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Prostate Cancer Screenings Essentially Useless

mono5
Posts: 98
Joined: Jan 2009

Regular prostate cancer screening has no effect on the risk of death from the disease, according to a large-scale, long-term study conducted by researchers from the National Cancer Institute and published online in the New England Journal of Medicine.

"There was little or no scientific evidence that it saved lives," said Otis Brawley, chief medical officer for the American Cancer Society. Go to...

http://www.naturalnews.com/026477_cancer_Prostate_prostate_cancer.html

4MYGUY
Posts: 12
Joined: May 2009

mono5
Was there recommended effective alternative?
A roll of the dice isn't much of an option.

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

If I had not been having regular yearly screening since my dad was diagnosed then the Dr. would not have found my cancer. Mine is classified as borderline aggresive. Dr. told me If I waited 5 more years the cancer would be in my nerves and spread through out my body. So I disagree and believe that the regular prostate cancer screening for me helped.

Larry

lshick's picture
lshick
Posts: 63
Joined: Apr 2009

I haven't worked my way down to the original NEJM article yet, but note that the men were followed "from seven to ten years." PC, untreated, rarely kills in 7 years, nor even 10 (according to Scardino's book), so it's no wonder they found little difference. You don't start to separate the quick from the dead until after 10 years. I assume that the people who organized the study know that, so the conclusion is that they rigged the study (by choosing the duration) to give the answer they wanted to publish.

If they really wanted to find out whether screening works, they needed to look at 10, 15 and 20 year survivals.

I also notice that the naturalnews.com page is advertising selenium as a PC treatment. Obviously they didn't get the memo.

hopeful and opt...
Posts: 1305
Joined: Apr 2009

Is selenium a no no now? I started taking 1000 D3 and selium 200 (yeast) and pomogranate juice each day. I had been taking e, but now I read that thats e no no.

On the screening issue, I'm glad that I know where I stand. Of course on an overall basis, it cost a lot to screen men for prostate cancer, and find those who would benefit from treatment. I guess that there are many who are diagnosed early and get early treatment, with potential side effects, which may not be necesary.

On the other hand,it must be serious because doctors spend a lot on staging, monitoring and treatment once you are diagnosed.

Ira

Kentr
Posts: 111
Joined: May 2009

Although I will continue to have my PSA tested on a regular basis, I kind of wonder about how usefull it is. I saw my doctor today on another matter, mentioned this website and told him there are some guys posting with pretty high PSA levels.

He said that he held the record for having a patient with the highest PSA - 19,000 - holy smoke! The guy was 88 and lived about another 18 nonths ultimately dying from a heart attack instead of cancer.

I know it's most assuredly the exception but still.....kind of makes you wonder.

shubbysr's picture
shubbysr
Posts: 87
Joined: Jun 2009

In Sunday's newspaper magazine there is an article by Dr. Ranit Mishori "Breakthrough News In Prostate Cancer"
I was quite surprised at some comments in the article. . . "Many men are better not taking a PSA test". or
"But there's another way to look at the numbers. While a man has a 17% chance of getting the disease in his lifetime, he has onlya 3% chance of dying from it, according to the journal, American Family Physician". . .
My conclusion: I am part of the 17% and the debate continues!

Jim (shubbysr)

Watch.repair.man's picture
Watch.repair.man
Posts: 49
Joined: May 2009

If I had waited much longer the cancer might have been through the wall in my prostate and I don't want to think of where it would head next.
If my blood PSA didn't come back a little high in Feb, who knows.

jimbeam50
Posts: 47
Joined: Oct 2008

What a foolish report to publish. When my husband was first diagnosed I was asking every man I met "have you been screened yet" Most always it was a no. Now they will hear about this report and think there is no need of it! I think there should be a public screening offered for anyone to go. Just take a blood test. You need to discover PA before it leave the prostate why don't they do a study on that. Since my husband has been sick I do know of a few men who have been check out with him in mind. Sheila

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

I agree with you. I have several friends that have gone and got tested since I found out about my cancer. Luckily they are OK (Which makes me a little jealous) But now they have a baseline. Two of the men have a family history of PC and had not bothered to get a check and they are both older then me.

Larry

Kentr
Posts: 111
Joined: May 2009

After I found out about my cancer, I suggested everyone of my friends get checked out so they had a baseline to work from. Sadly, I think only one or two actually did. My guess is that reluctance to do so is fear based, foolish but understandable to a point.

gleason9
Posts: 6
Joined: Jul 2009

My PSA scores were below 4 for 8 years then 4.6 10 months later 6.8 not outrages compared to others I have heard of. However my other systems consisted of blood in urine and pain plus significant fatigue in my legs. After a pathology report on my prostate the camcer had spread beyond the prostate and A Gleason score of 9. NOT GOOD> So the PSA isn,t they only test or symptom to consider.

Mark58
Posts: 29
Joined: Jun 2004

In my opinion, these studies can be manipulated to show what the researcher wants it to show, by looking at restricted populations, and extended or restricted periods of time. There is also the problem of bad data. I had 2 uncles that died of Prostate cancer, however the most recent was said to have died of a stroke. His bone mets was so bad he could barely move. The other had developed Leukemia during his battle with Prostate cancer. It was probably difficult to determine which disease got him. My point is that neither death certificate mentioned Prostate cancer. If I were to gain weight during harmone treatment and die from a heart attack, I'm sure the death certificate would say I died of a heart attack. In my mind the root cause would have been Prostate cancer and the resulting treatment. Basically, I don't put much stock in studies done by researchers. Just my opinion!!!

Watch.repair.man's picture
Watch.repair.man
Posts: 49
Joined: May 2009

I agree with you.
It depends which way they are paid to go, Kind of like the news, just my opinion.
Keven

lion1
Posts: 240
Joined: May 2007

It saved my life-----------------------I was 46------ Lion1

lshick's picture
lshick
Posts: 63
Joined: Apr 2009

There's another way to look at small studies (this isn't a small study, but it is NOT A LONG TERM STUDY, at least in the context of PC).

When I was younger I had a temporary interest in ESP (say, reading hidden cards), from the skeptic's point of view. One of the things I learned was that, when you have a small study, you typically have a threshold of statistical significance of maybe 5%. That means that, if you were to run a study 20 times, in one of those you'd get a statistically significant result supporting your hypothesis EVEN WHEN the underlying facts/mechanism were contrary to your hypothesis.

So the way the ESP guys do it, they just keep trying, maybe with different volunteers, doesn't matter. Roughly one time in 20 they'll get a "statistically significant" result, and THAT'S what they report to the uncritical press. Just don't mention the other 19 tries. Or say that 5% of the people have the ability.

Now for PC drugs, maybe they re-jigger the formulation, or the dosage, or whatever. I'm sure it's all done in good faith. I'm sure they're convinced that THIS time, they've got it right and they really have achieved a cure. Or maybe 5% of guys respond to their treatment.

But maybe it's just one in 20.

shipjim's picture
shipjim
Posts: 130
Joined: Apr 2006

I agree that the PSA test doesn't diagnose anything. That is not it's goal its a marker or indicator of change. The biopsy is the telling test. If you don't want to know the answer or risk factor then don't take the PsA and certainly not the biopsy.
Personally I'm thrilled there is a PSA which allowed me to move on the biopsy (thrilled and biopsy dont really go together) but we caught it and got it out at that point.

I fail to see how regular testing could not help but effect the long term risk as you at least have knowledge on which you can act.

I just went to NEJM and NCI and read their comments. The long term (as described in a 7-10 yr study) deaths weren't different but those who were suspected either by digital or psa and went on for treatment didn't die at no point do the studies or commentaries say they are useless just that the death rates are similar. AGAIN no comment on treatment if cancer is suspected.

Additionally, note the followiing copied from NCI website:

Review of Prostate Cancer Prevention Study Shows No Benefit for Use of Selenium and Vitamin E Supplements

Initial, independent review of study data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), funded by the National Cancer Institute (NCI) and other institutes that comprise the National Institutes of Health shows that selenium and vitamin E supplements, taken either alone or together, did not prevent prostate cancer

gkoper's picture
gkoper
Posts: 174
Joined: Apr 2009

A substantial rise in psa levels is a signal that something may be wrong. Biopsy confirms it. The testing is so easy...I get my psa & cholesterol done at the same time. I suppose there are those who don't want to know.....

Winchef's picture
Winchef
Posts: 13
Joined: Jun 2009

If it hadn't been for PSA testing, I shudder to think where I may be headed. Luckily my Dr. does PSA tests as part of the normal yearly physical. The test is not covered by insurance and costs $50.00 The best $50.00 I ever spent.
Last year my numbers were a low 2.2 One year later, it was 4.9 which prompted him to send me to a urologist for further investigation. My biopsy revealed 2 tumors with Gleason scores of 3+3 and 4+4 and a clinical stage 2. Post pathology revealed the cancer had spread to nerves on one side that had the 4+4 score. The surgeon spared the nerves on the other side. My point is that if it hadn't been for that rise in scores, nothing would have been done and the cancer would have infiltrated my body and possibly spread elsewhere.
I have 2 older brothers who have had scores in the 20's, had biopsies and negative for cancer. Are the results consistent and reliable? Not really, but they do raise flags and that leads to more reliable tests like biopsies. Now that I had cancer, the tests are free for me. I would gladly pay the $50 for peace of mind.

Dave

lshick's picture
lshick
Posts: 63
Joined: Apr 2009

The full text of the original article that prompted the hoo-hah is now out, and it's no surprise that the popular press took a subtle, complex message, and got it wrong. Rational commentary and pointers to the original articles are here: http://prostatecancerinfolink.net/2009/07/02/brawley-et-al-on-prostate-cancer-screening/#more-6242

dopplerjockey's picture
dopplerjockey
Posts: 39
Joined: Jul 2009

In my case folks, my PSA's have always been low. Two years ago my PSA was 0.18, and I had a normal digital rectal exam by my family physician, (I chose her because she had small hands.) LOL. The next year, my PSA was 0.24, and that rectal exam revealed "nodules". She referred me to a urologist in Boise, ID, who also palpated a single nodule. The initial biopsy revealed HPIN cells. A follow-up biospy 11 months later revealed adenocarcinoma in the left lobe of the prostate, and again, my PSA was low at 0.34. After undergoing robotic radical prostatectomy in Boise, ID, the pathologist who reviewed the entire prostate specimen isolated cancer in the right and left lobes, leading to a Gleason score bumped up to 7.
So, I'm not sure that the PSA levels I had without the digital rectal exam would have given us the true diagnosis. Fortunately, the surgical margins of my prostate where clear, which gives my surgeon hope that I might beat this thing, but only time and frequent PSA levels will tell. So, the moral of the story, "get the digital rectal palpation exam" when you get the PSA drawn. The digital exam is only uncomfortable for a short time.

shubbysr's picture
shubbysr
Posts: 87
Joined: Jun 2009

The more we read or the more that is published about screenings, i.e. PSA, mammograms etc. The more we cannot decide which way to go. Today's New York Times has an article that downplays the value of cancer screenings. Well, I think they should ask those of us with PC and how we found out we have cnacer
"and the beat gores on . . ."

Peter51's picture
Peter51
Posts: 29
Joined: Nov 2004

Yes it is true that many men "die WITH prostate cancer and not FROM it". I have often heard it referred to as an "old man's disease". Well some of us may develop it at a young enough age that we could possibly live longer as a result of early detection! So let's say that someone develops prostate cancer and is age 70 years old. He may be better left alone and live on to succumb for other reasons. Now how about a person in his mid-forties that developes prostate cancer. Isn't it likely that his life will be shortened from the disease and could have been prolonged from early detection and treatment? Now apply this to a cross section of men of different ages and each in differect levels of health. Maybe we have a 70 year old who is as fit as a 40 year old and would live quite long if detected and treated at that age.

I was in excellent physical condition when at age 49 I had a PSA of 8.4. A year later it had increased to 13.6. I then was diagnosed and treated with RP. I believe that since I am now five years out with no detectable PSA reading that my life has been saved and prolonged. I humbly thank our medical industry for the testing of my PSA and pursuing further investigation which ultimately led to my Radical Prostectomy. I am convinced that PSA tests can save lives.

Peter

gaburrell
Posts: 25
Joined: Jul 2009

I agree. A PSA test only a signal that something may be wrong. I am 54 with a PSA of 6.4 but after by biopsy I found that I have a Gleason Score of 7 (3+4). Had I not had the PSA test I would not have had the biopsy. My results are not terribly high but at age 54 I should take action.

Gil

shubbysr's picture
shubbysr
Posts: 87
Joined: Jun 2009

Hey Gil,
I like you had an elevated PSA (4.8) and Gleason of 7 (4+3)
Had Radical DaVinci on May 1. two prominent cancer nodules but, contained to the prostate gland. Will always wonder if I had not taken action but, not for long.

shubbysr

Medcomglen's picture
Medcomglen
Posts: 95
Joined: Jun 2009

Diagnosed as a stage 4 two years ago. I was 56 yrs. old when I received my FIRST PSA score of 14.7. No prior PC symptoms. I have to thank the Doctor filling in for my Primary care Physician while he was on vacation. I probably wouldn't have had a PSA test ordered from my PCP for sometime. Can't look back but I often wonder about my current situation if I had only demanded a PSA at age Fifty.

shubbysr's picture
shubbysr
Posts: 87
Joined: Jun 2009

Well, we can look back and wonder but, not for long because it does not matter. We may never know why some docs treat differently that others, especially with preventative or early detection.
I relocated to the South 5 years ago and I get puzzled looks from docs when I expect certain exams during my annual physical. I remember one doc who would not do a DRE. Another did not recommend colonoscopy, even though I have STRONG family history af male colon cancer. One can only wonder . . .

shubbysr

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Curious where in the South you are at. I live near Chattanooga Tn.

Larry

shubbysr's picture
shubbysr
Posts: 87
Joined: Jun 2009

Hey Larry,

Aiken, South Carolina. (near Augusta, Georgia)
I relocated from Detroit, Michigan due to job reduction!

Jim (shubbysr)

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