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Anybody see AP article on Prostate CA by Marilynn Marichione yesterday? Any point to PSA testing?

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Posted 2/26/2009 5:50 AM (GMT 0)
My local paper just ran a story yesterday about doctors telling men who are screening for prostate CA to start taking finasteride (ie Proscar) to decrease the odds of prostate cancer by 25%. The most disturbing thing to me  about this article is the author's comments about Prostate CA and I quote ,"about 186,000 American men this year will be told they have cancer of the prostate. The disease is often diagnosed from a biopsy after a suspicious PSA blood test..........PSA can be high for many reasons, and there's no proof that screening saves lives-the reason no major cancer groups recommend it. Most men over 55 get the test anyway, then face a dilemma if cancer is found. It usually grows so slowly it is not life-threatening, but it can prove fatal.  Treatments often causes sexual or bladder control problems. "We still don't know if screening and aggressive treatment is a good thing,".........said American Cancer Society's chief medical officer, Dr. Otis Brawley

So all you guys out there, (like me), was it worth it to you to find out you had prostate cancer? Or would it have been better if we had just forgotten about taking the annual PSA test and went on our merry way with our lives oblivious to this condition. Honest answers please, I want to know how you feel about this...........................

Posted 2/26/2009 11:30 AM (GMT 0)

To me - "An Ounce of prevention is worth a pound of cure."

One of the first things I read when starting my research-> Most men will die WITH prostate cancer versus dieing FROM it...I found that statement to be very good...

So all you guys out there, (like me), was it worth it to you to find out you had prostate cancer? Or would it have been better if we had just forgotten about taking the annual PSA test and went on our merry way with our lives oblivious to this condition.

Alot depends on your age....If I were 82 instead of 52 when the doc found the nodules, I probably would not have done anything...

Posted 2/26/2009 1:29 PM (GMT 0)
With what they found with me, it was agressive, and had all the signs of being fast moving. My dr. thought that without doing anything, I might only have been in the 5-7 year of survival group.

Being 56 and otherwise healthy, that would have been unacceptable, and had I not been faithfully getting PSA done yearly since age 50, I would have never known until it was too late. So I am thankful for the psa and a very diliegent local GP that knew my body and systems well.

David in SC
Posted 2/26/2009 2:00 PM (GMT 0)
Dunno....seems like a question of do you want to fix that tooth cavity...or wait until it hurts. To me age is the biggest factor...I want to see my great grandkids so I vote Yes I wanted to know.
Posted 2/26/2009 2:47 PM (GMT 0)
I was 43 when I was dx. I had no other option but to treat it. I could not take knowing PC was growing inside me without taking some action. Slow-growing, fast-growing, they still can not reliably predict with certainty which type you may have. Like a lot of you guys I am otherwise very healthy and I plan to stay that way as long as I can. DaVinci Surgery for me was a no brainer.
Posted 2/26/2009 4:09 PM (GMT 0)
That particular article is either the same one that was published several months ago and I recall discussed here or at other forums, or is piggy-backing on the earlier article which was controversal.  That someone would seriously suggest prevention isn't good personal behavior is troubling to hear/read.  But some people value their lives more than others do.  Count me amongst the men who don't want to surrender my life prematurely to a death preventable for probably most of us.  In the grand scheme of things, ED and incontenence are relatively insignificant issues.
Posted 2/26/2009 4:48 PM (GMT 0)
It would be interesting to know what Drs. do when they find they have PC.  I would venture to guess that they choose similar paths to those we have.  Theory is one thing.  Reality is quite another.  At my age I chose to get it out.  If I had to do it over again I would probably do the same thing.  Thanks for the article.  Allan
Posted 2/26/2009 5:51 PM (GMT 0)
Mavica is correct. We had this same discussion a while back.

Other things cause PSA to go up? Yes. I was told I had an 80% of having a negative biopsy. So I guess everybody on this board is a big fat loser because we could not beat those odds. Bummer.

For me, the PSA test saved my life. I had aggressive PCa, and it was right on the verge of breaking out of the capsule and heading off to who knows where. At the age of 52 or 53, do I want cancer cells flowing thru my system? Is that not going to eventually kill me? I had 3 highly regarded doctors in the area tell me to get it out of there as soon as possible. Am I going to ignore them?

I can understand people being concerned about being over-diagnosed or over-treated, but in my opinion you can NOT just ignore it. You need to be aware of it, make your decisions, and proceed with life. I understand that in many cases the choice may be to do nothing, but that should be an informed decision on the patient's part.

If PCa is so slow-growing, why do 500 men in the US die from PCa EVERY WEEK?

Just my 2 cents,
kcragman
Posted 2/26/2009 6:06 PM (GMT 0)

I wonder about this issue.

Was the PSA a blessing or a curse to me.  I'll never know.  I do know that once I was told I had cancer, I had to do something about it.

It is interesting that the death rate from prostate cancer has not seemed to drop much since the PSA testing started.  I don't understand that.  Unless I'm mistaken and there has been a decrease in the death rate.

Posted 2/26/2009 6:14 PM (GMT 0)

Hi All:

FYI, here is a link to a more extensive Q and A with Dr. Brawley on the subject of PSA screening:

http://www.cancer.org/docroot/SPC/content/SPC_1_Brawley_Prostate_Q_A.asp

My specific answer to mspt98's question is, yes, it was worth it to me.  I think knowledge is power.  I would much prefer to learn the truth, then deal with options, than to stick my head in the sand and not have any information.  Maybe, if I had never been tested, my cancer would not grow and I would have lived just fine never knowing.  Or, maybe it would have spread and I would have died an ugly premature death.  I preferred to know what I had, get properly informed, then deal with it.

Anyway, that's my take.

Tudpock

Posted 2/26/2009 9:42 PM (GMT 0)
It's hard to believe that the the Chief medical Officer would take PCa so lightly. If I listened to his advice I would probably be dead in 5 years. My biopsy report was such that the surgeon wondered why I wanted surgery. As you can see from my stats, I'm glad I convinced him to do the surgery.
Posted 2/26/2009 9:52 PM (GMT 0)
Greetings, everyone.  There is something about knowing you have cancer and doing nothing about it that I just couldn't deal with.  I can't believe that all the urologists out there who are treating prostate cancer would agree that screening is a waste of time.  As for me, once I found out I had it, I'm glad I chose the treatment I did and am not looking back.  David
Posted 2/26/2009 10:11 PM (GMT 0)
From one David to another: And with your post surgery pathology showing a 4+3, it's a good thing that you did choose treatment while it was still contained. Good call.
Posted 2/27/2009 1:10 AM (GMT 0)
Sure looks likes PCa is the Jungle and combination of Twilight Zone, which is it? Which ones are idolent PCa and which ones are viralent forms and/or for how long of time period before it mutates/changes or becomes more defiant against drugs. Looks like many answers are the correct ones a diechotomy of parameters and choices, including monitoring or w.w. (watchful waiting) and therapies that are outside the box even.

Their is an abstract out of Sweden or Switzerland that compared similar sets of patients, treated for PCa and no treatment for PCa.....they were not found equal in this study. The treated patients did have better survival or maybe even fit the criteria of 'cured' as it may have been defined. Alot of cure rates are based upon 10 yr. survivals, maybe a few years ago that is all they could find for data, I might mention that failure of cured status can show up after 10 yrs.(so that is not a defined ending), and does in some cases...why? Perhaps the answer lies within the idea of 'micro mets' which Dr. Barken has mentioned concerning PCa. It is as wild and inconsistent in the World of PCa. Not enough is currently known to make the most righteous assessment of disease level and aggressiveness and also localization of PCa cells, so the treatments can lack or fail because of such. We have to look at our own comfort levels, own long term scenarios, own set of parameters and make our best judgements, and it should not be left to the doctor giving you all the inputs and decisions.
Get envolved, get education, get opinions, and look at everything and don't stop looking, especially for us in the non-cured/failed post treatments, psa threshold and stats.
Posted 2/27/2009 1:26 AM (GMT 0)
Hey MSPT,

After watching my dad die from prostate cancer, I decided if I was ever diagnosed with I would definitely do everything I could to get rid of it. No matter how small the amount of cancer that was in me, I wanted it all gone as quickly as possible. It took 18 months for dad to die after he was diagnosed. None of it was easy for him or for the family.

You asked how we feel about this topic. I feel that it is sheer lunacy to walk around knowing that cancer is growing in your body. Not knowing if it is aggressive or not. And not doing anything about it.

Jim
Posted 2/27/2009 6:36 AM (GMT 0)
Europe under treats because only 1 in 10 has aggressive PCa and the USA over treats because at least 1 in 10 has aggressive PCa. The point is that 1 in 10 will have aggressive PCa and doctors still have no way of knowing which one out the ten is at risk. That is why a good doctor informs his patient of all the variables and options, and then lets the patient decide the best way to proceed. Because for the patient the risk is not 1 in 10... the risk is either he's the 1 or he's not the 1.

The issue for me is that when my pathology came back my oncologist told me I was not the 1 in 10, but the 1 in 100. And in my case PSA was an excellent indicator of aggressive PCa, even more so than the biopsies. I wish I would have asked for the thing to be removed when my PSA hit 10.

Shawn
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