USPSTF advises against all PSA screening in healthy men

Just to offer a different perspective, I agree with the recommendation.  All the data I've seen says there is no evidence that early treatment has any effect on mortality rates, but it has a profound effect on quality of life. Given that data, we are spending billions to treat something that could probably be better spent elsewhere, perhaps on delveoping a better test or on delveloping a cure that didn't cause such traumatic side affects. I don't understand the assertion that this is being driven by the insurance companies.  For every insurance company lobbying to reduce treatment, there is another industry lobbying to increase treatment, so why do you think one industry has more pull than the other?  Why can't the recommendation just be the result of good data analysis, why does there have to be a conspiracy? And yes, at some point, as a society, we are going to have to put the good of the many in front of the good of the few.  If I do nothing to treat my PCa I will still live to be well over 60 years old, probably over 70, so is spending all that money on my treatment, which may or may not extend my life, better than putting that money into treating a younger person, maybe one of our troops that needs alot of care due to war injuries?  or putting it into Alzheimers research?  And is a longer life really a better life? I know many will say "It's a personal choice", but that's the point, once it's out there that you have "cancer", even a slow growing, non-life threatening one, people panic.  I know a man, 72, diagnosed with a T1c cancer, that underwent aggresive treatment becuase "my doctor said to" and "it scared my wife".  Did I mention he has an aortic aneurism that could burst at any time and is 100% gaurenteed to have killed him long before the PCa ever would have? And that's the heart of the problem, he is the rule, expensive, potentially harmful treatment for no benefit, not the exception. Dave Age 49 stage T1c diagnosed October 2010 No treatment

Dave,

First, I respect your opinion. But people need to step up and be accountable for themselves. I feel too many times people look to blame others for their own accountability (yes there are exceptions). Everyone has an example of the exception or the rule. What do I tell my friend's wife and children whose husband//father (my friend) did not have a PSA test until he had symptoms and died shortly thereafter in his mid-40's from a very painful metastic PCa? I believe it is a personal choice. It would be nice that we could foresee the future and spend the billions of dollars in all the right places that desperately need the assistance, but I don't think that is realistic or will happen under any circumstance. What will be the next PCa screen dilemma where money is being "so called wasted?" As long as there are people with individualities (instead of robots) there will be risk and reward decisions to be made. Some will be right and some will be wrong and we will need to learn from our mistakes. Is PCa screening right or wrong, I don't know for sure. Not many things are for sure in this world other than eventual death. I do know that I'm glad I had the screening and the treatment and thankful for the opportunity for a personal choice. I always have been known to be a little selfish though, just ask my wife.

Good luck with your personal journey!!!!

Like Americans don't grow up with propaganda. We're told how great we are yet our educational system sucks. We're told how free we are yet our civil liberties have been slowly eroding over the last decade, we're told how generous we are and yet we are the richest country in the history of the world with the biggest disparity between haves and have-nots on the planet.

I know why most Canadians love their healthcare system because I too spent years in a country with socialized medicine. Curiously, life expectancy in that country and in Canada is greater than in the US.

Thank you David and Question for making my point. An exception and rule for every experience. When we become robots rather than humans, we will have a better chance to have one consistent experience. Unless humans are behind the design of robots!!!!

a very simple query on Google will list all the civil liberties that have been taken away form you since 2000. Many have come out and called these unconstitutional. There are college courses geared at this now.

some RW politicians attack our educational system in a thinly veiled attempt to promote vouchers and to remove funding from public schools. Especially those situated in lower income areas. Plenty online about this also.

The growing disparity between haves and have nots and the speed at which the gap is widening ever since Bill Clinton is a fact, very much covered and again easy to verify online.

No idea where you come up with drunk driving and gang banging as causes for our lower life expectancy. It's probably more like obesity and decadence if I had to guess.

But this isn't a political board so no need to continue.

From the small amount of research this morning on this panel, I gather that they are private DR.s funded by the Feds. I dont want to break any forum rules here, so I wont share my opinion. But, they also had negative recommendations for breast cancer screening 2 years ago and one Dr. quit over the backlash. This is an example of why the blue ribbons need to mirror the pink ribbons. This will certainly hurt the cause of both.

I couldnt find out what their agenda was.
Saving Medicare $$$$?
Saving Insurance companies $$$$$?
Saving the patient $$$$ and/or unnecessary misery?????
Or just getting a check for themselves from the Feds?

We all know that diagnosing any cancer early, gives the patient a better chance of cure.

One of the things I learned after finding this forum is the patient is his/her best own advocate. I fired the first Dr. in my life for not agreeing to that just this summer.

I believe the best way to help the public is to make sure they understand that no matter what agency, group, Dr. or whoever gives them advice, that they better take the time to research and make their own decision as to what screening is, or is not, in their best interest.

Startech,

Thank you for bringing us back on subject. I obviously made a mistake (probably in disappointment) and used the two words of "government" and "healthcare" unwisely in the same sentence and the discussion veered!

So can I now go and apply for life insurance and not be denied? Besides my PSA score, I'm one healthy...

If people actually paid attention to probabilities, the casinos of the world would be empty and the lotteries would have no players. The overwhelming majority of players are just throwing their money away.

Each of us that was born male is a part of the "you are going to die from prostate cancer" sweepstakes. The best available data shows that only a tiny fraction of us will "win" that bet by dying of PCa. Now the question is, can we improve our odds of not dying of PCa by having PSA tests and following up with treatment according to present medical practice? The data underlying the new recommendation on PSA testing suggests not. Why? Because most of those treated were not going to die of PCa in any case. Further, some who are tested and treated will die of PCa anyway. Even worse, everyone who is treated has been entered in the "reduced quality of life and possible mortality" sweepstakes -- a game where you have a very good chance of "winning" a prize.

Yes, a lot of people believe that by buying the "PSA test and treatment" ticket they will duck a "win" at dying of PCa. But ultimately that kind of thought is simply baseless fortune telling -- none of us knows what would have happened without treatment.

I had a RRP 4 1/2 years ago at age 55.  I for one do question whether I acted to quickly to have surgery.  Needless to say the USPSTIF press release has not been of comfort. It is to late for me but I do wonder how many of us with PCa went through this invasive surgery and have suffered from the complications needlessly. I guess I am alive although incontinent and impotent, if you call that being alive.

Gentlemen

My stats will show you exactly what happens when you DO NOT have PSA testing.  My first was required by a life insurance company.

Without any treatment, my URO gave me less than 3 yrs before Hospice.  My now XGP was clueless about PSA and DRE.

"If any benefit does exist, it is very small after 10 years," the task force said, citing two major trials in Europe and the United States on the value of PSA testing.
Immediately I ask, what about 15 years? 20 years? If you're diagnosed around age 50, like many of us, you had been reasonably expecting to live much longer than age 60.
If there isn't much data for longer than 10 years--then don't make that policy decision until you get that data.
DJ"

I started another thread but it was closed as being repetitive, so let me bring my comment/question to here. My comment has to do not directly with these latest recommendations (with which I disagree), but with the data. Specifically, they claim that there is not much difference, if any, in mortality regardless of whether PSA testing is used. OK, but when I went through my decision process I was looking at data as is shown on this chart that shows a 17% decrease in PC deaths after PSA testing was widespread:
http://www.scielo.br/img/revistas/ibju/v30n1/1a02f01.gif

So my question is, was this data made up? Either this data was made up and they were lying then, or the data they are looking at now is made up and they are lying now. OK, so maybe it's not direct lying, maybe it's statistics, which is the worst kind of lying. But really, I'm pissed at the way these doctors can show us data that convinces us to do A then later they say they have no data or the data shows we should do B.

Very good response, North, hope some of my fellow Americans pay attention.