It is hard to rationally convince someone their trip to Hell was not necessary.
Example: Ladies who opt for a full radical mastectomy when lumpectomy would suffice.
The deaths from P
ned123 (imported) wrote: Fri Jul 20, 2012 12:15 pm
rostate cancer have been cut in half.
Why?
Earlier intervention or improved treatments over the years? Both happened simultaneously.
I guess we can agree a PSA alone is no reason to cut.
Personally, I don't like needle biopsy as it allows an escape for walled off malignant cells.
This procedure should only be done when surgery is gonna happen, so the surgeon knows the pathology of what he is going after and the field of clearance required .
Ultrasound is probably the most reasonable and with signs of change, make a decision.
I have been on TRT since my boys were removed last year for signs of cancer. That's another whole story... As a routine, I had a PSA test done and the results were 2x from a year prior. The doc took me off TRT and wanted a biopsy and suggested surgery based upon statistics! I said no! Instead, I went to a large university urologist, and had an MRI performed on my prostrate. The results showed two areas of concern. I then agreed to a "targeted" biopsy, going after the areas of interest. This was done comparing the MRI to real-time ultrasound, directing the needles to the areas of interest. This was done under general, and included external as well as trans-rectal biopsies. Twenty-two needles were taken. The results, negative for cancer, no malignancy. Did I mention, my PSA fell back to normal just prior to the biopsy?
Seems PSA is impacted by anything stressing the prostrate as well as changing T levels. Even having sex raised the PSA temporatily.
I spent over $12,000 on this odyssey, but I am confirmed cancer free, and have restarted my TRT.
Be careful with the PSA. Take several tests over a time period, and try to rule out things that can impact PSA. There is an article from I believe Chapel Hill University that helps explain my experience with fluctuating PSA. Oh, and stay away from small town surgeons. They live to cut. My butchered scrotum is proof.
Until the advent of the PSA screening, the most common way men found out they had prostate cancer was to come to the doctor complaining about back pain. What that meant was it had metastasized in their bones. Moi, indeed treatment has improved, but as you mention, earlier intervention happened as well. What do you think the introduction of the psa test was. Without it as a starting point for the whole screening and diagnosis process, the numbers would not have dropped as they have.
Also I do take offense at your comment regarding convincing someone rationally that their trip to hell was unneeded. I think it is patronizing and down right insulting. You have your opinions and that is fine. I will not address your lack of wisdom on this subject, and just suffice it to say that I hope someday you don't go to your doc with unexplained back pain.
AtomicMush good for you, this is just the kind of effort and questioning one needs to do, when given this sort of news. Yes your doc was right to be attentive regarding a doubling of you psa, and yes there are a ton of reasons it could be up. of course suggesting surgery even before a biopsy set off red flags and you spotted them. But you didn't just leave it at that, you sought out the best people you could find to figure out what was going on. There are those that would sight this as an example of unneeded testing, but even at a cost, I am sure you sleep much better knowing you are good to go.
Again the PSA is not perfect, and I am sure over time they will come up with better screening tools, but for now I think it is fool hardy to not take advantage of this simple screening test.
About equal numbers of men die of prostate cancer as women do of breast cancer. Mammograms, and breast exams save lives, yet both have false positives, yet they don't dare tell women they are wasting their time. The ladies are too smart and too organized to ever fall for that. Yet men will just bury their heads, rationalize, and continue to allow themselves to die a decade sooner than women.
Oh by the way just for your info, 9 of the 15 members of the task force are women. 2 are nurses, and one an administrator.
tugon (imported) wrote: Fri Oct 07, 2011 7:54 pm
My current doctor must not read my chart because I was billed $107 for lab work to check my PSA. Dumbass I am a eunuch I do not need a PSA. I am waiting until the next time I see him to ask how worried I need to be about prostate cancer. Sorry back to the thread.
For my fortieth birthday, I went to a health fair and decided to go ahead with getting a prostate check anyway. It was done the old fashioned way with the physician changing gloves and washing between victims -er patients. He was a good man and told me that he couldn't even find my prostate at all but at any rate if it was there anywhere it certainly couldn't swollen by any account. He also said that this test is for men of normal size and that I'd probably never need another examination again.
1) Don't trust just one PSA test, take a few over time to confirm that it is not transient. PSA does fluctuate for MANY reasons.
2) Know your body and trust your instincts. Do not fall for the statistical crap. Instead, find out what is going on inside you. I did. Had the results been different, I would have not hesitated to have the needed surgery. But, do everything you can to identify what you may or may not have going on, then make a decision. Blind faith in your surgeon and statistics will only make one person weathy.
I have confirmed my health, and fired my small-town Uro. I am much better off today for it. Even though I have no balls, I grew enough of them back to ask the right questions.
Gosh, so there is really no point in even doing anything. Neat! makes life so much eaiser. We are all going to die so why worry. Just so I get this right, you get prostate cancer and you will either out live it or you will die from it. No need to even think about it. No need to ever get treated. It basically isn't worth mentioning. and I guess there is no need for a "prostatic epidemiologist".
ned123 (imported) wrote: Thu Jul 26, 2012 7:34 am
Gosh, so there is really no point in even doing anything. Neat! makes life so much eaiser. We are all going to die so why worry. Just so I get this right, you get prostate cancer and you will either out live it or you will die from it. No need to even think about it. No need to ever get treated. It basically isn't worth mentioning. and I guess there is no need for a "prostatic epidemiologist".
no that wasn't the point of anything.
The PSA test has been proven over time to be an unreliable guide to prostate cancer. It gave as many false postitives real posistives. ALSO, certain prostate cancers required minimal to no treatment because the treatment shortened the life span of the man. That's what first clued the doctors behind this push against the PAS. They saw men that went untreated or got minimal treatment live longer with less discomfort that men who were undergoing radical treatments, chemo-therapies and x-rays. These were clearly cases of overtreatment and not undertreatment.
What the Feds did in this ruling was to acknowledge that one PSA is never definitive and a course of treatment should not be embarked upon with one PSA to back it up. The new guidelines say that other factors must be considered and routinely giving the PSA is not a good screening tool.
Treatment of men for prostate cancer was falling into the realm of "Give me an antibiotic for a cold or virus" when it is obvious an antibiotic does not affect viral illnesses.
ned123 (imported) wrote: Thu Jul 26, 2012 7:34 am
Gosh, so there is really no point in even doing anything. Neat! makes life so much eaiser. We are all going to die so why worry. Just so I get this right, you get prostate cancer and you will either out live it or you will die from it. No need to even think about it. No need to ever get treated. It basically isn't worth mentioning. and I guess there is no need for a "prostatic epidemiologist".
That's how I would manage it.
When I get it, discovered by some symptom such as difficulty urinating,
I would follow it first. If there is evidence it is aggressive, I might consider
treatment. Many in the medical community have felt this way from experience before the data appeared.
moi621 (imported) wrote: Sat Oct 08, 2011 4:42 pm
Think of all the unnecessary pro
tatectomies. No victim will cop that it was needless.
And people have been programed that all is preventable with good screening. <sigh>
Nor will I get scoped. The importance of cancer screening has really decreased in this post tobacco era. Nicotine excites all malignancies. ALL! No nicotine, less need for "screening" this or that.
