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Posted 7/17/2013 8:11 PM (GMT 0)
I was watching TV the other night when one of those lawyer ads came on trolling for folks who'd been treated via Da vinci surgery. What's that all about?

I certainly don't have a dog in this fight and I've not heard here of a rash of unhappy patients. I suspect the asbestos train has about run its course and lawyers are casting about for the next big target. Is there an alternative explanation or some big failure that I'm not aware of?
Posted 7/17/2013 8:36 PM (GMT 0)

The target may be the promotion of prostate cancer OVERTREATMENT.

"The gross overdiagnosis and overtreatment of this non aggressive prostate cancer and the insignificant number of lives saved by the crippling surgical treatment have been underscored by the embarrassing USPSTF report on prostate cancer screening as well as the flurry of class action lawsuits against the robot equipment makers."

 

Which Prostate Cancers Really Need Treatment?

Posted 7/17/2013 8:54 PM (GMT 0)

Article said...
The AUA now suggesting greatest evidence for "benefit" from routine screening was for men ages 55 to 69 only)

I'm younger than that that group, absolutely no symptoms. I'm glad my PSA was tested.

Article said...
Most prostate cancers diagnosed are classed as the low or favorable-risk Gleason 6 (3+3) prostate cancer and the majority of these cancers behave like insignificant pseudo cancers

And if 12 of 12 cores are positive with 3+3? Is that still low or favorable-risk?
Posted 7/17/2013 8:59 PM (GMT 0)
 

ddayglo said...

And if 12 of 12 cores are positive with 3+3? Is that still low or favorable-risk?

No.

 

I recommend reviewing the NCCN risk criteria which can be found in the link below titled, "Newly Diagnosed with PC? - read this thread first"

 

 

Posted 7/17/2013 9:23 PM (GMT 0)
Casey, I read the article in your link and my first thought was "oh come on people." The guy was obese and probably wasn't a good candidate for any type of surgery. In addition, the article doesn't spell out the "crippling" effects the surgery had on the poor man's life. And I found the use of the word "crippling" rather over the top...is the article implying that the man was bed ridden for the rest of his life and unable to perform basic human functions?

Good heavens but it seems that those who are all for not treating the alleged 'non' prostate cancers are just as good at using scare tactics as those medical professionals who are alleged to push treatment to improve their bottom lines.

All I can think of is that poor guy who reads this stuff and says "I don't have to treat my prostate cancer because it's really not cancer" and then, 10 years later, is "crippled" because the cancer has spread to his bones. Wonder if those who are pushing for no treatment for these supposed "insignificant" cancers will be willing to stand up in court and explain to the family of this man why their husband/father died from an insignificant disease.
Posted 7/17/2013 9:24 PM (GMT 0)

Casey59 said...

I recommend reviewing the NCCN risk criteria which can be found in the link below titled, "Newly Diagnosed with PC? - read this thread first"

I see that now. I guess I stopped at the intermediate category (which is where my soon-to-be-evicted prostate decided to take up residence), and the # of cores is listed at the last "Low" Category

Post Edited (ddayglo) : 7/17/2013 3:27:23 PM (GMT-6)

Posted 7/17/2013 9:35 PM (GMT 0)
Amid the wildly hyperbolic statements in this article, I did find one phrase with which I agree:  "embarrassing USPSTF report."  The frequent disagreements here on HW often focus on that report.  The only question, is this:  WHO should be embarrassed by the report?  The uro-surgeons who do DaVinci surgeries, or the USPSTF itself for concocting a report with which so many prostate cancer "survivors" disagree?

Really, haven't we had sufficient discussion regarding this issue?  Are any minds being changed? 

Posted 7/17/2013 9:38 PM (GMT 0)
sephie -- these guys claim to be advocates.  they sure as hell don't represent me.  maybe the insurance companies but not ME!

ed

 

Posted 7/17/2013 9:39 PM (GMT 0)

Sephie said...
Wonder if those who are pushing for no treatment for these supposed "insignificant" cancers will be willing to stand up in court and explain to the family of this man why their husband/father died from an insignificant disease.

Sephie, one does not die from insignificant disease. 

 

As Tudpock18 said today in another thread, patient education about PC "is one of the most important messages we can share with new members of our forum."  Prostate cancer is really two, or perhaps three, very different diseases........

 

Posted 7/17/2013 9:39 PM (GMT 0)
Casey -- you are not a doctor.  please quit playing one on the internet!

ed

 

Posted 7/17/2013 9:42 PM (GMT 0)
Casey, you know I agree with you on most of what you have to say. But, when it comes to "insignificant disease," my gut reaction is that the degree of "insignificance" is directly proportional to the degree to which the victim of that disease is "not me." Even if I disagree with a man's decision to have a prostatectomy for a Gleason 6 cancer, I guess you might say I still support his "right to choose" to do that.
Posted 7/17/2013 9:49 PM (GMT 0)

clocknut, I’m not sure I understand what you just said…?

Are you suggesting that what I wrote (“…one does not die from insignificant disease”) is not accurate?

Or, are you suggesting that your idea of what “insignificant disease” is might be different than mine? 

Or something else? 

 

I’d be willing to have a conversation on any of these points…I’m just not sure which one you meant.

 

Today, you are correct…men have a right to "choose" to have a prostatectomy.  And as Dr Partick Walsh says, if you are going to have an unnecessary prostatectomy, make sure it is done by an experienced surgeon.  I do think that men having expensive unnecessary treatments is driving up our taxes (Medicare) and insurance costs…

Posted 7/17/2013 9:54 PM (GMT 0)
Casey, what I'm saying is that if someone I've never met has a disease, it is much easier for me to label it "insignificant" than it might be if my son or my father, or myself had the same disease.

When I was first diagnosed, my personal cancerous prostate was the most "significant" thing in the world to me. If someone had suggested it was an "insignificant" disease, I would have resented that greatly.

Viewed in the macro, a small volume Gleason 6 prostate cancer may, indeed, be an "insignificant disease." At the personal level, it is never insignificant, and I think that whole concept is a tough sell to the newly diagnosed.

And, as I've said in the past, I don't think a month has passed here on HW where we haven't met a new member whose "insignificant" disease turned out to include positive margins, EPE, and even SVI that should have been treated earlier.  As long as those complications are a possibility, I have a hard time accepting the term "insignificant disease."

Posted 7/17/2013 10:10 PM (GMT 0)
Just to be clear, one does not die from insignificant disease.   I don't see the classifications—for example the NCCN risk categorization—as variable, or dependent on who is the patient.   ("insignificant" is not a NCCN category) clocknut said... Viewed in the macro, a small volume Gleason 6 prostate cancer may, indeed, be an "insignificant disease." At the personal level, it is never insignificant, and I think that whole concept is a tough sell to the newly diagnosed. This is exactly , I believe, why patient education right up-front is soooo important.   What if the doctors all agreed (as some PC leaders have suggested) to call low-risk PC a “pseudo-disease,” then would you still think it was as significant as if it had the “full-blown big ‘C’ word?”  
Posted 7/17/2013 10:12 PM (GMT 0)
I have found the issue of overtreatment to be one where members of this forum quickly find entrenched positions from which they argue and discussions become increasingly pointless -- and annoying -- as participant after participant finds his/her spot, climbs up on a soap box and gets out the megaphone. Better options are to either refrain from continuing the argument after it becomes clear that no minds will be changed, or to reach out to the other side through email. Often that person with whom you never agree on anything on the forum will be a much more satisfying correspondent in individual conversations where they don't feel the pressure of a public forum keeping them absolutely on message.
Posted 7/17/2013 10:28 PM (GMT 0)
Casey, just shot an e-mail your way, check it out.
Posted 7/17/2013 10:28 PM (GMT 0)
Casey So are people smoking ,eating greasy burgers,non exercise, obesity, driving up our medical costs,you get the drift. Your statement "Today, you are correct", is revealing and you want it to be so. Why not just get to the end point of your thesis, instead of dawdling. You see, and may be right, a day when the the lifestyle police will keep our costs in healthcare, down, at the expense of our personall freedom. I sense no remorse on your part about that possibility, and fact I sense a certain bit of glee and self-righteous, satisfaction about being so ahead of the curve, as a new paradigm unfolds to protect us from ourselves. Your thesis is not a slippery slope, its a ski run. (Flame sentence deleted by Tudpock18) Politicians, are famous for it and has become rampant in all venues of communication. I could go on but fear the truth will out run the good.

Post Edited By Moderator (Tudpock18) : 7/17/2013 7:44:00 PM (GMT-6)

Posted 7/17/2013 10:30 PM (GMT 0)
STW, I'd be interested to hear if my guess was correct (back to your original question).  I watch very little TV so I haven't seen this ad, but I have read about some lawyers advertising for prostatectomy patients.  Please let us know if see it (the ad) again and can tell what they are suing for...  thanks
Posted 7/17/2013 10:33 PM (GMT 0)
logoslidat, if you are asking whether I think this will change...then just ask.  "Yes," I do think it will change.
Posted 7/17/2013 10:48 PM (GMT 0)
Casey, there is not one question mark in my post.
Posted 7/17/2013 10:54 PM (GMT 0)
logo, ok then...you need to "assume" a little more clearly...
Posted 7/17/2013 10:59 PM (GMT 0)
WORD
Posted 7/17/2013 11:06 PM (GMT 0)
There is a chat room tonight folks.  Why not take it there.  You are not going to resolve anything here.  Same old story from the same old folks............
Posted 7/17/2013 11:19 PM (GMT 0)
Casey, it's pretty clear that you truly believe that low volume G6 is insignificant and need not be treated. You also say that one doesn't die from insignificant disease. That is true, but you can't know that until the person dies from something else, so it's not a helpful statement.

I understand your statement about unnecessary procedures adding to costs of the healthcare system. I believe that the recommendation to curb PSA testing is an effort to cut costs. The men you are talking about will never be diagnosed without PAS testing. On the other hand, men who have serious disease will be missed and lose the chance for a cure.

For me, this always goes back to the fact that today, we just don't know enough to predict with reasonable certainty who has insignificant disease and who has a more urgent need for treatment. Since 35% of cases diagnosed as G6 on biopsy are later upgraded after RP, we know that.
Posted 7/18/2013 12:22 AM (GMT 0)
Putt, we are not worthy, help us to your air or ignore.
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