to rise again, as the hormone-resistant cells start to multiply. This is when both patients and their physicians begin to worry, because if these cells cannot be stopped, a man’s lifespan is generally only one or two years from this point.
Now, having said this, we also add that for men facing this today, there is great hope. Within the next five to ten years, we expect major new advances that will make it possible for us to control these hormone-resistant cells. Monumental research efforts are being focused on finding new and better ways to treat advanced prostate cancer. And it is entirely possible, if and when you ever reach the point where the hormonal therapy is no longer working, that more effective treatments will be there waiting for you.
Therefore, it is impossible to tell any man with prostate cancer how long he will live today because there is great and reasonable hope that he will have a much brighter outlook tomorrow.
So, to sum up: All of this means that if you have positive lymph nodes and embark on a plan of watchful waiting, you will be avoiding unnecessary side effects today from treatments that will not prolong your life; that these treatments will be there tomorrow, if you develop symptoms and need them. And that, in the future, there is a strong likelihood that we will have new treatments available for you that will do a better job of controlling this cancer.
No comments:
Post a Comment