Years ago I was coming home from work and saw this old-fashioned office chair in the trash of a friend’s house. It was on the curb and placed to be picked up by the garbage folks. I pulled over and looked it over and brought it home. I put it in my den, much to the chagrin of my wife, and positioned it next to the fire-place. I loved to watch American Idol in it and sip on scotch. My wife let me keep it there for about a year and one day “pulled the plug.” I took it out to the lake to the table pictured above and in this chair I wrote the majority of my book. The chair is positioned so in the cabin at the lake that I can throw sticks through the front door, through the porch to the outside yard for Penelope to chase and then bring back to me. If I am lucky the stick will traverse uninterrupted the various portals and then be of such diameter that she will play with a while before bringing it back to me…thereby allowing a bit more time for me to write. The next best option would be for her to bring it back in, but instead of dropping at my feet and barking, just chew on it or about 20 minutes until it is a shredded mess. In this case the clean up is worth the time gained. The later scenario ends with her dropping a small portion of the stick, almost like the size of a cigar, at my feet to then begin the whole process over again.
I told my friend that I was the one who took his chair and he told me a bit of history about it and for this history I will never part with this chair. My friend married the daughter of the first general surgeon of our city. At the time I took the chair this surgeon was in his eighties and was somewhat a local icon. The chair was his office chair for many years and then I guess upon retirement gave it to my friend. He kept it for years and then he and his wife must have felt it’s being old and squeaky out weighed the historical and sentimental value. I am big on sentimental and historical value. In the cabin seen above is a chair from my grandmother’s house in which my grandfather died. My grandmother said , ” I heard Cooper say,’Bess’ and when I went to see what he wanted he was slumped over in the chair by the door in the television room as peaceful as you please and dead.”
See the microphone….you guessed it Podcasts. I enjoy doing those, over 800 listens on Podbean, however I don’t know what real benefit it ads to those wishing to learn more about prostate cancer. I think I’ll start doing mini-chapters from portions of my book that I think someone might find interesting. Consider listening to “Waiting on the biopsy” and see if you can relate if you have been through it or empathize with a loved one who has been through the process.
The last line of this article is excellent and a point that needs to be understood (the ramifications of) by all men facing the difficult decision of what to do with their newly diagnosed prosate cancer.
Active surveillance versus radical treatment for favorable-risk localized prostate cancer.
Sunnybrook Health Sciences Center, University of Toronto, 2975 Bayview Avenue, #MG408, Toronto, Ontario M4N 3M5, Canada. firstname.lastname@example.org
Widespread prostate-specific antigen (PSA) screening in North America has resulted in a profound stage migration and a marked increase in incidence. One in six men is now diagnosed, many with small-volume, low-grade cancer. This incidence is dramatically higher than the 3% lifetime risk of prostate cancer death that characterized the pre-screening era. This article summarizes the case for active surveillance for “favorable-risk” prostate cancer with selective delayed intervention for rapid biochemical progression, assessed by increasing PSA levels, or grade progression. The results of a large phase II trial using this approach are reviewed. To date, this study has shown that virtually all men with favorable-risk prostate cancer managed in this fashion will die of unrelated causes. Based on the Swedish randomized trial of radical prostatectomy versus watchful waiting, the Connecticut observation series, and the Toronto active surveillance experience, a number needed to treat analysis of the benefit of radical treatment of all newly diagnosed favorable-risk prostate cancer patients, compared with a strategy of active surveillance with selective delayed intervention, is presented. This suggests that approximately 73 patients will require radical treatment for each prostate cancer death averted. This translates into a 3- to 4-week survival benefit, unadjusted for quality of life. This figure is confirmed based on an analysis of the 2004 D’Amico et al. PSA velocity data in favorable-risk disease. The approach of active surveillance with selective delayed intervention based on PSA doubling time and repeat biopsy represents a practical compromise between radical therapy for all patients (which results in overtreatment for patients with indolent disease) and watchful waiting with palliative therapy only (which results in undertreatment for those with aggressive disease).