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Define "Cure"

Posted: Mon Oct 20, 2003 7:02 am
by MastCells
Mark and I recently had an interesting discussion about the word "cure." Should this problematic word be used to describe treatment successes of CPPS/PM patients who are completely free of symptoms? If so, when should one consider himself cured? After 2 weeks? 6 months? 1 year? 5 years? Remember, chronic prostatitis / chronic pelvic pain syndrome is a condition that tends to wax and wane. There are even cases (archived by Google) in which patients were completely asymptomatic for months or sometimes years, only to have their symptoms return.

What about people who have beaten this thing down to a point where their symptoms are negligible, yet they still experience minor discomfort once in a while? Are they "cured?"

The word "cure" has a long, ugly history in the newsgroup SMPP. (It was used by the Felicianos before they were exposed.) It is a word that is appropriate for infections. If a person has an active bacterial infection, he takes a course of antibiotics, and is usually cured. But since we now know that chronic prostatitis / chronic pelvic pain syndrome is not an active infection, but something much more complex, is "cure" a word we should avoid?

Any comments are welcome.

Posted: Mon Oct 20, 2003 1:39 pm
by webslave
Let's assume that this is a neuromuscular condition, in the main. Can one be cured of such a thing? I believe in this context that a cure represents the controlling of the condition to such an extent that it no longer interferes in daily life.

There are many conditions that are never fully cured, but may be successfully controlled or treated. I use migraine as an example again: people are prone to migraine by a mixture of their genes, their psychological natures and their susceptibility to environmental triggers.

Can one be cured of migraine? No.
Can you find strategies to avoid migraine? Yes.
Can you find medications that abort migraine? Yes.

Comments?

Posted: Mon Oct 20, 2003 5:16 pm
by Richard.N
a cure represents the controlling of the condition to such an extent that it no longer interferes in daily life
This would make sense if we wanted to put a positive spin on things. Being able to manage the condition to the extent of normal life is a reasonable aim. From a psychological point of view I guess it would be rewarding to say, "I am cured". Positive people tend to shrug off chronicity faster than negative people - if indeed they fall into the rut at all.

But it's a bit like moving the goal posts. Should we settle for semantics?

Posted: Mon Oct 20, 2003 6:21 pm
by faceinthecrowd
My opinion would be that the word "cure" should not be used. Cure implies that the disease is gone permanently - that no more medication needs to be taken, that nothing has to be done at all to combat the disease. I have been on Flomax for over a year and there is no hope of me getting off of it any time soon, same with Elmiron. "Cure" would be if I could go back exactly to how I was before, with no instances of frequency, retention, or pain. I am still relatively new to chronic prostatitis / chronic pelvic pain syndrome but it seems to me that even men who are doing really well still have to manage their symptoms, and they still have flareups and discomfort from time to time. I'd say right now the best a man can hope for is to get his symptoms under control to a point where they don't drastically interfere with his life - this is good, but not the same thing as being cured.

Posted: Mon Oct 20, 2003 10:52 pm
by Mike
Definition of Cure:
(from Cambridge Dictionary of American English)
http://dictionary.cambridge.org/results ... &image.y=7


Some comments:

What about a pre genetic susceptibility to CPP then you can never be cured without genetic technology ever totally even without on set of symptoms as there is a problem in you.

This disease seems all about control to me, I guess even our best docs work best on control than cures.

I have had no symptoms today but a few days ago it was certainly there, where does a cure by definition fit into a stop start up and down disease like this.

Cure of symptoms temporally but not the disease might be plausible to the men with no symptoms currently...they win the battle but the war goes on.

Posted: Mon Oct 20, 2003 11:37 pm
by webslave
In my own case, I can go months and months without noticing any discomfort in my pelvic area. Am I cured? Most of the time, yes.

Posted: Tue Oct 21, 2003 11:41 am
by alprost
webslave wrote:Just thought I'd interject that David Wise maintains that he is cured and never has any symptoms.
I know Dr Wise talks of being 'Symptom free' - Maybe that might be a good phrase to adopt.

Posted: Tue Oct 21, 2003 1:09 pm
by scotsman
That feels right to me.

Posted: Wed Oct 22, 2003 2:43 am
by MS
To me, being "cured" would be driving in a convertible in Florida on a sunny day near the beech, pulling over at a rest-stop, taking a piss, buying some bottled water, laying out in the sun, swimming, and going back to a hotel with my girlfriend, and having sex.

Then looking back at the day and realizing that I did all those wonderful things, without thinking about or feeling pain, urgency, hesitancy, or spasms.

Just taking a vacation and having a normal person's day. I will do this someday!

Posted: Wed Oct 22, 2003 10:14 am
by Richard.N
To me, being "cured" would be driving in a convertible in Florida on a sunny day near the beech, pulling over at a rest-stop, taking a piss, buying some bottled water, laying out in the sun, swimming, and going back to a hotel with my girlfriend, and having sex.
I'd have to add some booze in there somewhere, but that's what I call 'cured' :-D

Posted: Sat Oct 25, 2003 9:08 pm
by tractor316
I'm with MS , being cured would be doing all the things I used to do . Now I'm pain free most days but one mistake of not staying on top of CP and it comes back . Not as bad as it used to but still there . Being in control of my CP is a good thing , but cured would be never having to think about it again .