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Another twist ~ The US study lead doctor backs off?

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Posted 3/28/2009 5:38 AM (GMT 0)
Gerald Andriole, MD, the lead study doctor of the PLCO Study that showed no improvement in mortality has lessened the blow of the "no benefit" study release.  First he indicates that the study is only for years 7 to 10 after diagnosis of patients 55 and older screened.  You can read it below.

http://record.wustl.edu/news/page/normal/13743.html

Dr. Andriole goes on further to say he encourages screening in men aged 50 and above...

Huh?  So why didn't they say that?

Here's my take... I was diagnosed at 44.  I believe that men should start testing at 40.  Now many organizations are using this study to verify what I already know and that it is entirely possible that men who screen at an earlier age will benefit more than an older man from screening.  This is quite a twist from the US study when released showing that it is so flawed that it may be in itself 'indolent'?  As this study continues we may see an entirely different results at 15, 20, 30 years...

Arrrrgggggghhhhh!

I wish these guys would think these things through more before releasing contraversial stuff...There was a better way to announce these results IMHO.

Tony

Posted 3/28/2009 11:55 AM (GMT 0)
Tony,

My opinion as well that testing should start at 40. In my case I was diagnosed at 43 by pure luck (a new doctor after we moved to Florida ordering a PSA test without any symptoms on my end) and with my stats, I just dont believe the cancer would have been contained by the time I am 50. Also looking at the stats in this forum, seems most of the men diagnosed in their 40s do have a more advanced cancer indeed.

Study or not, the PSA tests do save lives.
Posted 3/28/2009 12:57 PM (GMT 0)

 I with ya' on that Tony. I've probably mentioned it before but I started testing at forty. I had an older cousin dx'd in the early 90's, hence my own and my uro's dedication to the yearly test(I was three months late last year, finally getting into the office in Feb 08', whew)  .....My first PSA was 5.1 @ 40yo, 3 months later it was down to 3 somthing and three months after that it had settled in around the 1.5 range where it remained until Feb 08 when it went back up to the 5.0 mark....I've told my son and nephews they should start at forty, with one at thirty, thirty-five...wouldn't hurt a thing. Give em' a good baseline ya' know...

Posted 3/28/2009 1:06 PM (GMT 0)
I too think all men should be screened at 40, to get an accurate base line.
Posted 3/28/2009 8:56 PM (GMT 0)
I agree with the testing at age 40. I was diagnosed at age 48. I know I sound like a broken record but I believe the PSA test saved my life.
Posted 3/29/2009 4:14 AM (GMT 0)
Geesz, I hope you guys are right about screening for prostate cancer at such an early age. I started with colonoscopies every 5 years and yearly PSA with DRE at age 35 due to my father dying of colon cancer in his 50's. That did freak me out, no doubt. I feel now that I overreacted but that's just me. The first time I had a DRE  at 35 I thought I'D DIED! Over the years it got easier, until at 52 I got so sick of doing the test I was ready to skip a year or two. Why bother with this grief?  Then a friend of mine 3 years older said he recently had prostate ca with surgery and that goaded me into getting my yearly test. Bingo, second biopsy showed prostate cancer, went ahead and had the surgery too. No recurrent cancer so far but no real sex again without injections. I hope we are all doing the right thing here turn   
Posted 3/29/2009 5:24 AM (GMT 0)
mspt,
You have a valid question for so many in the younger groups. But how can the 40 year old group use any studies? My concern in the US "prostate mortality" study is that it's based on information gathered in men 55 and older and over a 7 to 10 year period. When you are my age and diagnosed with advanced disease I can't help but think I didn't have a choice and had to intervene, thus I can live with it. my life expectancy still had 39 years to go. But for guys with lesser tumor, the decisions are excrutiating. And getting a study to help us younger guys is next to impossible. For so long the study takers are stuck on the recommended 50 and older patients. That's just great when the system ignores the younger patients.

Peace.

Tony
Posted 3/31/2009 5:32 PM (GMT 0)
skull  Too freakin bad I didn't read that B 4 the freakin surgury.  I told my uro, if I had a chance to do it over...I wouldn't.  Sometimes, doctors can be bad for your health. skull
Posted 4/1/2009 3:52 PM (GMT 0)
Tony,

I could not agree more with you.  It's the fact that we, god willing, still have another 35+ years to live.  Without early detection and treatment making 50 would have been iffy at best.

Roger

Posted 4/1/2009 4:08 PM (GMT 0)
This subject has been debated as much as the back and forth debates over vitamins and diet have. It's the debate of the which study gets what attention debate. The fact is, no one seems to know what PCA will do if left in its more non agressive form except spread when given enough time. Common sense tells us the rest!

Swim
Posted 4/1/2009 5:13 PM (GMT 0)
Swim, I agree with you again. Cancers don't ever sit in a holding pattern of non-growth, they either grow real slow over a long period of time, or they grow at agressive rates, but the point being, they are growing all the time. That's what I don't understand in the infamous "watchful waiting" or "active survience" debate here, what is it that men are waiting for? Yes, waiting will delay unpleasant side affects that any treatments will cause, but the same waiting is just allowing a potentially killer cancer a free pass to grow, whether it be slow or fast.
Posted 4/1/2009 7:06 PM (GMT 0)

Hi David:

Re watchful waiting, I can certainly understand your point as it is certainly likely any PCa is growing if even at a slow rate.

In my case, with an intermediate grade cancer, I didn't qualify for WW and would not have done it.  However, I can understand the logic of men who do.  If my cancer had graded out at a 5 or 6 with 1 core out of 16 at 5%, I think I probably would have waited for treatment (WW).  In the ongoing Johns Hopkins WW program, 2/3 of the men in the program have not shown disease progression that would indicate that treatment is needed (of course that means that 1/3 eventually did need treatment). 

As I have said before, I think that there is also a pyschological aspect of treatment choice that has to do with the willingness to take risk. Any WW patient would have to have the ability and willingness to put some of the worry aside because, clearly, the cancer is still there and may be growing to "treatment size".  Or, it may grow to an advanced stage. 

And, if I was 75 instead of 62 years old...I think it would be an easier choice to WW with an early stage cancer since the odds would be high that something else would kill me first.

Anyway, this remains an interesting topic of debate...

Tudpock

Posted 4/1/2009 9:01 PM (GMT 0)
I agree Tudpock, if I had been 70 instead of 56 at my dx, might have had an entirely outlook at my choices for treatment or not being treated. Also, having had 3 bouts of a previous dangerous and rare cancer in my past didn't leave me much room to ponder.

David in SC
Posted 4/2/2009 2:33 PM (GMT 0)
Nothing angers me more than the news media pulling snippet from a study and yelling "Danger Wil Robinson, Danger"

I would think removal of the prostate by surgery will slow considerably but treatments like Proton therapy will increase. Knowing what I know now the Proton therapy might have been a better choice.

The choke hold lawyers have on doctors will still control their suggested methods of treatment.

I have an appointment Monday. I will ask my doctors point of view on all this.

Hard not to be a little pissed with all this.
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