Wednesday, March 18, 2020 | 2 a.m.
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I’m a prostate cancer survivor, for now. Unfortunately, I have to take exception with Jane E. Brody’s March 5 story “Before undergoing prostate surgery, consider ‘active surveillance.’ ” The bottom line message published was that the diagnosed patient does not necessarily have to believe or accept that radical treatment procedures such as surgical removal of the gland or intense radiation bombardment offer the best solutions.
Brody refers to advice from some urologists that “active surveillance” offers a less intrusive regimen. True, but six months or a year’s time for a PSA (prostate specific antigen) or biopsy test interval may exceed a prudent observation period for the affected man. In my case, the aggressiveness and multiplication of the mutating cells suddenly accelerated. By the time I elected gland removal, my numbers had more than doubled, and the disease had spread beyond my prostate and was headed for my bone marrow. Mortality from bone cancer is one of the most painful ways to die.
Yes, “radical” approaches to thwart prostate cancer may lead to various levels of incontinence or impotence, but is death a superior alternative? My urologist’s preferred advice: After age 45, get a PSA test at least every year. Establish a base number. It can span from 2 to 30,000; really. Then, if in subsequent years it goes up, get to a urologist post haste. Insist on a 24 core biopsy; not the often insufficient 12 sample procedure. That’s my potentially life-saving opinion about the active surveillance concept.
