Listening to a discussion of Prostate Cancer on Science Friday and especially the comments of Mark C. Scholz who wrote a book with the provocative title of “The Invasion of the Prostate Snatchers”  felt it was time once again to make a plea for men not to rush to be treated. At the age of 51 some 14 years ago,  it was determined that i had prostate cancer.  I have written a bit about my experiences here and here.  At that time, I believed that there was a high probability that if I was not treated, I would die of prostate cancer.  I choose radiation because it appeared to have better result with respect to side effects especially impotence (which was for me frankly a big  concern ).  My procedure went as expected.  I was able to continue to work during the weeks I received radiation.  There were a few months where my bladder which received some radiation was irritated and I had to pee all the time (I am still traumatized by the few times I was trapped and could not get to a toilet fast enough like the time I  had to pee into a water bottle while I was stuck in a traffic jam).  But realizing that I was now sterile (I of course already had three wonderful children) and that I  could no longer ejaculate had an effect on my psyche.  Then things appeared to go bad and instead of my PSA going down it went up.

After almost two years, it looked like I had metastasized  prostate cancer which is pretty much death sentence.  But it turns out that it was a false alarm.   The PSA levels started going down and the last time I checked they  were at a level the indicated that I had no longer active prostate cancer (while you can no for sure that you have prostate cancer, you can never know you do not).  Now 14 years later, I can say that I do not have any significant effects other than the ones already mentioned.  An after all, I am 65 and now more concerned that I might fart during a massage then worried that I would get an unintended erection.  But the bottom line is I should have done Watchful Waiting which means just monitoring PSA levels and having a biopsy ever year or two.    If I understand the statistic well, 28% of men over 60 have prostate cancer.  Of these, 3% of men will die of prostate cancer if untreated.  This is an argument for not doing a PSA test since you only have a 3%  but I believe in information.  But then if you do have prostate cancer, you have a 10% chance of dying from it.  But this includes men that clearly have an aggressive form of the disease.    I would guess that for someone like me who had a non aggressive version, the probably might be less than 3%.  I could have waited years or maybe for the rest of my life and never had the procedure.  However, when I explain this to men who have been recently diagnosed, they always opt for treatment.  Frankly, most of these men would do better by losing some weight, going to the gym and reducing a bit of stress.  But then who would keep the urologist  in business.

A review of the book mentioned above can be read here.