3 ms·
(I didn’t read the article due to paywall). The reason they are reluctant to aggressive treatment is because risk of side effects that affect quality of life,
by Ma8ee 3y ago
(I didn’t read the article due to paywall).
The reason they are reluctant to aggressive treatment is because risk of side effects that affect quality of life, such as impotence and incontinence. Do you want to wear a diaper for the rest of your life or live with a relatively low risk of earlier death from cancer?
- s1artibartfast 3y agoFYI, It seems like you are agreeing with the parent post, but your tone comes off pretty hostile. What point are you trying to make?
- Ma8ee 3y agoMy point is that it isn't population considerations that make physicians reluctant to treat many cases of prostate cancer, but balancing relatively low risks of the cancer being aggressive against quite severe quality of life degradation for the individual patients. I really don't see how my post would be considered hostile.
- jrpt 3y agoThe vast majority of radical prostatectomies don’t have incontinence (like 95%), and impotence isn’t common either. Furthermore, they’re usually in older men who are already impotent. Many years ago incontinence was a side effect but it isn’t common any longer as surgery has gotten better. The story of how they discovered the nerves they were cutting that causes impotence is kind of crazy, because for years it is basically like nobody even looked into it. Then one day someone decided to and they figured it out pretty quickly. That was in 1982.
- Ma8ee 3y agoI don’t have time to dig out some definitive study, but top google results list incontinence as a “common” side effect.
- jrpt 3y agoI’m talking about long-term incontinence which is what people are most concerned about. You probably are reading about short-term incontinence. If you are having a radical prostatectomy done, you probably are hoping to live at least ten more years or even longer, so you’re basically saying you want short-term pain (surgery, pain, incontinence, etc) for long-term peace of mind (no metastases).
- Sebb767 3y ago1 in 10 is the usual order of magnitude for side effects labelled "common", so this doesn't disagree with the 90% number at all.
- s1artibartfast 3y agoPopulation considerations are what make it low risk. If prostate cancer was most common in 10 year old boys, the risk tradeoffs for a slow cancer would be quite different. >I really don't see how my post would be considered hostile. To make a point, you are quite literally asking someone with elevated PSA, whos father died of prostate cancer, if they want to wear a diaper.
- fortran77 3y agoI would happily wear a diaper in my 70 and 80s if I was in good health otherwise.
- petesoper 3y agoThere is a solution for chronic cases like this: a manually operated valve that stands in for the sphincter. Some of the guys in my prostate cancer support group have described this as "life changing".
- fortran77 3y agoYes! Also, most people will dribble a bit when they get old no matter what--with or without prostate cancer. I'm much more concerned about my mental health than having to wear incontinence pads in my 80s.