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Excellent questions! In fact, a study was just published in the British Medical Journal pointing out that screening for prostate cancer did not improve (lower) death rates compared to those who were not screened. When we perform autopsies to confirm or prove cause of death, up to half of these men died with prostate cancer, not because of it. So yes, you can live years, even decades with prostate cancer and then die of something else, like heart disease.
So why look for it? Because we can! Also because most of us don't want to live knowing that we have a cancer inside us. We'd rather get rid of it, even if there's proof that doing so won't mean a hill of beans when it comes down to our life span. In fact,we're willing to give up quality of life, as measured by incontinence and erectile dysfunction, so that we don't have to walk around with a cancer inside us.
It turns out the other major problem when it comes to prostate cancer is that we really can't predict who's going to die with it and who's going to die from it. If we could weed out the "from" vs the "with", we'd obviously only aggressively treat the "from" group. But since we can't, we treat everyone. That's kind of like using a shotgun rather than a rifle to get rid of a small varmint.
One last point. The Prostate Cancer Prevention Trial looked at using finasteride to prevent prostate cancer. It worked, kind of, depending upon how comfortable you are with statistics. What's interesting and is often overlooked, is the exponentially greater number of men who died from heart disease than from prostate cancer during the study. Some editorialists even noted that the best way to prevent dying from prostate cancer was to prevent heart disease.
The best advice, as always, is to talk w/your primary care physician, be it your family physician or internist. Ask who they would go to themselves or for their family. And ask those folks for their opinions. It all comes down to you, your age (I hate to admit it), your health (if you have other severe medical conditions that are more likely to kill you, why bother with surgery or radiation?), your sexual function (if you've been celibate for a while, then theoretically, erectile dysfunction shouldn't bother you as much), and your risk (in)tolerance (could you continue to live a full & complete life if you chose active surveillance or would the thought of the cancer inside you gnaw away at you).
So why look for it? Because we can! Also because most of us don't want to live knowing that we have a cancer inside us. We'd rather get rid of it, even if there's proof that doing so won't mean a hill of beans when it comes down to our life span. In fact,we're willing to give up quality of life, as measured by incontinence and erectile dysfunction, so that we don't have to walk around with a cancer inside us.
It turns out the other major problem when it comes to prostate cancer is that we really can't predict who's going to die with it and who's going to die from it. If we could weed out the "from" vs the "with", we'd obviously only aggressively treat the "from" group. But since we can't, we treat everyone. That's kind of like using a shotgun rather than a rifle to get rid of a small varmint.
One last point. The Prostate Cancer Prevention Trial looked at using finasteride to prevent prostate cancer. It worked, kind of, depending upon how comfortable you are with statistics. What's interesting and is often overlooked, is the exponentially greater number of men who died from heart disease than from prostate cancer during the study. Some editorialists even noted that the best way to prevent dying from prostate cancer was to prevent heart disease.
The best advice, as always, is to talk w/your primary care physician, be it your family physician or internist. Ask who they would go to themselves or for their family. And ask those folks for their opinions. It all comes down to you, your age (I hate to admit it), your health (if you have other severe medical conditions that are more likely to kill you, why bother with surgery or radiation?), your sexual function (if you've been celibate for a while, then theoretically, erectile dysfunction shouldn't bother you as much), and your risk (in)tolerance (could you continue to live a full & complete life if you chose active surveillance or would the thought of the cancer inside you gnaw away at you).
