Friday, October 14, 2011

"If I'd been kept in the dark by a federal task force, I might not have been here to write this."

A reader sent me an article from the Mercury News entitled "Milken: Why block a cancer test that saves lives?"
The U.S. Preventive Services Task Force (USPSTF), a panel supported by a congressional mandate, now recommends that healthy men not receive prostate-specific antigen (PSA) tests, which measure a protein in the blood produced by prostate tissue. I agree that the current PSA test is inexact and, in many cases, leads to overtreatment that can have terrible side effects such as incontinence and impotence. However, research supported by the Prostate Cancer Foundation has led to the development of several new molecular markers that could soon complement or even replace the PSA test. These new tests, now in clinical trials pending approval from the Food and Drug Administration, should greatly improve diagnosis and treatment of prostate cancer. In the meantime, the USPSTF recommendation is a disservice to the majority of men. While it would eliminate some short-term health care costs, long-term costs of treating metastatic disease would be higher. And some men will die. A recent European study showed that testing reduced deaths significantly among men ages 55 to 69....

The Prostate Cancer Foundation agrees with the American Urological Association that PSA screening provides important information for men and their doctors. In 1993, I was one of those "healthy" men the task force says should not be tested. I asked for the test. The result was a reading six times the upper limit of normal. If I'd been kept in the dark by a federal task force, I might not have been here to write this.

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16 Comments:

Blogger kmg said...

Helen,

You really ought to check out Dalrock's blog - a perfect source for a conservative source that instructs women on the evils of feminism :

http://dalrock.wordpress.com/2011/10/14/all-the-lonely-feminist-spinsters/#comment-16861

2:29 PM, October 14, 2011  
Blogger kmg said...

Hyperlink here.

2:29 PM, October 14, 2011  
Blogger Unknown said...

kmg,

Thanks, I have read some of the blog and really like it.


Helen

2:32 PM, October 14, 2011  
Blogger VMM said...

This comment has been removed by the author.

3:11 PM, October 14, 2011  
Blogger VMM said...

This comment has been removed by the author.

3:12 PM, October 14, 2011  
Blogger br549 said...

Mary's back!

Out of meds again, Mary?

6:10 PM, October 14, 2011  
Blogger davod said...

How do we find out if this about money, not science

11:58 PM, October 14, 2011  
Blogger Dave114 said...

If only it were effect like mammograms. Oh... wait.

1:37 AM, October 15, 2011  
Blogger SGT Ted said...

Well, something needs to be done about a test that also leads to the unnecessary immasculation of alot of men.

Imagine this applied to the More Equal sex:

"well, Ms Jones, Your MSA came back high so, we better cut off your breasts to be sure you don't get cancer."

11:05 AM, October 15, 2011  
Blogger Joe said...

All the men that died as the result of false positives aren't around to write the opposing viewpoint.

This is the same problem with early mammograms and a lot more medical testing. You can almost always find a survivor, but the victims have no voice, they're dead.

As a side note, almost a year ago, my doctor discussed this. His actual experience was that for those not diagnosed with prostate cancer, the test was a waste of time and money and caused more problems that it solved. He pointed out that without a baseline for an individual, the test is essentially meaningless. However, for someone with prostate cancer, using the test before and after treatments serve as a very good indicator of how the treatment is going and if the cancer has returned.

What's truly bizarre is that the author concedes that the PSA test is horrible and then argues that research will come up with something better as though this obviates the fact that the PSA test stinks.

Finding that something is medically ineffective doesn't mean it won't lead to something that is effective. That's how science works. But to load up the politics and say that a medically ineffective test and/or treatment should continue because it sounds good and does help some people (even if kills far more) isn't science, but politics.

(And do note that the task force isn't saying that the test should be banned, just that it should be optional. The author is resorting to the same hyperbolic bullshit as the wackos pushing useless mammograms.)

3:37 PM, October 15, 2011  
Blogger davod said...

One of the Doctors who pontificates on Fox recently discussed a new report on prostrate cancer. He said that you are better off having the surgery as soon as the cancer is confirmed. The reason being that if you didn't have the surgery your body is in a much worse position to withstand surgery after all the interim procedures failed to kill the cancer.

4:13 PM, October 15, 2011  
Blogger davod said...

Ps. No early test, more incurable cases.

4:15 PM, October 15, 2011  
Blogger davod said...

WRT mamograms. As I recall, the problem for the "Death Panel" was when they made the ruling about less mammograms they also couched the measure in terms of dollars saved.

4:30 PM, October 15, 2011  
Blogger dr.alistair said...

my prognosis; stay away from hospitals and doctors as long as humanly possible.

in the spring i contracted a urinary tract infection and went to the walk-in clinic. the doctor there gave me antibiotics and i went home, only to experience shivering fever that evening like i've never had before.

at 2 in the morning i drove to the emergency and they pumped me full of all sorts of things and attached me to devices until i was released at 10.00am with new meds and the understanding that the first meds were for children.

two days later i read some of the tests the doctor at the walk-in wanted me to undergo and discovered they were suggesting that i was experiencing early signs of prostate cancer and that i needed be tested and treated early.......

needless to say, six months later i'm fine and can urinate with ease!

11:46 PM, October 15, 2011  
Blogger hga said...

"He pointed out that without a baseline for an individual...".

And just how difficult is that? My last test was ~ $80 cash out of my pocket. Having learned in middle of this year that I have a family history of aggressive prostate cancer on both sides you can be sure I'll continue to establish a baseline with regular tests.

5:22 PM, October 17, 2011  
Blogger Betsy said...

My father in law had prostate cancer -- or maybe not. Maybe he just had a false positive. We'll never know. Left him with incontinence problems -- don't want to know if he's also buying little blue pills.

Women with so-called stage 0 breast cancer get a course of radiation treatment and, from what I understand, are pronounced cured. Not so for men and a positive PSA test. But what's the right proportion -- how many false positives, leaving men with unpleasant impairments afterwards, are acceptable for each life saved?

11:13 PM, October 20, 2011  

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