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The cost I am talking about is human as well as financial.
Those who feel the PSA has helped them, with no complications, may not care about the hospital admissions, and even mortality rates for prostate biopsies.
pdf file: Increasing Hospital Admission Rates for Urological Complications After Transrectal Ultrasound Guided Prostate Biopsy (http://download.journals.elsevierhealth.com/pdfs/journals/0022-5347/PIIS0022534709029322.pdf - broken link)
Exactly.
"First, Do No Harm" comes to mind.
Of course.
Everyone should take charge of their health.
In terms of prostate cancer, the tricky part is:
1) Making sure you actually *are* the 1 in 10,000
2) Making sure your treatment is appropriate.
First: You said in your previous post you were done.
Quote:
I am beginning to repeat myself here, so will probably just bow out of this thread.
Second: Mortality by biopsy... Seems your grasping there.
Third: You mention do no harm. Yet you advocate withholding a test. When in reality the test is non invasive and withholding that test potentially delays diagnosis and treatment. With that application of test you are, in fact, doing harm by withholding a PSA test.
As it presently stands it is best test at the moment. And most reasonable agree that all cancer is bad and evil.
At What Cost?
Because of the limitations of the test, routine mass screenings just don't make sense to me. However, education about protest cancer does.
I am beginning to repeat myself here, so will probably just bow out of this thread.
Quote:
Originally Posted by SD4020
First: You said in your previous post you were done.
Second: Mortality by biopsy... Seems your grasping there.
First: This is my last attempt to get through to you. Without a doubt we will have to agree to disagree, but I would like to at least know that you understand my point.
Second:
Grasping?
Have you looked at any of the information that I and others have posted here?
Example: This information was presented at a urologists' convention. Most (not all) men have a PSA test before a biopsy.
Quote:
Third: You mention do no harm. Yet you advocate withholding a test. When in reality the test is non invasive and withholding that test potentially delays diagnosis and treatment. With that application of test you are, in fact, doing harm by withholding a PSA test.
What I said was that I was interested in opinions and experiences in light of recent opposition (by medical professionals) to routine PSA testing.
I heard from several people who had varying opinions and experiences.
Never have I said that PSA testing cannot save lives. I think we all can agree that it would be nice to have a more specific test.
The post that probably makes the most sense in this entire thread is #12.
There are simply more questions than answers. Educating ourselves as best we can will help us make *informed* decisions.
Quote:
As it presently stands it is best test at the moment. And most reasonable agree that all cancer is bad and evil.
All cancer may be bad and evil, but it is scientific research, not hyperbole, that can save lives.
I wish everyone who has participated in this thread all the best.
First: This is my last attempt to get through to you. Without a doubt we will have to agree to disagree, but I would like to at least know that you understand my point.
Second:
Grasping?
Have you looked at any of the information that I and others have posted here?
Example: This information was presented at a urologists' convention. Most (not all) men have a PSA test before a biopsy.
What I said was that I was interested in opinions and experiences in light of recent opposition (by medical professionals) to routine PSA testing.
I heard from several people who had varying opinions and experiences.
Never have I said that PSA testing cannot save lives. I think we all can agree that it would be nice to have a more specific test.
The post that probably makes the most sense in this entire thread is #12.
There are simply more questions than answers. Educating ourselves as best we can will help us make *informed* decisions.
All cancer may be bad and evil, but it is scientific research, not hyperbole, that can save lives.
I wish everyone who has participated in this thread all the best.
last attempt? Promise?
I have made my point several times, and others who have survived cancer agree. There are others here who testify that it works, you dismiss it as anecdotal evidence. While science plays a major part in medicine, and science is very important. it is, however, not the end all in healing. So what you call anecdotal evidence, thinking people call it a success.
The thing with science and you seemingly miss the point several times, this is best bet for early detection and there is a need to find better ways. You put the fingers in your ears and go "la la la la" I'm not listening.
Again, I will try to simplify it. A PSA isn't the sole test for diagnosis of prostate cancer. If that test indicated something amiss, a doctor will order more tests to make a final diagnosis. It is a tool, A simple blood test tell if more tests are needed. Gee if that test gets the jump on diagnosis that seems be a good thing. You tout "do no harm" yet you think this test is bad and evil.
Thanks Starlite, Annie, and Charley. I'm fine. Really. I saw my oncologist, I crack him up, he thinks I'm great. He even told me I'm a real trooper and he apprechiates that. I told him I apprechiate everything he does. He's a great doctor. We have not been able to stop the progression of my cancer yet. I had more scans today and I'll find out tomorrow what my new chemo will be. It's just what I have to do to stay alive as long as possible. Because only the good die young I'm sure I'll live for many more years!
As far as cancer testing goes, well, it's not mandatory. If you don't believe in them Blue Willow then don't have them. There are no certanties in medicine. You may or may not be that one in a thousand. The only way to know is to tes all one thousand. You can't test just the high risk because of people like me that had no risk factors.
Thanks Starlite, Annie, and Charley. I'm fine. Really. I saw my oncologist, I crack him up, he thinks I'm great. He even told me I'm a real trooper and he apprechiates that. I told him I apprechiate everything he does. He's a great doctor. We have not been able to stop the progression of my cancer yet. I had more scans today and I'll find out tomorrow what my new chemo will be. It's just what I have to do to stay alive as long as possible. Because only the good die young I'm sure I'll live for many more years!
As far as cancer testing goes, well, it's not mandatory. If you don't believe in them Blue Willow then don't have them. There are no certanties in medicine. You may or may not be that one in a thousand. The only way to know is to tes all one thousand. You can't test just the high risk because of people like me that had no risk factors.
Thanks! Glad you are in good spirits about all of this!. I think there is something positive to the healing process when you are optimistic about what is going on!
Thanks Starlite, Annie, and Charley. I'm fine. Really. I saw my oncologist, I crack him up, he thinks I'm great. He even told me I'm a real trooper and he apprechiates that. I told him I apprechiate everything he does. He's a great doctor. We have not been able to stop the progression of my cancer yet. I had more scans today and I'll find out tomorrow what my new chemo will be. It's just what I have to do to stay alive as long as possible. Because only the good die young I'm sure I'll live for many more years!
Since my diagnosis, my mantra has been "Attitude is Everything". I think you've got the right attitude. Hang in there and never surrender!
As exampled in this thread there are several success stories of how the PSA led to detection that otherwise would have gone unnoticed. I will repeat what I wrote in the other thread.
The PSA test are effective and at the moment the best test for early detection of prostate cancer. It is a non-invasive test for cancer. The test, like anything else, is not 100% there false positives and false negatives. As it stands it is the bests detector of prostate cancer we have right now. So testing those at risk males over 40 is prudent and wise. Albeit there needs to be a newer better test developed. The effectiveness of the present test has been proven. To delay or cut back a simple blood test is asinine.
Actually prostate cancer can be an invasive cancer - it can have perineural invasion which means that type cancer likes to use the nerves as a pathway out to the lymph nodes and bones. Not every man will have the invasive type but some will.
I am glad things worked out for you personally. The thing is, it simply does not work that way for everyone.
And treatment can be problematic.
I know a woman whose husband almost died from his biopsy.
His Gleason was 6. The risk of infection had definitely been down-played.
To me, *that* is asinine.
Starlite, I am a preschool teacher with a 59 year old husband.
Thank you, Charley.
It is definitely the best detector that now exists. And of course there is anecdotal evidence of success stories, and I am truly happy about that.
But at what cost?
The problem is that the PSA can't distinguish benign conditions, or between fast or slow growth cancer.
A simple blood test can lead to over-diagnosis.
What it comes down to is a chance of undergoing debilitating treatment possibly leaving a man unable to control his bladder and/or with little sexual function, or a 3% chance of dying of prostate cancer.
As exampled in this thread, the inventor of the PSA says the testing does have a post-treatment place, but deplores what has been done with it.
Between 1993 and 2001, 76,000 men (two groups, screened, and unscreened) were followed in this study.
The researchers determined that:
After 7 to 10 years of follow-up, the rate of death from prostate cancer was very low and did not differ significantly between the two study groups.
A European study of 182,000 men did show some benefit for PSA testing, but also showed that that 1410 men would need to be screened and 48 additional cases of prostate cancer would need to be treated to prevent one death from prostate cancer.
The vast majority of those who get infections from biopsy have either gone to a substandard provider or have not followed instructions (use of antibiotics) as directed - skipped some or didn't take. Those who lose bodily function control are in a low percentage - 3%-5%. If women can adjust to leaking when they sneeze so can men if it means a healthy, happy life and enjoying their future. The treatment is dependent a lot on the age. The younger a man is with a lot of positive cores, the more the need for removal to be considered cured. Those who opt for radiation can have a lot of side effects as well and if the radiation doesn't work and it is spreading, surgery has been taken off the table due to the radiation so they have no choice but chemo. Some people would rather not know if they are sick and those are often the ones to skip PSAs and digital rectal exams. A PSA and biopsy can save a life - when prostate cancer gets into the lymphs and bones, it is a painful, long death.
To any of you who doubt the value of PSA testing let me tell you our story or part of it. Hubby had PSA testing for many years in Texas. A few times the numbers were up, he had a couple of TURPS, numbers went down. In NM where we lived for 7 years his numbers were pretty regular, usually around 3 or so. There was no room for conncern, but he did see a urologist before we moved here 4 years ago. The guy simply said, not to be too concerned, it is a wait and see game and at hubby's age why do anything. Well, after a few years of no testing about 16 months ago he was tested again: :PSA: 5, then 7, then 9. He agreed to the biopsy, which did not cause any infection I will add. It did cause a little swelling. Anyway, long story, the results showed cancer in 4 of the groups tested. They were 3+3: 3+4, 4+4 and 4+5. Luckily no signs of mastatisizing (spelling) but he has also had a lipo scarcoma removed twice. Now he in on hormone threatments and will start 8 weeks of radiation in the next few days. It is too late for surgery. Hopefully, because he is 75 he will live a normal life and something else might take him before the cancer, but we still wish we would have paid more attention to PSA testing.
I also believe too many tests are given in todays world, but when it hits home you suddenly are thankful they are available.
Nita
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