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Here we go again: Limit PSA Screening to Men with Symptoms

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Posted 5/20/2023 12:33 PM (GMT 0)
https://www.medscape.com/viewarticle/992137

Sorry guys but I couldn't help myself from posting this. The article itself reads like Charlie Brown listening to his teacher. More interesting to me were the doctors' comments at the end of the article.

Have a good weekend everyone.
Posted 5/20/2023 12:43 PM (GMT 0)
The idiocy of this make my blood boil. Big Brother at his worst.

Jim
Posted 5/20/2023 12:58 PM (GMT 0)
Agreed.
Posted 5/20/2023 1:16 PM (GMT 0)
These articles bother everyone with PCa. Like all things prostate, they are looking backwards for data and not looking forward. While there is a lot work to be done to educate doctors, PCP’s and Uro’s are getting the general idea that over-treatment has been a problem and are taking steps to minimize that with better scans, lab tests, and biopsies.

I see no move in auto safety to remove the “check engine” light from cars which would be the same logic since the dealers want to rebuild your engine when the light comes on vs. black tape over light. A PSA test is not a danger, it is the doctors who don’t know how to use it properly in today’s PCa world, IMHO.
Posted 5/20/2023 2:47 PM (GMT 0)
I saw this German study regarding "overtreatment" just today:

Changing nationwide trends away from overtreatment among patients undergoing radical prostatectomy over the past 25 years
(2023, Full Text)

"Abstract
Purpose
The objective of the current study was to assess whether and how preoperative risk group distribution and pathological outcomes have changed in men treated with radical prostatectomy (RP) over the past 25 years.

Methods
11,071 patients from a large contemporary registry-based nationwide cohort with RP as primary treatment between 1995 and 2019 were included. Preoperative risk stratification, postoperative outcomes, and 10 years other-cause mortality (OCM) were analyzed.

Results
After 2005, the proportion of low-risk prostate cancer (PCa) decreased from 39.6% to 25.5% in 2010 and decreased further to 15.5% in 2015, and 9.4% in 2019 (p < 0.001). The proportion of high-risk cases increased from 13.1% in 2005 to 23.1% in 2010 and 36.7% in 2015, and 40.4% in 2019 (p < 0.001). After 2005, the proportion of cases with favorable localized PCa decreased from 37.3% to 24.9% in 2010 and decreased further to 13.9% in 2015, and 1.6% in 2019 (p < 0.001). The overall 10 years OCM was 7.7%.

Conclusion
The current analysis documents a clear shift in utilization of RP toward higher-risk PCa in men with long life expectancy. Patients with low-risk PCa or favorable localized PCa are rarely operated. This suggests a shift in applying surgery only to patients who may really benefit from RP and the long-standing discussion of overtreatment might become outdated."
Posted 5/20/2023 3:30 PM (GMT 0)
That trend makes sense because of the need for surgeons to find new patients to compensate for the loss of low risk patients to AS and focal treatments. They appear to be increasingly including ADT as part of the surgical protocol.

I think that the overall percentage of men choosing radiation has held steady during this time, with SBRT and protons gaining patients, while brachytherapy suffered a huge decline as a first line treatment.
Posted 5/20/2023 3:35 PM (GMT 0)
carry the message brothers
Posted 5/20/2023 3:57 PM (GMT 0)
Thankfully this group has no authority. They must have an agenda. Their recommendation on PSA testing makes no sense, as evidenced by the experience of many here.
Posted 5/20/2023 6:43 PM (GMT 0)
If your symptomatic from prostate cancer,
Your way too late.
Posted 5/20/2023 10:43 PM (GMT 0)
Prostate cancer has impacted my grandfather, my dad, my only uncle, and now me ...

We have ALL lost "battle brothers" here ...

We must continue to "beat the drum" in ways that we can ~ advocating for timely check-ups for men & encouraging our male friends, neighbors, relatives, and work colleagues to be proactive.

It's a VERY simple blood test ~ so why is PSA testing so controversial?

Beat the drum, be an advocate in whatever ways you can, spread the word~

CYCLONE ~ # Iowa State University
Posted 5/23/2023 1:28 PM (GMT 0)
If my doctor followed this advice, I wouldn’t be dead yet, but I’d be headed in that direction. The PSA test is just one tool available, why not use it?
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