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Comment by Ma8ee | Hacker News Reader

My point is that it isn't population considerations that make physicians reluctant to treat many cases of prostate cancer, but balancing relatively low risks of the cancer being aggressive against quite severe quality of life degradation for the individual patients. I really don't see how my post would be considered hostile.

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The vast majority of radical prostatectomies don’t have incontinence (like 95%), and impotence isn’t common either. Furthermore, they’re usually in older men who are already impotent.

Many years ago incontinence was a side effect but it isn’t common any longer as surgery has gotten better.

The story of how they discovered the nerves they were cutting that causes impotence is kind of crazy, because for years it is basically like nobody even looked into it. Then one day someone decided to and they figured it out pretty quickly. That was in 1982.

I don’t have time to dig out some definitive study, but top google results list incontinence as a “common” side effect.

I’m talking about long-term incontinence which is what people are most concerned about. You probably are reading about short-term incontinence. If you are having a radical prostatectomy done, you probably are hoping to live at least ten more years or even longer, so you’re basically saying you want short-term pain (surgery, pain, incontinence, etc) for long-term peace of mind (no metastases).

1 in 10 is the usual order of magnitude for side effects labelled "common", so this doesn't disagree with the 90% number at all.

Population considerations are what make it low risk. If prostate cancer was most common in 10 year old boys, the risk tradeoffs for a slow cancer would be quite different.

>I really don't see how my post would be considered hostile.

To make a point, you are quite literally asking someone with elevated PSA, whos father died of prostate cancer, if they want to wear a diaper.

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