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JB

There are two that I know of, atough there

are bound to be more:

The older of the two is a list you can

join here http://www.prostatepointers.org/mailman/listinfo/ww

The second is part of The New Prostate

Cancer site and the relevant page is here http://prostatecancerinfolink.ning.com/group/activesurveillance

There have been others but they closed due

to lack of interest. You will find very few posts on either of these forums

either. For some reason I have never been able to establish (and I’ve

been trying for about 13 years) men who choose Active Surveillance or Watchful

Waiting seem very much more reluctant to discuss issues than the men who choose

conventional treatment. my basic theory is along the lines that (1) AS/WW men

tend to be somewhat non-conformists, perhaps not very good “Group”

people, marching by and large to their own tune and (2) because their choice is

nt a popular one, they are reluctant to post because they know that they will attract

a good deal of mail urging them to stop being in denial and have surgery –

or……………………………fill

in the treatment the mailer had himself.

I have a site, badly in need of re-construction

here www.prostatecancerwatchfulwaiting.co.za

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of jb indc

Sent: Monday, 1 February 2010 1:23

PM

To: ProstateCancerSupport

Subject:

Active Surveillance

Does

anyone know of a Yahoo group, or other support group, for active surveillance

or " watchful waiting " ? JB

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Terry said...

Watchful Waiting seem very much more reluctant to discuss issues than the men who choose conventional treatment. my basic theory is along the lines that (1) AS/WW men tend to be somewhat non-conformists, perhaps not very good “Group” people, marching by and large to their own tune and (2) because their choice is nt a popular one, they are reluctant to post because they know that they will attract a good deal of mail urging them to stop being in denial and have surgery

 

 

May I offer a few more possible reasons for limited participation in AS/WW groups? Here are my thoughts:

(3) These folks don't (yet) have the host of post-treatment/failed-treatment issues that dominate discussions on more general PCa lists. The AS/WW guys are in the mode of getting routine PSAs, DREs, biopsies, CDUs, etc. Maybe there is not as much to question here?

(4) I don't know the numbers, but I suspect that with the push for treatment by the medical profession in most cases, many more men receive treatment than go on AS. Along the lines of numbers, I also suspect that a fair number of men who have treatment do not participate in groups because any SEs from their treatment have been resolved satisfactorily and they go on about their lives. It is likely, however, that numbers of men with questions regarding which treatment to pursue and men with questions regarding post treatment issues far outnumber men with AS questions

Ant thoughts?

Stan

 

 

JB

 

There are two that I know of, atough there are bound to be more:

 

The older of the two is a list you can join here http://www.prostatepointers.org/mailman/listinfo/ww

 

The second is part of The New Prostate Cancer site and the relevant page is here http://prostatecancerinfolink.ning.com/group/activesurveillance

 

There have been others but they closed due to lack of interest. You will find very few posts on either of these forums either. For some reason I have never been able to establish (and I’ve been trying for about 13 years) men who choose Active Surveillance or  – or……………………………fill in the treatment the mailer had himself.

 

I have a site, badly in need of re-construction here www.prostatecancerwatchfulwaiting.co.za  

 

All the best

 

Terry Herbert

I have no medical qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.net  and www.prostatecancerwatchfulwaiting.co.za 

Dr “Snuffy” Myers : " As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data "

 

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of jb indc

Sent: Monday, 1 February 2010 1:23 PMTo: ProstateCancerSupport

Subject: Active Surveillance

 

 

Does anyone know of a Yahoo group, or other support group, for active surveillance or " watchful waiting " ?  JB

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Stan,

You are certainly correct about the

numbers of men who have chosen Active Surveillance in the past. They are a

small percentage of eligible men because of the focus on the ‘gold

standard’ of surgery – this may change in the future when the new

Guidelines (downloadable here after registration http://www.nccn.org/professionals/physician_gls/f_guidelines.asp

) are more widely circulated and acted on and as men come to realize that,

as a study last year showed, there may be more than one million men in the US

living with the side effects of treatment that was unnecessary.

But having said that, there is a significant

number of men who did not choose immediate treatment and the Forums have

several hundred members. In any forum about 5% of members post on a regular

basis and another 10% (roughly) post intermittently – the balance do not

directly participate, although there is always contact off the forum or list. So

one would expect far fewer posts from AS men but none of the forums I have

participated in show anything like a 5% post rate.

You certainly have a point about the lack

of side effects which do form the basis of many posts on PCa forums, but they

are not the sole reason for a post and there are some issues that could be

usefully discussed by AS men.

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From:

ProstateCancerSupport [mailto:ProstateCancerSupport ]

On Behalf Of Stan Leake

Sent: Tuesday, 2 February 2010

2:47 AM

To:

ProstateCancerSupport

Subject: Re:

Active Surveillance

Terry said...

Watchful Waiting seem very much more

reluctant to discuss issues than the men who choose conventional treatment. my

basic theory is along the lines that (1) AS/WW men tend to be somewhat

non-conformists, perhaps not very good “Group” people, marching by

and large to their own tune and (2) because their choice is nt a popular one,

they are reluctant to post because they know that they will attract a good deal

of mail urging them to stop being in denial and have surgery

May I offer a few more possible reasons for limited participation in

AS/WW groups? Here are my thoughts:

(3) These folks don't (yet) have the host of post-treatment/failed-treatment

issues that dominate discussions on more general PCa lists. The AS/WW guys are

in the mode of getting routine PSAs, DREs, biopsies, CDUs, etc. Maybe there is

not as much to question here?

(4) I don't know the numbers, but I suspect that with the push for

treatment by the medical profession in most cases, many more men receive

treatment than go on AS. Along the lines of numbers, I also suspect that a fair

number of men who have treatment do not participate in groups because any SEs

from their treatment have been resolved satisfactorily and they go on about

their lives. It is likely, however, that numbers of men with questions

regarding which treatment to pursue and men with questions regarding post

treatment issues far outnumber men with AS questions

Ant thoughts?

Stan

On Sun, Jan 31, 2010 at 8:44 PM, Terry Herbert <ghenesh_49optusnet.au>

wrote:

JB

There are two that I know of, atough there

are bound to be more:

The older of the two is a list you can

join here http://www.prostatepointers.org/mailman/listinfo/ww

The second is part of The New Prostate

Cancer site and the relevant page is here http://prostatecancerinfolink.ning.com/group/activesurveillance

There have been others but they closed due

to lack of interest. You will find very few posts on either of these forums

either. For some reason I have never been able to establish (and I’ve

been trying for about 13 years) men who choose Active Surveillance or

or……………………………fill

in the treatment the mailer had himself.

I have a site, badly in need of

re-construction here www.prostatecancerwatchfulwaiting.co.za

All the best

Terry Herbert

I have no

medical qualifications but I was diagnosed in ‘96: and have learned a bit

since then.

My sites are

at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr “Snuffy” Myers : " As a physician, I am painfully aware that

most of the decisions we make with regard to prostate cancer are made with

inadequate data "

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ]

On Behalf Of jb indc

Sent: Monday, 1 February 2010 1:23

PM

To: ProstateCancerSupport

Subject:

Active Surveillance

Does anyone know of a Yahoo group, or other support

group, for active surveillance or " watchful waiting " ? JB

Link to comment
Share on other sites

Terry I suppose whichever way you look at it, AS is a thousand times better than WW. Certainly from our UK point of view.

WW seemed to mean wait till you you hurt somewhere and we show it is bone mets or whatever manifestation secondaries turn up as. True in many men this didn't happen before the apparition with the scythe carried them away with some different cause.

The newer AS in its true sense tries to monitor changes in PSA etc. In some cases indication comes that there is agressive movement that indicates either radical action or maintainance of the close watch. In other cases indications are that there is slow or imperceptable change, thus the periods between tests can be lengthened.

Regarding e-forums such as ours, membership tends to be mainly those who still have issues. Only a few of those who have radical treatment and minimal side effects stay with groups, I'm grateful for those that do. Also I can imagine that if AS is going well, there are more important things in life than reading about other people's troubles, again I am grateful for those who stay with us.

Best wishes to you all

RE: Active Surveillance

Stan,

You are certainly correct about the numbers of men who have chosen Active Surveillance in the past. They are a small percentage of eligible men because of the focus on the ‘gold standard’ of surgery – this may change in the future when the new Guidelines (downloadable here after registration http://www.nccn.org/professionals/physician_gls/f_guidelines.asp ) are more widely circulated and acted on and as men come to realize that, as a study last year showed, there may be more than one million men in the US living with the side effects of treatment that was unnecessary.

But having said that, there is a significant number of men who did not choose immediate treatment and the Forums have several hundred members. In any forum about 5% of members post on a regular basis and another 10% (roughly) post intermittently – the balance do not directly participate, although there is always contact off the forum or list. So one would expect far fewer posts from AS men but none of the forums I have participated in show anything like a 5% post rate.

You certainly have a point about the lack of side effects which do form the basis of many posts on PCa forums, but they are not the sole reason for a post and there are some issues that could be usefully discussed by AS men.

All the best

Terry Herbert

I have no medical qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr “Snuffy” Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Stan LeakeSent: Tuesday, 2 February 2010 2:47 AMTo: ProstateCancerSupport Subject: Re: Active Surveillance

Terry said...

Watchful Waiting seem very much more reluctant to discuss issues than the men who choose conventional treatment. my basic theory is along the lines that (1) AS/WW men tend to be somewhat non-conformists, perhaps not very good “Group” people, marching by and large to their own tune and (2) because their choice is nt a popular one, they are reluctant to post because they know that they will attract a good deal of mail urging them to stop being in denial and have surgery

May I offer a few more possible reasons for limited participation in AS/WW groups? Here are my thoughts:

(3) These folks don't (yet) have the host of post-treatment/failed-treatment issues that dominate discussions on more general PCa lists. The AS/WW guys are in the mode of getting routine PSAs, DREs, biopsies, CDUs, etc. Maybe there is not as much to question here?

(4) I don't know the numbers, but I suspect that with the push for treatment by the medical profession in most cases, many more men receive treatment than go on AS. Along the lines of numbers, I also suspect that a fair number of men who have treatment do not participate in groups because any SEs from their treatment have been resolved satisfactorily and they go on about their lives. It is likely, however, that numbers of men with questions regarding which treatment to pursue and men with questions regarding post treatment issues far outnumber men with AS questions

Ant thoughts?

Stan

On Sun, Jan 31, 2010 at 8:44 PM, Terry Herbert <ghenesh_49optusnet.au> wrote:

JB

There are two that I know of, atough there are bound to be more:

The older of the two is a list you can join here http://www.prostatepointers.org/mailman/listinfo/ww

The second is part of The New Prostate Cancer site and the relevant page is here http://prostatecancerinfolink.ning.com/group/activesurveillance

There have been others but they closed due to lack of interest. You will find very few posts on either of these forums either. For some reason I have never been able to establish (and I’ve been trying for about 13 years) men who choose Active Surveillance or – or……………………………fill in the treatment the mailer had himself.

I have a site, badly in need of re-construction here www.prostatecancerwatchfulwaiting.co.za

All the best

Terry Herbert

I have no medical qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr “Snuffy” Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of jb indcSent: Monday, 1 February 2010 1:23 PMTo: ProstateCancerSupport Subject: Active Surveillance

Does anyone know of a Yahoo group, or other support group, for active surveillance or "watchful waiting"? JB

No virus found in this incoming message.Checked by AVG - www.avg.com Version: 8.5.432 / Virus Database: 271.1.1/2662 - Release Date: 02/01/10 12:37:00

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Terry,

Your links are very, very interesting and seem to support my own research of

available papers. One thing you did not highlight, at least on the pages that I

perused was the issue of PCA3 as a biomarker of PC.

For some time I have been looking for some informative research papers on its

efficacy, especially as it relates to the " middle ground " where a subject has

biopsy indications of LGPIN and/or HGPIN. My urologists office uses a pass/fail

measure of PCA3 yet when I inquired of the calling technician/nurse what my

actual score was, they were totally befuddled and had to call back the next day

after educating themselves as to the range of the scores. The test is usually

marked as " fail " with a score of 35 or more. Mine happened to be 86.9 where, as

the best I can gather, the probability of finding a biopsy result of cancer is

approximately 35% plus or minus. But no where did anyone connect the prior

biopsies listing of L/HGPIN to the PCA3 score results.

When PCA3 testing is mentioned, it is usually shared that cancer cells cause

PCA3 to be expressed anywhere from 50-200 times that of normal cells. But rarely

does one find a relationship of PIN cells to normal cells until I found one

reference where it appeared through comparing data group results that PIN

expresses PCA3 in approximately 20-40 times normal cells (my estimate derived

from the comparison).

M point in mentioning this is that, if there are others like me, who are getting

periodic biopsies (two so far and probably another soon) and are potentially

suffering the consequences of those biopsies (greater incidence/risk of ED in

particular), any data can be useful in analyzing next steps. At least that would

be true if they can get past the initial PSA (and now PCA3) anxiety or later

" get it out! " with a " minor " /insignificant biopsy result.

I also suspect that, like your site and your message above notes, many do not

take an active interest in assessing their situation until the news seems more

ominous. I would offer that one of the things that folks can do for others under

scrutiny is to encourage them to get involved in their diagnosis very actively

and critically.

Rich L

Green Bay, Wi

>

> JB

>

>

>

> There are two that I know of, atough there are bound to be more:

>

>

>

> The older of the two is a list you can join here

> http://www.prostatepointers.org/mailman/listinfo/ww

>

>

>

> The second is part of The New Prostate Cancer site and the relevant page is

> here http://prostatecancerinfolink.ning.com/group/activesurveillance

>

>

>

> There have been others but they closed due to lack of interest. You will

> find very few posts on either of these forums either. For some reason I have

> never been able to establish (and I've been trying for about 13 years) men

> who choose Active Surveillance or Watchful Waiting seem very much more

> reluctant to discuss issues than the men who choose conventional treatment.

> my basic theory is along the lines that (1) AS/WW men tend to be somewhat

> non-conformists, perhaps not very good " Group " people, marching by and large

> to their own tune and (2) because their choice is nt a popular one, they are

> reluctant to post because they know that they will attract a good deal of

> mail urging them to stop being in denial and have surgery -

> or...........fill in the treatment the mailer had himself.

>

>

>

> I have a site, badly in need of re-construction here

> <http://www.prostatecancerwatchfulwaiting.co.za/>

> www.prostatecancerwatchfulwaiting.co.za

>

>

>

> All the best

>

>

>

> Terry Herbert

>

> I have no medical qualifications but I was diagnosed in '96: and have

> learned a bit since then.

>

> My sites are at www.yananow.net <http://www.yananow.net/> and

> <http://www.prostatecancerwatchfulwaiting.co.za/>

> www.prostatecancerwatchfulwaiting.co.za

>

> Dr " Snuffy " Myers : " As a physician, I am painfully aware that most

> of the decisions we make with regard to prostate cancer are made with

> inadequate data "

>

>

>

> _____

>

> From: ProstateCancerSupport

> [mailto:ProstateCancerSupport ] On Behalf Of jb indc

> Sent: Monday, 1 February 2010 1:23 PM

> To: ProstateCancerSupport

> Subject: Active Surveillance

>

>

>

>

>

> Does anyone know of a Yahoo group, or other support group, for active

> surveillance or " watchful waiting " ? JB

>

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Rich

I have been meaning to write up something

on PCA3 for some time now. I’ll try to do that fairly soon. I believe it

is over-hyped and is no more accurate (and maybe a good deal less accurate)

than a PSA test in practical terms. Ever since it was announced I felt that

since it depends on ‘the vigorous massage’ of the prostate gland to

shake enough material loose and into the urine, there are bound to be

difficulties – just what is ‘vigorous’; glands vary in size,

shape and position,; doctors fingers vary in length and strength. It is one

thing producing results in laboratory conditions and quite another to do the

same thing in the doctor’s office. Published studies have shown some of

the problems.

Jon, who posts here quite regularly, has

had a very scientific approach in setting up his AS protocol which involves the

use of color-Doppler imaging, which is not invasive. If he doesn’t

respond to this mail of yours you can do one of two things (or both) put his

posting name into the Messages Search engine – he posts as ccnvw –

or mail him at ccnvw@... – he’s

always happy to hep a fellow traveler along his chosen path.

In the absence of the color-Doppler

procedure in South Africa

(where I was living) or here in Australia,

my ‘protocol’ excluded biopsy procedures. after discussing the

issues with a doctor in Netherlands,

who shared my views about treatment, he suggested that I keep having PSA tests

at regular intervals, and have a bone scan every second or third year, or act

on the development of symptoms. Most people would not agree with that approach

and I am certainly not recommending it, but it has worked for me and I am

content with my decisions – and the potential result of those decisions,

especially bearing in mind the fact that I was nearly cured four years ago when

I had a heart failure episode!! As someone mentioned here a post or two back,

that’s the only guaranteed cure.

Incidentally, I assume you have read up

the stories of the 30+ men who chose the AS route originally – they’re

indexed at http://www.yananow.net/Experiences.html#as

All the best

Terry Herbert

I have no medical

qualifications but I was diagnosed in ‘96: and have learned a bit since

then.

My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za

Dr

“Snuffy” Myers : " As a physician, I am painfully aware that most of

the decisions we make with regard to prostate cancer are made with inadequate

data "

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Rich

Sent: Tuesday, 2 February 2010

3:07 PM

To:

ProstateCancerSupport

Subject:

Re: Active Surveillance

Terry,

Your links are very, very interesting and seem to support my own research of

available papers. One thing you did not highlight, at least on the pages that I

perused was the issue of PCA3 as a biomarker of PC.

For some time I have been looking for some informative research papers on its

efficacy, especially as it relates to the " middle ground " where a

subject has biopsy indications of LGPIN and/or HGPIN. My urologists office uses

a pass/fail measure of PCA3 yet when I inquired of the calling technician/nurse

what my actual score was, they were totally befuddled and had to call back the

next day after educating themselves as to the range of the scores. The test is

usually marked as " fail " with a score of 35 or more. Mine happened to

be 86.9 where, as the best I can gather, the probability of finding a biopsy

result of cancer is approximately 35% plus or minus. But no where did anyone

connect the prior biopsies listing of L/HGPIN to the PCA3 score results.

When PCA3 testing is mentioned, it is usually shared that cancer cells cause

PCA3 to be expressed anywhere from 50-200 times that of normal cells. But rarely

does one find a relationship of PIN cells to normal cells until I found one

reference where it appeared through comparing data group results that PIN

expresses PCA3 in approximately 20-40 times normal cells (my estimate derived

from the comparison).

M point in mentioning this is that, if there are others like me, who are

getting periodic biopsies (two so far and probably another soon) and are

potentially suffering the consequences of those biopsies (greater

incidence/risk of ED in particular), any data can be useful in analyzing next

steps. At least that would be true if they can get past the initial PSA (and

now PCA3) anxiety or later " get it out! " with a

" minor " /insignificant biopsy result.

I also suspect that, like your site and your message above notes, many do not

take an active interest in assessing their situation until the news seems more

ominous. I would offer that one of the things that folks can do for others

under scrutiny is to encourage them to get involved in their diagnosis very

actively and critically.

Rich L

Green Bay, Wi

>

> JB

>

>

>

> There are two that I know of, atough there are bound to be more:

>

>

>

> The older of the two is a list you can join here

> http://www.prostatepointers.org/mailman/listinfo/ww

>

>

>

> The second is part of The New Prostate Cancer site and the relevant page

is

> here http://prostatecancerinfolink.ning.com/group/activesurveillance

>

>

>

> There have been others but they closed due to lack of interest. You will

> find very few posts on either of these forums either. For some reason I

have

> never been able to establish (and I've been trying for about 13 years) men

> who choose Active Surveillance or Watchful Waiting seem very much more

> reluctant to discuss issues than the men who choose conventional

treatment.

> my basic theory is along the lines that (1) AS/WW men tend to be somewhat

> non-conformists, perhaps not very good " Group " people, marching

by and large

> to their own tune and (2) because their choice is nt a popular one, they

are

> reluctant to post because they know that they will attract a good deal of

> mail urging them to stop being in denial and have surgery -

> or...........fill in the treatment the mailer had himself.

>

>

>

> I have a site, badly in need of re-construction here

> <http://www.prostatecancerwatchfulwaiting.co.za/>

> www.prostatecancerwatchfulwaiting.co.za

>

>

>

> All the best

>

>

>

> Terry Herbert

>

> I have no medical qualifications but I was diagnosed in '96: and have

> learned a bit since then.

>

> My sites are at www.yananow.net <http://www.yananow.net/>

and

> <http://www.prostatecancerwatchfulwaiting.co.za/>

> www.prostatecancerwatchfulwaiting.co.za

>

> Dr " Snuffy " Myers : " As a physician, I am painfully

aware that most

> of the decisions we make with regard to prostate cancer are made with

> inadequate data "

>

>

>

> _____

>

> From: ProstateCancerSupport

> [mailto:ProstateCancerSupport ]

On Behalf Of jb indc

> Sent: Monday, 1 February 2010 1:23 PM

> To: ProstateCancerSupport

> Subject: Active Surveillance

>

>

>

>

>

> Does anyone know of a Yahoo group, or other support group, for active

> surveillance or " watchful waiting " ? JB

>

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