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Panel says “no” to routine prostate cancer testing
- Author: Patrick J. Skerrett,
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if the treatment is more harm than the cancer itself, I prefer to not have the treatment. I’ll try some alternative that safer than treatment, because it’s better than doing nothing…
Its amazing news that in this day and age that LESS is the right choice over MORE MORE MORE. Now lets hope that MDs and DOs follow through with this and take action. While I’m watching the olympics and seeing all of these prostate commercials, I’ll shake my head.
It’s great to see some concern for men with cancer screening, shame there is zero respect for informed consent in women’s cancer screening. We see the shocking overuse of the pap test to IMO, generate high profits from over-treatment…and then there’s the black cloud that hands over breast screening.
Take a look at the new Dutch cervical screening program, focused on what’s best for all women, not vested interests. Their 7 pap test program, 5 yearly from 30 to 60 will be replaced with 5 hrHPV primary triage tests offered at ages 30,35,40,50 and 60 and ONLY the roughly 5% who are HPV positive and at risk from cc will be offered a 5 yearly pap test. Those negative, the vast majority, will be offered the HPV program and there is a long overdue self-test option, the Delphi Screener. (also being used in Italy, Singapore and elsewhere) Those negative and monogamous or no longer sexually active can forget all further testing. This will greatly reduce invasive pap testing, potentially harmful over-treatment and is more likely to prevent these rare cancers. The Dutch are light years ahead of most countries where programs are controlled and influenced by vested and political interests. The Finns also have a 7 pap test program and have the lowest rates of cc in the world and they and the Dutch refer far fewer women for colposcopy/biopsies.
Then we have breast screening – the Nordic Cochrane Institute concluded 10 years ago that it is of little benefit, but leads to significant over-diagnosis – they now say it’s marginal benefits and that 50% of screen detected cancers are over-diagnosed. Yet we keep urging women to screen…IMO, all for the benefit of vested interests.
I think the dishonestly and lack of proper ethical standards in women’s cancer screening is disgraceful and reflects very poorly on the medical profession.
In the States women are routinely coerced into elective cancer screening and denied reliable birth control until they submit…and this is allowed to continue. That conduct would amount to professional misconduct here.
It’s clear to me a double standard exists in medicine and paternalistic attitudes are still alive and flourishing.
Needless to say I did my own research and rejected both programs….informed decisions.
Your numbers are even more off than the numbers in the USPSTF report. For every 1000 men SCREENED there will be 200 to 300 cases of impotence? Perhaps you mean that for every extra 1000 men TREATED for prostate cancer there might be 200 to 300 cases of impotence. The USPSTF made a similar although smaller error in saying there might be 40 cases of impotence or incontinence per 1000 men screened. This 40 figure represents the extra side-effects of screening only if the unscreened group had no prostate cancer or side effects, which is untrue. If one believes the European study, the true ratios are this: for every 1000 men screened, there will be one life saved from prostate cancer, which should be compared with 8 to 13 extra men with serious side effects from prostate cancer treatment.
No it isn’t.A diet HIGH in dairy products is thguoht to be a possible risk factor for prostate cancer. Note the words high’, thguoht’ and possible’.And a risk factor is not a cause. Insurance companies regard being male’ as a risk factor for having a car crash, but being male doesn’t cause car crashes.The greatest risk factor for prostate cancer is getting older. It’s extremely rare in men under 50; over 80% of men diagnosed with it are over 65 and half of all cases occur in men over 75. It’s so rare in young men that there are no statistics available for the disease incidence in men under 35.
There are definitely two arguments to this subject but I would prefer to err on the cautious side.
But what does “cautious” mean? I have PC. At age 46 I had my third digital rectal exam, or “Prom Night Redux” as I like to call it, which was normal (again), and my first PSA: it was 138. My biopsy showed a Gleason of 9. I had a radical prostatectomy on 12-9-09, upon which my urologist found that the cancer was “not contained,” and then I enjoyed 6 weeks of radiation. My oncologist says I have about an 85% chance that the cancer will metastisize, and that my most likely outcome is death from cancer by 2016. Isn’t my life worth a blood draw for a test that costs $45? And why wasn’t a “baseline” done on me when I turned 40? I’m convinced that if the PSA had started at age 40 and been repeated biannually for me, my course would have been much better. I think the decision by the panel is reprehensible, because it tells guys like me, “we can accept one in 1,000 deaths, because some patients and some doctors get too aggressive when PC is found any way.” Why not deal with the over-aggressive treatment as the problem, rather than choosing to accept losing several hundred lives per year over a $45 test?
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