"20 years of progress" (report from the Prostate Cancer Foundation)

Thanks for the link. That is really good stuff. Hard to believe that these drugs were not around 8 aga years when I was diagnosed. To Quote a good friend ( we will beat this crap )

DrJimO -

You're absolutely right! PCRI (www.prostate-cancer.org) is indeed a great source for information, and is one of the PCa sites that I regularly visit.

Thanks for the reminder!

81

Lieutenant,
Yes, we have come a long way in regards to drugs, innovative surgical procedures, and radiological and other treatments and diagnostic tools. With the advent of the psa test PCa mortality has been reduced 40% but the reduction cannot be explained or at least there is no agreement.
1. The USPSTF has recommended "No Screening" based on a European Trial since the US trial could not be utilized due to contamination. The co-vice chair of the task force, Dr LeFevre, has stated that with increased screening mortality of those projected to die would be reduced by 0-2800 (10%) with increased screening.
2. The Goteborg Sweden portion of the trial showed a 44% reduction in PCa mortality with screening. The Netherlands portion of the trial showed mortality reductions in the 30+ percentile range.
3. Dr Catalona-the father of psa testing-has stated that with increased psa testing the mortality rate could be reduced by 40%.
4. Northern Ireland conducted a study where mortality was reduced by 37% with screening.
5. Dr Myers--tongue in cheek(?)--has stated that only 3,000 men would die annually with increased screening.
6. In contravention of the USPSTF recommendation, the Veterans Service Administration has made "no recommends for or against screening for prostate cancer with psa" for high risk men which included Viet Vets exposed to Agent Orange or African Americans since these men were not represented in the European trial.

In my opinion, "Nero fiddles while Rome burns and men die". I cannot help but feel moral outrage when I discover men diagnosed by symptoms at an advanced stage due to no screening that could have detected their disease at an early stage..Our President and his challenger had psa tests which are effectively being denied to our citizens. Sorry, but I had to restate my beliefs!
Bill

The solution, at least in part, to that problem is continued education of those of us who are not physicians who treat PC. I've not seen another class where an educated patient is more important. In order to prevent those overly aggressive treatments.

However, there is another side to that story. I am one of those who was not overly scared of my rising PSA from 1.6 to 2.4 to 2.5 to 4( all over about 10 years) and even that big jump to 8.9 after another 2.5-3 years. I figured with my 30 year history of prostatitis and definite BPH ( my prostate was actually much larger than even I suspected at 107 gms, and could have easily accounted for all of my PSA), with all of that and a free PSA of 23% I figured most likely it was all that other stuff and not PC.

And I knew there were some possible bad complications of a Pros biopsy. And if they found some PC, then what was I going to do, since most guys with PC don't die of it and the treatments had possible or even likely horrible complications? When the PSA went up another 2 pts in about 2 or 3 weeks, I was the one who said "OK, let's do the Bx", my Uro who agreed with all my concerns did not push me at all.

So guess how that worked out for me? It turns out I had a bad cancer, Bx showed G9s and 8s and PNI, which the surgery showed was also(one small dot, but that may be enough) outside the capsule plus in the seminal vesicles.

So how do I know feel about my hesitancy to be tested early and seek treatment early, at the risk of falling into the hands of unscrupulous practitioners who have an incentive ( $ ) to do a procedure on me? Not too good! Boy do I wish someone had talked me into a Bx back at PSA 4, BPH be darned! Or at the very least talked me into PSAs every 3 or 6 months after that 1st 4 showed up.

So be careful about being too resistant to what might be ( or might not) an overly aggressive approach.

I have read many posts here and never replied to any. I choose to answer because I'm in the same condition . My history as best as I can write . Diagnosed May 2013 PSA 12 had the biopsy Gleason scores all nines and tens and it came into my vessels . So I'm on Lipton , casadex now on Zytiga . My score went down but came up again when I stopped taking it when the flu hit me so your symptoms are the same as mine .

Hey Guys - no rant here.

No matter how you cut it, everyone is right and everyone is wrong! Overly aggressive screening and treatment for low level disease does considerable harm, but the point is well taken, that sitting around with a G9 is not conducive to good health!

Unfortunately, until there is a 100% accurate test that can determine who needs aggressive treatment and who doesn't, there is little to be solved by kicking it around.

The caveat is education. A well-informed guy has a much better chance of getting treatment if he needs it, and avoiding it when he doesn't. But, as long as there are financial rewards directly linked to aggressive treatment, there is little hope for poor guys like us to weed out a compassionate doc from the simply greedy one.

I know I'm gonna get kicked around for this, but in that regard, a system of socialized medicine, where professional compensation has little to do with how many procedures are performed, -- works.

Hey - before you start on me - I know, just like the V.A. right?

Jim