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Dead men don't have sex!

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I summarize good videos because I can search through the printed text at any time I might need it in the future. Words in videos are lost forever.

Today's Dr Snuffy Myers video is very easy to summarize:

Dead men don't have sex!

Quite simply – patients often make poor judgements with regard to risk.

One that he often sees is men with small cancers of Gleason Score 8 to 10 who decline treatment saying that sex is more important. They don't understand that the sex will only last a short time in untreated aggressive prostate cancer.

  • [*:3muznony]A problem some patients have is in assessing relative risk – the risk of one thing compared to another – humans are not good at this.
    [*:3muznony]Sit down and do the numbers – put down the % risk at different time points – 5 years, ten years
    [*:3muznony]Don't use your gut feelings – your gut will deceive you every time.
    [*:3muznony]If you have watched someone die of prostate cancer you will know that the side effects of treatment pale in comparison to the untreated prostate cancer.
    [*:3muznony]On frequent PSA measurement - Picking up recurrent disease early means that there is a lot more that we can do for it than if it has been allowed to become widely metastatic.
    [*:3muznony]CT induced malignancies typically emerge 10-20 years later.

{jm: One thing Dr Snuffy Myers won't see a lot of that we in support groups will see more of is patients who choose "alternative" treatment. A treatment that has been shown to work becomes "medicine". A treatment that has not been shown to work, or has not been shown NOT to work becomes "alternative".

I have seen the pattern many times with ulcerative colitis/Crohn's support groups

  • [*:3muznony]Firstly there is the triumphant declaration that the "alternative" is the ant's pants – with referrals to anecdotes instead of evidence, and sometimes bizarre stories of plots by the "medical establishment" to push away this treatment.
    [*:3muznony]Then come evidence of a relapse – after which there are two different responses:

    • [*:3muznony]The person starts using treatment for which there is real evidence; or, more worryingly
      [*:3muznony]The person blames the relapse on some factor in the environment – they've had the flu, the temperatures have been too high ... and continues with the "alternative". In this case the end is a tragic relapse, and death.

Mostly I heard about this in online newsgroups.

But I was also unfortunate to see this happen at first hand. While I was in hospital having curative treatment (17 years ago now), a young lady was brought in with end stage ulcerative colitis. Called 'toxic megacolon', the large bowel (colon) is so diseased it can no longer move faeces through. The build-up stretches the bowel wall until it bursts – bringing peritonitis and death.

As she lay on her bed continuously releasing the foulest stench from her rotting innards, she was telling me about how wonderful the music-based therapy had been in treating her illness, and wondering why they had flown her to Brisbane for treatment, blaming her relapse on missing the last couple of visits to her "therapist".

She died alone in a few days, seeing only the medical staff, and occasional visits by me.

I knew when they took her away – they switched off the large fan/deodoriser that had been at her door since she arrived.}

Forum: Other prostate cancer topics including radiation Title: Dead men don't have sex!

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