Consumer's report on Health (10/10) take on prostate cancer
treatment --AS (Active Surveillance) vs. SUR (surgery) vs
RAD (external radiation) vs. SEEDS (Radiative seeds implant)
(Hope this has not duplicate a previous post)
(1) for low-risk and intermediate risk --10 year death rate
is higher for AS by about 2% (vs. SUR) to 1% (vs. RAD)
(2) 1/2-2/3 of AS does not need further treatement within 5 years.
(3) 2-year urinary leakage (> 1 leak per day) is 14%/7%/10% for
(4) 2-year BM problems (frequent, urgent, bloody, or painful)
is 1%/11%/8% for SUR/RAD/SEEDS
(5) see the newsletter for recommendations
The October 2010 issue of "Consumer's report on Health"
newsletter contains an interesting (and to me surprisingly
detrimental) take on the effect of Prostate cancer treatment
and on AS. While I often view some of Consumer's report's
result as perhaps somewhat unreliable, it is at least honest.
The 10-year death rate is based on an observations study
published in 2010 of 6849 Swedish men diagnosed with localized
prostate cancer (treatment in the 1990's, so, the results might
not reflect what one might get today).
For low-risk (Gleason 6, low %, PSA <10) and intermediate
risk (localized) cases, the 10 year death rate is
AS 3%/5%, SUR <1%/3%, RAD 2%/4%, SEEDS probably similar to RAD.
Thus, while AS saves you from side effects (see below),
it does raise the anxiety level, and DOES COST higher death rate--
2% extra compared to SUR, and 1% compared to RAD.
Note that for people who choose AS, 1/2-2/3 does not need further
treatment within 5 years (this means perhaps 40% does need further
treatment within 5 years, and for those people, their 10-year death
rate is higher than if they have chosen SUR/RAD at the beginning
--perhaps up to 5% vs. SUR). I don't know the statistical uncertainty
in this, and whether other studies back these results up.
The 2-year long term adverse effect is based on a 2008 study on
survey on 1201 men. The rates for SUR/RAD/SEEDS for 3 major effect are
poor sexual function --53%/58%/46%
urinary leakage (>1 per day) 14%/7%/10%
BM problems 1%/11%/8% (frequent, urgent, bloody, or painful)
They also note that Robotic have similar results as Open, but the
Robotic clients are 3-4 times less satisfied (they expected better
results based on marketing hype--note that Robotic does have
faster recovery, and less liklihood of need for blood transfusion.
However, for those case with cancer that has spread, Open is probably
more effective in removing nearby cancer (like my case--I regretted
not having chosen Open, since my PSA DID NOT drop after robotic surgery)
I wish for a larger sample for this study, though.