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Dr. Samadi's recommendations for testing

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Posted 5/15/2013 5:26 PM (GMT 0)
sorry if this has been posted before.

http://online.wsj.com/article/PR-CO-20130506-905778.html
Posted 5/15/2013 5:28 PM (GMT 0)
http://online.wsj.com/article/PR-CO-20130506-905778.html

always works better in IE instead of firefox for links

Posted 5/15/2013 5:29 PM (GMT 0)
Saw it this morning...

Here's that link activated...

online.wsj.com/article/PR-CO-20130506-905778.html

He makes no statement for or against the new recommendations. He goes on to explain why they are in place and how they might be best put into practice.

Certainly a reasonable assessment.

Tony
Posted 5/15/2013 6:10 PM (GMT 0)
Tony:

I think Samadi is clearly stating he does not agree with some of the recommendations:

" Are you under age 40? The AUA says you should not be screened.

Dr. Samadi says:

"With blanket recommendations we run the risk of letting younger men fall through the cracks. Men under 40 need to be educated about prostate cancer and given a clear understanding of how risk factors apply to their individual status. This is a critical time in a man's life for establishing a healthy lifestyle that optimizes disease prevention. It's also primetime for baselining a man's PSA level."


One can also read between the lines:

"David B. Samadi, MD, Chief of Robotics and Minimally Invasive Surgery and Vice Chairman of the Department of Urology at The Mount Sinai Medical Center, was a key presenter at the meeting but not part of the new PSA recommendation."

"The earlier monitoring starts, the better."


I posted this same response in your original thread. A few responded that my good doctor was out for publicity. Call me insane, but his response makes a whole ot more sense than the actual guidelines to me.

Post Edited (davidg) : 5/15/2013 12:17:58 PM (GMT-6)

Posted 5/15/2013 6:36 PM (GMT 0)
You know, whether you're for PSA screening or against it, it's nothing but an INDICATOR!
A PSA test does not say you have cancer, or don't have cancer, a biopsy can only determine that. Even then biopsies are a hit and miss.

But to be flat out against testing the PSA of 40 year old's or even younger, is sad. You're putting a man in a dangerous situation that he could die from. I don't understand people like that.

If the argument is, the affect on someone is bad (they can't handle it) because knowing they "may" have cancer because an indicator test said so, well then, I say they have other problems, and may need to be delt with by a psychologist!

Nothing wrong with testing the PSA of a 40 year old, and depending on the result, proceed from there with your doctor.

That's my .02
Posted 5/15/2013 6:57 PM (GMT 0)
So, one thought I had recently on this whole issue....

According to the new guidelines, men under 50 don't need routine screening, but if we have a family member with PCa, then we should be screened. I have no siblings. If my father hadn't been screened and diagnosed, then I wouldn't have thought to even talk to my doctor about it, starting two years ago at age 46. So, do older men who have sons do a disservice to their sons if they decide not to get screened, even at older ages? Just something else to consider....
Posted 5/15/2013 6:59 PM (GMT 0)
Tony you've been posting a lot since the AUA recommendations.  you've also become quite the spinmeister!

ed

 

Posted 5/15/2013 7:00 PM (GMT 0)
good point. and how about people who can't track family history? There are groups in society where up to 60% of kids are raised in single mother households often without even knowledge of where their father is.
Posted 5/15/2013 7:54 PM (GMT 0)
Montee - not sure if this "psa 4.7 (psa rose 1 point per year for 3 years, urologist said still under 4 and no concern. If I can find out about PSA velocity, why didn't he know!)" referred to you or to the article.

My case is similar except my urologist thankfully ordered the biopsy when PSA rose from 1.7 to 2.62 (8 month doubling time) to 3.68 (6 month doubling time).

He did not order a bone scan but again thankfully my second opinion urologist/surgeon did, and also a CT scan.

I ended up Gleason 9 (4+5) with bone mets but fortunately detected early while still in the Oligometastasis (<=5 distant bone mets) stage and being treated with curative intent by Univ of Florida & Shands.

Both urologists had said my case was treatable but not curable until I learned about Oligo from this site and another.

They over relied on some very vague CYA wording on the bone scan that said "multiple thoracic vertebral bodies and right posterior ribs" without every quantify 2 in spine and 2 in ribs plus another in right sacroiliac, as opposed to what everybody assumed body riddled with stage IV metastatic bone disease.

It's not the biopsies that are the over prescribed, but depending on who you talk to surgeries are what actually may be being overdone on low risk PCa. So I too oppose the new guidelines.
Posted 5/15/2013 8:38 PM (GMT 0)
4.7 referred to me. I guess you could say I was on Active Surv. for 3 years and didn't know it!
Posted 5/17/2013 8:59 PM (GMT 0)
F8 said...
"Tony you've been posting a lot since the AUA recommendations. you've also become quite the spinmeister!"

Not sure what you mean by spinmeister, but I have been posting about this as it is a very important topic. This was by far the most scientific set of recommendations that the AUA has ever put out whether you are for them or against them.

I stand in favor of them over past releases even though I know that I fall into a very gray area with screening and a very lucky area as far as disease management. I am able to look outside of my self and see a bigger picture. If that makes me a "spinmeister" then I'm ok with it. My role as an advocate is not to be just centered around my own experiences. For all too long few on the patient side care much about overdiagnosis and overtreatment. To the point that many treated, probably 90% of them, have anecdotally claimed, to all have been saved by screening when that statistically is impossible. To me that appears to be a very large group of men whom have been misinformed. To what percentage of men than have been actually saved is debatable. But if the ERSPC paper stands the test of time then that number is a percentage on the very small single digit category.

Tony

Post Edited (TC-LasVegas) : 5/17/2013 7:05:27 PM (GMT-6)

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