No one says emotional distress is unique to ASl et alone even to prostate cancer.
Maybe you're a new reader?
This newsletter and several support organizations, including AnCan and ASPI, have been trying to get leading organizations such as the American Urological Association to take anxiety and emotional distress issues seriously,
The American Society for Clinical Oncology, the American Cancer Society, the American College of Surgeons and the National Comprehensive Cancer Network all urge that ALL patients with cancer be screened for emotional distress. The AUA and ASTRO do not make this recommendation.
The focus here is on Active Surveillance, long the Rodney Dangerfield of cancers. We're not in a pissing match with other prostate cancer patients over who has it worse.
The issues are similar but different for the spectrum of patients. The issues are different for individual patients. There are many patients with low-risk prostate cancer who easily could go on AS but instead decide they MUST have surgery and take on the lifestyle risks.
That's their call and that of their doctors--some doctors won't operate on these men because they consider it unethgical to perform surgery on healthy patients.
A leading Italian psychologist says, "Prostatectomies don't cure anxiety."
Anxiety is not specific to patients on AS. Patients who have been curatively treated (RT or RP) are subject to even more intensive surveillance after their treatments, usually PSA tests every three months for two years, thereafter every six months.
This is just as anxiety inducing, if not more so, than AS, since the probability of recurrence is probably higher than progression for GG1.
RP patients will often have PSA rises that lead to salvage radiation therapy. RT patients will often have PSA rebounds before PSA levels finally decline and stabilize. All these possibilities are more anxiety inducing than routine AS and more common than progression from GG1.
So the argument against AS that treatment is anxiety reducing is nonesense. Treatment may cure but still not reduce anxiety, while also creating significant side effects.
If the AUA says there is insufficient data to warrant writing guidelines that factor can be easily resolved. As I have suggested many times, urologist should offer the self administered evidenced based best practices test for anxiety and depression at the patient entry point and at milestone events thereafter. Use the PHQ-9 and the GAD -7.
Phemepark.
No one says emotional distress is unique to ASl et alone even to prostate cancer.
Maybe you're a new reader?
This newsletter and several support organizations, including AnCan and ASPI, have been trying to get leading organizations such as the American Urological Association to take anxiety and emotional distress issues seriously,
The American Society for Clinical Oncology, the American Cancer Society, the American College of Surgeons and the National Comprehensive Cancer Network all urge that ALL patients with cancer be screened for emotional distress. The AUA and ASTRO do not make this recommendation.
Here's some background: https://open.substack.com/pub/howardwolinsky/p/deep-prostate-spills-the-beans-on?r=4ah4&utm_campaign=post&utm_medium=web
The focus here is on Active Surveillance, long the Rodney Dangerfield of cancers. We're not in a pissing match with other prostate cancer patients over who has it worse.
The issues are similar but different for the spectrum of patients. The issues are different for individual patients. There are many patients with low-risk prostate cancer who easily could go on AS but instead decide they MUST have surgery and take on the lifestyle risks.
That's their call and that of their doctors--some doctors won't operate on these men because they consider it unethgical to perform surgery on healthy patients.
A leading Italian psychologist says, "Prostatectomies don't cure anxiety."
HW
Anxiety is not specific to patients on AS. Patients who have been curatively treated (RT or RP) are subject to even more intensive surveillance after their treatments, usually PSA tests every three months for two years, thereafter every six months.
This is just as anxiety inducing, if not more so, than AS, since the probability of recurrence is probably higher than progression for GG1.
RP patients will often have PSA rises that lead to salvage radiation therapy. RT patients will often have PSA rebounds before PSA levels finally decline and stabilize. All these possibilities are more anxiety inducing than routine AS and more common than progression from GG1.
So the argument against AS that treatment is anxiety reducing is nonesense. Treatment may cure but still not reduce anxiety, while also creating significant side effects.
Thanks, Richard.
Though the comments were very interesting. from the AUA person.
Howard
If the AUA says there is insufficient data to warrant writing guidelines that factor can be easily resolved. As I have suggested many times, urologist should offer the self administered evidenced based best practices test for anxiety and depression at the patient entry point and at milestone events thereafter. Use the PHQ-9 and the GAD -7.