MSNBC.com Home Page "Regular prostate screening reduces deaths, study finds. Now what?"

Here we go again.. MSNBC is a pretty big forum for this discussion... hence I bring it to the members attention:

"Men who got regular PSA blood tests were 21 percent less likely to die of prostate cancer, according to a European study published in the New England Journal of Medicine Wednesday. The new research probably won’t change the current screening guidelines for American men, but the findings could reopen the controversy -- and confusion -- over prostate cancer screening.

“What am I am supposed to do?” my physician lamented during my most recent physical exam. “All my male patients are refusing PSA tests. How do I check for their prostate cancer risk?”...

What do we think about this line? Tell that to my G9 brothers!

"Medical science cannot distinguish between the killer form and the far more common one that can be left alone."

AND ON THE STORY GOES: http://tinyurl.com/7w2edgu

Good thoughts to all.

Post Edited (BobCape) : 3/14/2012 4:04:49 PM (GMT-6)

Overall mortality was unchanged between the groups. In other words, the screening group lived just as long as the unscreened group. Reasons for death were a bit different but rate of death was the same.
Providing a screening psa test may change the reason for death, but will not delay death, in this large group of men.

I dunno...

Something tells me that a 40 y/o guy whose father had a high Gleason grade PCA, sees his psa shoot up and is found to have a cancerous growth, might have a better chance at living till 90 if he uses that information to get what he consideres appropriate treatment under his circumstances.

If his treatment options destroy those cancerous cells.. he could in fact delay his death.

Now, if you're an 80 year old guy, maybe you dont bother with psa.


Seems to me.

BobCape:
The situation that you posit, with a man who has known closest family PCa, would be testing and not screening. Screening is done without regard to risk, symptoms, history. Testing takes these and all factors into account and requires the knowledge and participation of doctor and patient. Screening does not.

Basically what the ERSPC study shows is that mass screening will prevent prostate cancer deaths, but not improve overall survivability.

It also indicates that for every PC life extended 1055 men have to be screened and 37 need to be treated (36 treated men received no benefit from detection and treatment as to survivability).

The data over this and other studies is remarkably consistant and pretty hard to ignore. It is also hard for us survivors to believe as we all are convinced that screening and treatment saved our lives, but it did for only 1 in 37 of us.

I think this shows that current mass screening methods are not effective from both a cost and an added benefit to survival. This is not to say that at risk men should not be screened or that an individual should not be screened if he determines that it is in his best interests.

It does show that both our current screening methods and treatments are not as effective as most of us would care to believe.

I can only tell you this:

My 1st ever psa came back showing a 4.0 (I think it was).. I was 51. My primary said he thought that a little elevated and I should see a uro, I did. He said the DRE concerned him.

I didnt know what a prostate was, never mind psa.

2 years ago this week the biopsy came back and the uro told me I was Gleason 3+4-7 (The only Gleason I would have known of is Jackie).

Robotic surgery removed my prostate exposing a Gleason 4+3 with some tertiary 5. Positive margins.

Rise in psa again resulted in Radiation, 68g if I recall.

Post radiation showed undetectable psa. I hope that continues.

I have paid a HUGE price. I am NOT happy with how some of the principal medical consultants handled the matter regarding full disclosure to me of the benefits, rosks and potential negative results.

All that said, I had advanced prostate cancer of an aggressive variety resting in my abdomen, having eaten through my prostate gland.. certain to wreak further havoc in other parts of my body, if ignored.

So, if you ask me if I would have preferred to remain ignorant of psa, chosen NOT to have been tested, MY answer is "no". In spite of what it has cost me, no. I would be INSULTED had I not been given the opportunty to make that decision myself.

Screening might be done without regard to risk, but older males are THE PRIMARY risk group for the 2nd largest cancer in man. Whatever.

Obviously the leading medical experts and authorities disagree among themselves as to the 'correct" posture, so i\t doesnt surprise me that those among us might as well.

Good thoughts to all

Its funny how this works guys.

When I saw this article and posted it, I didnt do so from the perspective that, in my opinion, it's findings were right, or wrong.

I was really commenting on how astounding it is to me that professionals from all ends of the spectrum can have such conflicting views on one of the most common cancers among us. Good, decent, honest people all.

It seems a weird thing not to have consensus on. Maybe that gives everybody cover.

I know this, there are certain "quality of life" factors that only those having gone through it and living the results can accurately describe and assess. The doctors should rely on US to inform THEM about that aspect.

And number 1 on my list would be just that, a "list" of factors from Gleason to ED, impotence to Penile size, scarring to mobility, etc....

We've got a bunch of intellegent guys here, wayyy more so than myself.. but I bet there are things that MOST of you really understood or appreciated only AFTER you made your point-of-no-return decision.

And MOST guys aren't on this discussion board, the doctor will advise them of what to do, and the patient will be thankful.

So Do Test THEN Dont Test is NOT helpful to them.