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Originally Posted by stapfam
(Post 13367534)
So up to you. When you get to "A Certain Age"- then P Ca can hit. I was lucky in that my Doctor decided I was of that certain age and And the Rectal examination lead to a PSA test and then the Biopsy and finally the Removal of the Prostate. 10 years later and I am still alive- aged 64 and still enjoying life. That could have ended a good few years ago. Another issue that may counsel against routine testing is false negatives. I found this at the Mayo Clinic: "Some prostate cancers, particularly those that grow quickly, may not produce much PSA. In this case, you might have what's known as a "false-negative" — a test result that incorrectly indicates you don't have prostate cancer when you do." So routine testing may be prone to miss the unusual but dangerous tumors and catch the less aggressive ones. |
A question that really needs to be addressed is the efficacy of treatment. The recommendations seem to suggest that the treatment (keeping in mind we are talking about populations rather than individuals) doesn't seem to affect morbidity. In other words, treated or not the outcomes remain the same. If this is true, then the concept of early detection is of academic interest but not useful to the individual.
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I just had my annual blood screening yesterday and chose not to have the PSA. I went to the site provided by one of the posters here, the American Cancer Society, and followed their advice, which said that with a 2.5 or lower PSA screening is not needed every years. since last year I had a 1.5, I elected not to have the test this year. It seems to met that the American Cancer society is as good as any organization on advice about cancer screening. I am almost 64 and do not want to get involved in medical procedures that lead to more and more unless I absolutely have to. So it looks like previous PSA values should also play a role in the decision of getting or not getting a PSA every year.
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Originally Posted by stapfam
(Post 13367534)
There seems to be two trains of thought going-3 if you count the Undecided. First is that it is a waste of time and money and should not be bothered with. The other is from those of us where Prostate Cancer was detected through a PSA test and are gratefull for it.
P Ca is not a killer. It can sit in the Prostate for years without causing a problem. It can cause a few urinary problems and that could be the first sign that something is going wrong. Those urinary problems may not be P Ca but "ONE" of the tests that can be done that is very simple and non intrusive is the PSA test to see if there could be a problem. The definitive test is a biopsy and I do not want another one of those. My biopsy showed Cancer on all 6 samples. My cancer did prove to be aggressive on the autopsy but I was lucky in that it had not spread. That is the problem with P Ca- it can spread to other organs and that is when it can become fatal. Prostate Cancer is not a problem- A few minor inconveniences in the early stages but providing it does not spread may only cause you to be never far from a toilet or a bush. But if it breaks out it can cause cancer to the liver- kidneys- Bone or any organ of the body. That is serious and not easy to Cure- in fact that is when it can become fatal within a very short space of time. So up to you. When you get to "A Certain Age"- then P Ca can hit. I was lucky in that my Doctor decided I was of that certain age and And the Rectal examination lead to a PSA test and then the Biopsy and finally the Removal of the Prostate. 10 years later and I am still alive- aged 64 and still enjoying life. That could have ended a good few years ago. |
Originally Posted by rck
(Post 13368152)
A question that really needs to be addressed is the efficacy of treatment. The recommendations seem to suggest that the treatment (keeping in mind we are talking about populations rather than individuals) doesn't seem to affect morbidity. In other words, treated or not the outcomes remain the same. If this is true, then the concept of early detection is of academic interest but not useful to the individual.
And the morbidity rates of tested/untested 65-75 year old men in the study is irrelevant for a 50 year old man who has a much longer life expectancy. A lot of the 65-75 year old men are going to die of something else before the prostate cancer will get them. Not so with a 50 year old. |
Originally Posted by love2pedal.com
(Post 13368767)
I think the main studies used for the committee to make their decisions were 9 years long. This would be sufficient data for a fast growing cancer like pancreatic but slow-growing (in most cases) prostate cancer can take 10-15 or longer to go from clinically insignificant to deadly. We need longer studies before an accurate recommendation on testing is made. It is only in the 10+ years that the morbidity between tested/untested is likely to diverge in a significant way.
And the morbidity rates of tested/untested 65-75 year old men in the study is irrelevant for a 50 year old man who has a much longer life expectancy. A lot of the 65-75 year old men are going to die of something else before the prostate cancer will get them. Not so with a 50 year old. |
Originally Posted by rck
(Post 13375465)
The problem is in finding a control group. All things being equal, if you have 100 men between the ages of 50-65 with known ca of the prostate, how do you convince 50 of them to forego treatment in order that we see what happens?
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Originally Posted by rck
(Post 13368152)
A question that really needs to be addressed is the efficacy of treatment. The recommendations seem to suggest that the treatment (keeping in mind we are talking about populations rather than individuals) doesn't seem to affect morbidity. In other words, treated or not the outcomes remain the same. If this is true, then the concept of early detection is of academic interest but not useful to the individual.
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When I was seeing the consultant about Surgery- there were a group of us that always seemed to meet up. We were all confirmed by Biopsy to have P Ca. Out of the 5 of us- 3 are still alive after 10 years. One elected not to have surgery and he died 3 years later with Bone Cancer. The 4th- on the table and the Lymph nodes are taken for test before surgery is done. His showed that the Prostate Cancer had spread so pointless doing the surgery. He died within 6 months.
The PSA test does not confirm or refute Cancer but it is an indicator that Further tests should or should not be done. The Biopsy confirms Cancer and the degree. There is a scale that tells how serious your cancer is on the biopsy and if you are high- then the cancer is serious and treatment should be done A.S.A.P. A Low score and it may not progress further or may be slow growing. Now it is up to you. The PSA test is a simple Basic test that is non invasive- It is only a blood sample but unless there is a more basic easier test that becomes available- then that is the first test to be done that could save your life. |
This is political. The politicians are worried about the aging population. When Social Security began in 1936, people lived an average of 65 years, now, especially in Asia and Europe, they live much longer. Americans are living longer too, although not as much. At the same time, automation is doing away with many low skill jobs, making it hard for people to work into their old age.
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Resveratrol both prevents and is active against prostate cancer to some extent.
http://www.ncbi.nlm.nih.gov/sites/en...atrol+prostate It also helps with arthritis.. I posted some links on that earlier. Its best if you just buy the 50% powder extract and just put it in your mouth, letting it soak in. Thats what I do. 25 grams of 50% powder costs around $12. That lasts me several weeks. Walgreens sells 500 mg capsules that are a pretty good deal as they are just filled with that powder. There are Walgreens stores everywhere. Its more effective if you let it absorb, instead of swallowing it. A little bit goes a long way that way. It improves microcirculation and so it helps with dozens of illnesses. |
The idea that a mature man should decline to see a red flashing light, no matter how dim, lest we passively fall victim to too aggressive and potentially adverse treatment is condescending on the face of it.
My 50+ colleagues, a warning is just awarning, subject to personal analysis based on the clear light of logic we have honed to acuity at great personal cost. Give me the facts…let me investigate the background…trust me to face the realities of my own health…and accept my decisionsin regard to my fate. We are not children. |
My father told me some odd to me information about prostrate cancer.
His last 40 years as a pharmacist in public, private, then VA hospitals, gave him a lot of experience in more than this. What he saw was most prostrate cancer patients that die, do so not from the cancer itself, but from something they came down with during treatment. Pneumonia was very common, sad to say. My eyes popped open, so you know I'm going to talk about this with my trusted MD on my next visit. It's worth looking into. |
Originally Posted by Billy Bones
(Post 13384680)
The idea that a mature man should decline to see a red flashing light, no matter how dim, lest we passively fall victim to too aggressive and potentially adverse treatment is condescending on the face of it.
We are not children. |
Originally Posted by donheff
(Post 13384893)
. . .a big brave grownup? . . .this is a test you will continue to be able to take. . .foot the bill yourself.
Dude, us grownups pays our money and takes our choice. |
Originally Posted by Billy Bones
(Post 13386454)
Thanks also on the personal representation of someone you don't know.
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Let me see if I understand the position of the "No Test" people. You, personally, would not take the test because you fear that if it is positive you might be tempted to agree to potentially life changing treatment that might not, in fact, be necessary. You want to extend this to all men by removing the PSA test from the medical repetoire. Then no man could take the test because it would not be available.
On the other hand there are many who want the test available, even with all its' warts, as one in a group of tests to be considered in assessing personal health. Seems to me the Have It Available folks are the most reasonable. It allows each man to exercise some measure of control over his own life. BUT, like all tests, having the PSA available brings with it a responsibility to be engaged in personal health decisions and not leave them up to anyone else, including the doctor. |
Originally Posted by HawkOwl
(Post 13386717)
Let me see if I understand the position of the "No Test" people. You, personally, would not take the test because you fear that if it is positive you might be tempted to agree to potentially life changing treatment that might not, in fact, be necessary. You want to extend this to all men by removing the PSA test from the medical repetoire. Then no man could take the test because it would not be available.
What many of us testing skeptics have said is that the science appears to indicate that testing (and the biopsies and treatment that follow) do more harm than good. The choice to test and respond therefore seems to be a choice to risk fairly likely harm with a small hope that you will catch a dangerous cancer sooner than you would otherwise. Some of us are wondering if that is worthwhile. Very few of us skeptics have fully decided the issue, myself included. Some other countries have determined that the test is not worth covering under national health schemes. Based on the panel recommendations it seems possible that some US health insurance plans may stop covering the tests in the future. If so, you could still have the test and pay for it. I have not seen any posts calling for "removing the PSA test from the medical repertoire" as you put it. Edit: I have seen a number of posts that seemed to me to be hostile toward us skeptics. Examples are the one, above, that I read as describing us as immature and yours and others that wrongly accuse us of wanting to stop you from getting the test. I haven't noticed hostility from skeptics towards those who want to have tests. My suggestion is that you decide for yourself whether to get tested but slow down on assuming that people who choose otherwise are somehow the enemy of your choice. |
Originally Posted by donheff
(Post 13387236)
I have followed this thread from the beginning and NEVER saw anyone suggest any such thing. If I am wrong, please cite the post(s) that led you to that conclusion.
What many of us testing skeptics have said is that the science appears to indicate that testing (and the biopsies and treatment that follow) do more harm than good. The choice to test and respond therefore seems to be a choice to risk fairly likely harm with a small hope that you will catch a dangerous cancer sooner than you would otherwise. Some of us are wondering if that is worthwhile. Very few of us skeptics have fully decided the issue, myself included. Some other countries have determined that the test is not worth covering under national health schemes. Based on the panel recommendations it seems possible that some US health insurance plans may stop covering the tests in the future. If so, you could still have the test and pay for it. I have not seen any posts calling for "removing the PSA test from the medical repertoire" as you put it. Edit: I have seen a number of posts that seemed to me to be hostile toward us skeptics. Examples are the one, above, that I read as describing us as immature and yours and others that wrongly accuse us of wanting to stop you from getting the test. I haven't noticed hostility from skeptics towards those who want to have tests. My suggestion is that you decide for yourself whether to get tested but slow down on assuming that people who choose otherwise are somehow the enemy of your choice. If they, and others who feel like them, are able to have the PSA test declared uneconomical and holding dangers for men it will no longer be an approved test under Federal or Insurance Company rules. The follow on consequence then will be that to meet profitability goals the price will go up and people who cannot independently pay for the test will be denied it. Based on my personal experience that was cited earlier this is not a desirable outcome. |
Originally Posted by HawkOwl
(Post 13387375)
I detect usurping my decision making responsibility and ability.
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Bad analogy.
The seat belt is there, and you can choose to use it or not. Taking or not taking a PSA test has no legal or criminal consequences. |
I have no insurance so they don't even recommend anything to me. I used to have insurance and they recommended tests for things I didn't know existed. Always believed many tests were simply income generators. So no.
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Originally Posted by DnvrFox
(Post 13388662)
Bad analogy.
In many locales, not using the seatbelt violates the law and has legal liability consequences if you are injured in an accident and sue for damages, as well as the possibility of a ticket. Taking or not taking a PSA test has no legal or criminal consequences. |
Originally Posted by springs
(Post 13388604)
I agree with donheff that no one is taking anything away from you, or usurping your responsibilities. ... .
Another consequence is that the test will continue to be marketed by the manufacturer but people won't be able to afford the price; even the $100 you mention. Nope, I'd much prefer emphasis be placed on better analysis of test results rather than what appears to be current practice of automatically jumping to intrusive follow on procedures even though those are more profitable to the medical providers. |
9 out of 10 Feminists agree: Money spent on PSA and other prostate cancer screening is money wasted.
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