When a treatment is offered with a "40 percent chance of lowering your PSA," it also has a 60 percent chance of not lowering your PSA. The side effects of the treatment may be significant. Take into consideration the chance of failure as well as the chance of success when deciding whether to undergo the treatment. The side ef fects will probably be the same whether the treatment succeeds or fails.
This question of quality of life is important. Some people feel that three months of debilitating side effects are too much when they have a year to live; they'd rather live a shorter, more comfortable life. For others, it is more important to take advantage of any opportunity to prolong life.
The cancer is "hormone-independent" when your PSA rises even though you are taking hormone-suppressing drugs. When this happens it is harder to slow the spread of the cancer because some cancer cells can now grow without testosterone. You will probably continue hormone treatment, however, because not all cancer cells become hormone-independent. The growth of some cells is still stopped by the hormone-ablation treatment. In
other words, the spread of the cancer can still be slowed somewhat. Stopping all hormone treatment may cause increased bone pain and more rapid spread of the disease.
Get a second opinion. Try to get a consultation with a doctor outside your normal health plan or medical group, to be sure that medical care, not HMO rules, are dictating responses. A consulting doctor will have different experiences and possibly new information. Even if the second doctor confirms your physician's recommendation, you will have more confidence in the information upon which you base critical decisions.
Get a third or fourth opinion if the first doctors don't answer your questions or honor your right to take charge of your care.
Any doctor's estimate of your life expectancy is an educated guess, not a certainty. You may live longer or die sooner than the doctor's estimate, depending on the choices you make, your body's response to treatment, and the aggressiveness of the cancer. If there is something that you really want to do, do it now. Don't sit back and wait to die. Keep living and planning.