Study about PSA screening to enhance quality of life.

I am somewhat disturbed by this statement, which you see repeated very often:

"Because most prostate tumors are so slow-growing that men will die of other causes long before they become lethal, many experts believe routine PSA testing leads to "much overdiagnosis of cancers that don't need to be fixed," Zietman tells WebMD."

The word "most" is tossed out as if it were fact. But the FACT is only 40% of PC is graded Gleason 6 (slow-growing) at diagnosis. The other 60% (most) of PC is diagnosed at a higher, more aggressive level that if left untreated will indeed kill you...Even worse, while a cancer may be diagnosed Gleason 6 at the original biopsy, should the patient opt for surgery, the post surgery pathology report frequently upgrades the cancer to a higher grade...

Over-diagnosis of PC is not the problem.

Over-treatment of the high incidence of indolent PC is a problem.

Screening is a good thing, but we have to improve the education of men about PC at (or before) the time of screening so that they don't run off and unnecessarily "treat the diagnosis."

I agree with Casey too. If only 10 percent of men have indolent cancers that are over-treated, that's way too high.

It's unconscionable that urologist don't apparently know or care enough to make some finer distinctions. It's one more reason why patients need to be really well-informed.

Any man who is signing up for treatment of PCa should understand very clearly WHY he has chosen to be treated for it. For me it was having two positive cores that were over 50 percent cancerous. For others, it might simply be not wanting to have this hanging over their heads. Whatever the reason, it should be a conscious and well-researched decision.

My quality of life in the wood department is screwed up also. Gleason 6 in 4% of tissue and still depending on BIMIX injections after 16 months with no signs what so ever of improvement. Doctor told me before surgery that his stats with his robotic nerve sparing for men under age 60 were 80% chance of useful erections at 12 months. I was confident that I was making the right decision. I don't mean to be complaining, but yeah, I have to admit, I complain about it a lot.

Post Edited (North Alabama) : 11/5/2010 8:28:35 PM (GMT-6)