MangoKorat

There was no significant difference in the risk of dying, or dying of prostate cancer, between the three treatment options. Three‑quarters of the men in the active-monitoring group experienced growth or spread of the cancer and needed subsequent treatment, but a quarter of the men were alive without having received any form of treatment. Reginald Hall Retired urologist, Newcastle upon Tyne As someone who's had Prostate Cancer (PC) for 10 years and who's illness is in currently in remission but not necessarliy cured, I am shocked at the attitude of a 'Professional' towards this disease. He should know very well that you can't lump men who have low grade PC together with those who have a more aggressive type. Although its the same basic disease in terms of outcomes, there is a vast difference. Most people who have low grade PC are simply monitored as the disease often does not get worse or spread. The reason for the monitoring is just to confirm that. What is it they say? You die with it, not of it. However, aggressive PC spreads and must be treated if the subject is to have a chance of survival. Once PC spreads to other parts of the body, there is no curative treatment, it can only be slowed down. 'However, men should think very carefully and consider the evidence before asking their GP for a PSA test.' If my GP hadn't sent me for a PSA test, I wouldn't be here now. I went to see my GP on a totally different matter. It was only when I mentioned a few symptoms I was experiencing, one that isn't usually associated with PC, that my GP said "I think we'd better do a blood test. She didn't even mention PC but PSA was, as it turned out, one of the tests she'd requested. Two days later I received a phone call asking me to visit the surgery immediately. The results were a PSA of 189, my GP said she suspected PC and was requesting an urgent appointment with the Urologist at my local hospital. A subsequent biospy confimed PC and the resultant scans identified tumours occupying 60% of one lobe of my prostate and 100% of the other. I was given a choice of removal or radio therapy and told the 10 year outcomes were about the same - I opted for radio therapy. I asked the Oncologist to be brutally honest about my chances (as everyone was referring to my PSA count being massively high) and she told me I was only just within the criteria for curative treatment and she thought there was a 70% chance the disease would return as it was a highly aggressive form. The tumours had broken through the capsule of my prostate but there was no evidence of it anywhere else. At that time I was told that I was having the maximum dose of radio therapy and if it wasn't successful, any subsequent treatment would only be to slow the spread of disease down. Fortunately I responded to the radio therapy (+ hormone therapy) better than anyone expected. My PSA began to rise again 5 or 6 years later and the oncologist I saw then said he thought it was more likely that we hadn't quite 'got' the disease the first time around than it had returned. Things had moved on in treatment pathways during those 5 or 6 years and my response had been good. I had a PET scan to map out exactly where the cancer was active and it was still within my prostate. I could not have further beam radio therapy but I could have a more targeted version in the form of HDR Brachytherapy, better still should that not be succesful, other treatement options were now open to me. The HDR Brachytherapy was given in 2 sessions, 1 month apart and to date, my PSA has settled to a constant 0.70. Had I not mentioned my (few) symptoms to my GP or if she was one of those that is opposed to too much PSA testing, I would not be writing this post, I'd have been 6ft under a long time ago. The suggestion that: 'men should think very carefully and consider the evidence before asking their GP for a PSA test.' is ridiculous. Are we doctors? There is only one way to identify the likelihood that PC is the cause of any symptoms you may have and that begins with a PSA test. There is no other way. The old reasoning of false positives and the risk of infection though a biopsy is long gone. In many countries the next step after a high PSA reading is a newer form of MRI scan which, I believe can identify the presence of potential tumours and help urologists make a decision on a biopsy. I met my original oncologist in the hospital coffee bar recently when I was at the hosipital on a different matter and I asked he what she thought would hatve happened if I my PC had not been diagnosed when it was. She told me that it was very hard to say but she suspected that if I had not been diagnosed until 3 months later than I was, I would not have fitted the criteria for curative treatment......."and remember, yours was highly aggressive". I don't think there is a chance in hell that I would still be here now. I don't care what this man says, there is no other way to identify the possibility of PC and I tell everyone I know to get tested every year once they reach 50. You don't always have the usual symptoms, some people that have been diagnosed with PC had no symptoms at all. I apologise for the length of my ramblings but the debate of whether to test or not really stirs me up. Perhaps by reading what happened to me, men reading this will be convinced that regular testing is an absolute must.

Agreed, but let's say that all the unfortunate events did actually happen, the bits that might well be missing/short on detail are the reasons why they happened and his subsequent reactions. From what I've seen of the Thai police, they usually handle people fairly reasonably if they are compliant, the strongarm stuff takes place if someone kicks off. Things can turn very nasty from thereon in.

My thoughts exactly. If I'd encountered even a fraction of what this man claims to have, the first thing I would have done is contact a lawyer.

I'd suggest CABLE.......a hose is something fluids run through. 😁

You missed off........and sod everyone else.

Yes and a much higher percentage have absolutely no idea who has the right of way at roundabouts for example. They don't improve, even when you explain it to them yet. In the UK and Europe, roundabouts are not seen as a problem - its not difficult.

No, what people need to do is ignore this ridiculous wind up.

Yes, the skim reading was clear.

Yes, they clearly need to be shown - scientifically, why they shouldn't be doing those things. You can't just claim that its stupid or dangerous to behave in those ways though, you need to back that up with scientifically based evidence 😁 I note the guys on the truck are wearing their 'safety flip flops' and that at least the parents on the motorbike have helmets on so the children don't have to worry about them being killed in an accident.

Yes, politeness like refusing to stop at pedestrian crossings.....which conveniently takes me to a story about Enforcement. I apologise if this evidence appears weak and not obtained through any scientific survey. Its just what I've witnessed for that last 22 years. I suggest you go to Sukhumvit in Bangkok, more specifically to the crossroads with Soi's 3 and 4. That junction is traffic light controlled - sometimes automatically, sometimes by a policeman who sits in the box on the Soi 4 side of Sukhumvit Road. Not only is the junction controlled by traffic lights, a lighted pedestrian crossing is included in order that people, mainly tourists can get across the busy road, safely (in theory). The police box has a clear view of the lights on that pedestrian crossing yet cars go though the lights at red all the time - the green man is on clear view to the police officer who does precisely nothing about it, day in, day out. A tourist couple were killed there a few years ago yet the drivers still go through the lights at red every day whilst the policeman sits there looking at the green man being shown to pedestrians. Enforcement? Pfft. How much science does it take, exactly, for the police to take action and punish every driver that goes through those lights when the green man is showing? How does the officer in the police box keep his job when people have died? What would your science do about that?

Strange, I thought I had concentrated of that. Silly me.

Careful, you'll be accused of being unscientific. I agree though, lack of enforcement is the root cause of it all.

Its quite clear where you've either spent or spend your time in Thailand - 'usually drunk' - ha ha, I can't remember seeing any of my mates in Thailand drunk. 3 of us ride motorbikes, we all hold Thai licences. I'll admit to not being a spring chicken but I am not slow, I don't have poor vison and my reflexes are very fast - the Thai driving examiners couldn't believe it. Show me a Thai traffic sign and in most cases I'll tell you what it means. A country that accepts international drivers and their licences is supposed to provide both national and English versions of its signage. Whilst many of the things you mention, do go on, I'd suggest they apply mainly to tourists, not residents.

According to the news tonight, Armitage was arrested when he arrived back in the UK. No charges were mentioned just that he is being held for questioning on suspicion of murder. No mention of new evidence. The lack of an extradition request suggests that there is no new strong evidence. The normal time that he can be held for, without charge is 24 hours but in serious cases such as this the police may be granted extra time by a judge - up to 96 hours. Given his record so far, I suspect he'll 'no comment' all questions so if there is no new evidence that's enough to convince the CPS to agree to charge, he could be out again tomorrow. I wonder if he took any legal advice about the revocation of his residency?

A final thought on 'stupidity' how rational do you think someone who rides a motorcycle along a country road at night without any lights is? If you talk to many Thai people, they will agree about the stupidity, the risk taking and the lack of enforcement. They may well have lost a relative to one of those reasons. I have Thai friends, they talk about these things in the very same that we do. They are not all stupid, or selfish and I didn't say they were - it doesn't take many to cause the carnage that goes on almost every day.

Using the example I gave of stupidity. Do you seriously believe that any of the factors you have listed is at play? How much education does someone need to know that you can't just stop in the r/h lane of a fast moving 4 lane system, indicate and cut across 3 other lanes to go to a market stall. You cannot be serious. This is a wind up. Rubbish!!!

I have never said they are all stupid but the ones that cause accidents often are. That's very easy to answer, no science necessary. It can't be effective if it doesn't happen. 1 tiny example - why are schoolkids allowed to ride 3 up with no helmets on right in front of a policeman? Ever been stopped in Thailand and asked to produce your licence? Don't worry, even though the law says you are supposed to carry it with you, if you don't have it or as is the case with a good many Thai's (factual), you don't actually hold a licence, simply pay the 200 baht fine (in cash of course) and carry on your way - no need to produce it later. Lack of consequences is the same as lack of enforcement. They have the rules, they have the punishments - they just don't enforce or apply them. Quite often the 'consquences' are a far lesser punishment that somehow doesn't reach where its intended to - that's as far as I'll go on that one, other than to say that there are often checkpoints, targeting motorcyclists who are not wearing helmets. The 'fine' is often just 50 baht and they are allowed to ride off without a helmet. What I do understand is that despite all your training, you appear to have about zero undertstanding of Thailand, its people and laws. Not sure if you live in Thailand or not but you certainly have no idea what goes on, on the roads, with the police, or many Thai drivers. If you think a scientific approach will cure Thailand's road carnage - good luck to you. To a certain extent they are different people - I have never known a UK motorcyclist pull out of a side road without looking, for example. As I said, it goes against basic survival instincts - I don't know anybody, apart from maybe a 5 year old who needs training to know that there are cars coming and you are very likely to hit one. I see no point in discussing this further with someone who can't think beyond the science. Very few things fit well with science in this matter. I've given you examples, not science, things I've seen happen that despite driving 50k miles per year, I have never seen in the UK and you choose to ignore them or try to make them fit with your 'model'. You are almost completely wrong on all points.

Not being rude in any way but you apply far too much science and complicate matters unnecessarily. In my, and I'd guess, a lot of other people's opinions, based on their posts here and on other previous threads, there are only 3 major factors that cause the majority of road accidents in Thailand. These factors are not arrived at scientifically, they are the result of real world observations made by people who have driven in Thailand for many years and they are: 1. An almost total lack of enforcement. 2. The unbelievable stupidity and risk taking of Thai drivers. 3. Selfishness. Enforcement? There is very little, I'm not going to write volumes, most of us here are very aware of that fact. Stupidity, risk taking and selfishness? I'll give 3 of the worst examples I've seen: A). Supidity. Several years ago I was heading towards Bangkok on Highway 2, somewhere around Muak Lek. The road there varies between 3 and 4 lanes I believe and the traffic is fairly fast moving. There are fruit stalls at the side of the road (asking for trouble). I was in the outside (r/h) lane doing around 110kmh I'd guess and I'd describe the traffic as medium. The Toyota Fortuner in front of me suddenly decided he needed some fruit, screeched to a halt (how I managed to stop I know not) then indicated left and crossed the other lanes to the fruit stalls - causing the traffic in those lanes to also brake sharply. Some cars slewed across at an angle but miraculously, nobody hit him. B). Risk Taking. One of the roads leading from Buriram, onto the 24 and onwards to Highway 2 for Bangkok is the 218. Its a normal 2 lane (1 in each direction) road that in the UK would be classed as an A road. It can be quite busy, the traffic generally drives fairly fast and there are few major bends. I've seen several near misses on the 218 over the years, usually the result of frustration when following a slow moving truck and overtaking when its not safe to do so. On this occasion I was approaching a left hand bend, not major but sweeping enough that if you are more than 100m from it, you cannot see around it. The road is also lines with trees and bushes that also add to the lack of visibility around the bend. Just beyond the bend there is a r/h turn. I'd guess there were maybe 8 - 10 cars in front of me when brake lights came on and the traffic stopped. It wasn't possible to see around the bend (in any way) to know the reason for the stop. I queued for a few seconds - maybe 20 and a small queue built up behind me. Looking in my mirror I saw a pick up truck approaching at speed, overtaing the queue behind me. He continued on, past me and round the bend followed by a loud bang/crunch. When the traffic started moving again it became clear what had happened - a car had been waiting for oncoming traffic to clear before turning right - all perfectly normal. Until that is, this idiot, who in no way could see the cause for the queue, came speeding around the corner passing the queue. The right turning car had just started to make the turn when he was hit in the driver's door by that moron. (Note: the 218 may well be a dual carriageway now) 3). Another regular act of stupidity is on the expressways in Bangkok. On any day of the week, as you approach an exit you will get people coming down the left hand margin - in effect undertaking you. If you are leaving at the exit and are in the real l/h lane you're going to be in big trouble if you make that exit without checking your l/h mirror. I don't know what the Highway code says about using your l/h mirror when you are exiting a motorway in the UK (which many expressways are the equivalent of) but until I first drove in Thailand, I don't think that was something I'd ever done. Since driving in Thailand its something I do all the time. Nothing scientific is needed to analyse any of that - simple enforcement and the change of mindset that accompanies being heavily fined or losing your licence would deal with the majority of the above examples, given time. However, there will still be things that you can't change so easily - I cite the thing you'll see many times per trip in built-up areas - motorcyclists pulling out of side roads on your left without even moving their head and therefore, not checking their right. Not sure even proper training would fix that - I'm a biker and my basic survival instincts just wouldn't let me do that. Its as if they have a bracket between their head and the handlebars locking the 2 together and holding their head straight forward. As other people have said, you will see things on Thai roads that you just don't see elsewhere. Until recently I was driving 50,000 miles per year in the UK and I've never seen anyone do such stupid things - ever!

Doing something about road safety and law enforcement instead of talking about it is key to this. Its not so far from Songkran and the carnage that ensues. We will shorlty be bombarded with the annual 'talk' about what the Thai authorities intend doing to reduce the huge amount of road deaths and injuries that happen every year at both Songkran and New Year. Politicians will be spouting off on TV and in the media - as they do every year. Thai politicians and authorities simply talk a lot and do nothing - they are famous for it but this matter has real consequences. Last year there were 480 deaths recorded on Thai roads during Songkran - yet in my 22 years of involvement with Thailand, nothing has been done. Year in year out, the carnage continues.

There are no doubt, many issues that need attention but if the existing rules were enforced and proper punishments issued, it would make a massive difference. Even the decision makers are guilty. Where the road from my home meets the main road leading from Highway 2 to Khao Yai there used to be a set of traffic lights. There were many accidents there - 99% of which were caused by people on the main road running red lights, sometimes long after they had changed. I believe one year there was a total of 5 deaths there. The local authority's answer - take out the lights and put in 2 U-turns. We all know that U-turns are also very unsafe and there have already been several accidents at the U-turns. I find it ridiculous that they can't (maybe won't) make Thai drivers stop running red lights. I regularly see people in the UK run red or amber lights but not 10 seconds afterwards. They have laws, they have a police force (rarely seen after 5pm), I really can't understand the problem. I repeat - enforcement would make a massive difference.

Who knows? I will be visiting a shipping agent in Bangkok soon, I will ask them to call their customs contact and try to find out.

There is no need for long explanations of what makes Thailand's roads so dangerous. The country does have quite stringent rules about driving standards. 5 words are all that's needed to identify the biggest danger by far - a complete lack of enforcement.

I think I can see why.

I'm sure that his son and partner back in the UK would feel much better if they read your 'optimistic' posts - especially the ones that suggest he's indulging in the P4P side of Bangkok. Well done, you should be proud.

Do you have any idea how stupid you appear - making such arrogant statements? Probably as poor as a church mouse.