New Guidelines

Trew

randy_in_indy said:

Very interesting viewpoint Joe
I think you may be onto something...if it's true it's a shame and very sad that the reform will then certainly end in a huge disadvantage to the patient...very sad indeed.

And cancer patients need
And cancer patients need just about every advantage they can get. I see little room for cutting on expenses with cancer. It is amazing what some cancer patients have been through and the cost of their treatment. Is it worth it? Such a question should not even be part of any health debate. somehow I like to think that every cancer patient is helping those who may get the disease in the future.

active surveillance

jminnj said:

HealthCare Reform
I believe that this is a lead in to the health care reform. I think the medical community is seeing that they may need to change their guidelines, not for the benefit of the patient, but rather, for where they think they are going to need to be if/when a health care reform bill is passed.

Parts of the current proposal do not allow for annual testing but rather testing every other year or longer. That scares me for everyone, men and women alike. The other piece that frightens me a little is that one of the proposals out there that would include the "public option" would exclude "pre-existing conditions". Guess where that puts us?

Do we need better healthcare in this country? Yes, without a doubt. I am just not sure that any of the proposals (from either side of the fence) are going to work. They really need to work together, not against each other. (sorry i will get off that soap box now)

fact checker
The current package will not allow H.Ins.Co.s to "exclude" us for pre-existing conditions such as PC.

active surveillance

active surveillance said:

fact checker
The current package will not allow H.Ins.Co.s to "exclude" us for pre-existing conditions such as PC.

new guidelines, the messenger
Just in:

The ACS recommends that men age 50 with no symptoms of prostate cancer who are in relatively good health should be active in making an informed decision with their physician about prostate screening.

Men at high risk – African-Americans and men with a father, brother or son diagnosed with prostate cancer before age 65 – should begin that informed-decision talk earlier, at age 45. Those at higher risk, such as men with multiple family members affected by the disease before age 65, should start talking about screening at age 40.

For men unable to make a decision about screening after these conversations, the ACS recommends a doctor decide whether or not to screen based on knowledge of a patient’s health preferences and values. After a decision to screen is made, the new guidelines make the digital rectal exam portion of the testing optional, and they say it is acceptable to extend the period between screenings for men with low PSA levels.

Partridge says there are limits to both PSA and the digital-exam method, and even when these tests detect cancer, physicians often can’t tell how dangerous the cancer is without further tests or medical procedures. Some prostate cancers grow slowly and never cause any problems; others may grow aggressively.

Physicians and cancer-prevention experts note the urgent need for better ways to detect and treat early-stage prostate cancer, particularly the need to distinguish between cancers that do not require treatment and those that are actively growing. The American Urological Association, for example, insists that shared decision-making should involve personal data that is more in-depth than age, such as ethnicity, family history, previous biopsy characteristics and other factors.

Until new screening tools are available, it is crucial for care providers and cancer-prevention program directors give men the opportunity to decide whether they wish to pursue early detection for this disease.

About the UAB Comprehensive Cancer Center

The UAB Comprehensive Cancer Center is among the 40 cancer centers in the nation to meet the stringent criteria for the National Cancer Institute’s comprehensive designation. The center is a leader in groundbreaking research, reducing cancer disparities and leading-edge patient care.

hopeful and optimistic

active surveillance said:

new guidelines, the messenger
Just in:

The ACS recommends that men age 50 with no symptoms of prostate cancer who are in relatively good health should be active in making an informed decision with their physician about prostate screening.

Men at high risk – African-Americans and men with a father, brother or son diagnosed with prostate cancer before age 65 – should begin that informed-decision talk earlier, at age 45. Those at higher risk, such as men with multiple family members affected by the disease before age 65, should start talking about screening at age 40.

For men unable to make a decision about screening after these conversations, the ACS recommends a doctor decide whether or not to screen based on knowledge of a patient’s health preferences and values. After a decision to screen is made, the new guidelines make the digital rectal exam portion of the testing optional, and they say it is acceptable to extend the period between screenings for men with low PSA levels.

Partridge says there are limits to both PSA and the digital-exam method, and even when these tests detect cancer, physicians often can’t tell how dangerous the cancer is without further tests or medical procedures. Some prostate cancers grow slowly and never cause any problems; others may grow aggressively.

Physicians and cancer-prevention experts note the urgent need for better ways to detect and treat early-stage prostate cancer, particularly the need to distinguish between cancers that do not require treatment and those that are actively growing. The American Urological Association, for example, insists that shared decision-making should involve personal data that is more in-depth than age, such as ethnicity, family history, previous biopsy characteristics and other factors.

Until new screening tools are available, it is crucial for care providers and cancer-prevention program directors give men the opportunity to decide whether they wish to pursue early detection for this disease.

About the UAB Comprehensive Cancer Center

The UAB Comprehensive Cancer Center is among the 40 cancer centers in the nation to meet the stringent criteria for the National Cancer Institute’s comprehensive designation. The center is a leader in groundbreaking research, reducing cancer disparities and leading-edge patient care.

Thanks for sharing this information
To be honest, I am surprised by these guidelines, maybe because I have the disease and now I am aware of many who have the disease, I would have hoped that the guidelines would be more stringent, not less.

Tell me what dies UAB stand for.........does this center concentrate on active surveillance protocols.

I am doing the active surveillance protocol at ucla. I've heard that uc san francisco does a very good job.........I'm sure that there are other centers that are recognized as leaders for active surveillance protocol...........however, I don't know which centers are the leaders.......I wonder, do you(or other posters) have any knowledge about this.

Thanks,
Ira

2ndBase

jminnj said:

HealthCare Reform
I believe that this is a lead in to the health care reform. I think the medical community is seeing that they may need to change their guidelines, not for the benefit of the patient, but rather, for where they think they are going to need to be if/when a health care reform bill is passed.

Parts of the current proposal do not allow for annual testing but rather testing every other year or longer. That scares me for everyone, men and women alike. The other piece that frightens me a little is that one of the proposals out there that would include the "public option" would exclude "pre-existing conditions". Guess where that puts us?

Do we need better healthcare in this country? Yes, without a doubt. I am just not sure that any of the proposals (from either side of the fence) are going to work. They really need to work together, not against each other. (sorry i will get off that soap box now)

I guess we do not need health care reform because people should be fired if they have cancer, be unable to afford Cobra, and be driven to bankruptcy. It happened to me and it can happen to you. Vote for the status quo and keep quiet. God knows you shouldn't have to donate to the welfare of another human being. REALLY?

active surveillance

hopeful and optimistic said:

Thanks for sharing this information
To be honest, I am surprised by these guidelines, maybe because I have the disease and now I am aware of many who have the disease, I would have hoped that the guidelines would be more stringent, not less.

Tell me what dies UAB stand for.........does this center concentrate on active surveillance protocols.

I am doing the active surveillance protocol at ucla. I've heard that uc san francisco does a very good job.........I'm sure that there are other centers that are recognized as leaders for active surveillance protocol...........however, I don't know which centers are the leaders.......I wonder, do you(or other posters) have any knowledge about this.

Thanks,
Ira

Protocols are under construction for active surveillance
What they are using now is three consecutive PSA rises in a row (not sure what value assigned) and/or DRE with it. They want and need DNA biomarkers that define the cancer as agressive or indolent so the patient will know more accurately when/how to act with treatment.
They currently use more biopsies in their protocol (ugh). Color Doplar ultrasound imaging is on the horizon to establish status of our cancers , that should be well received.
So much seems in the development stage but watch the net for news every day on active surveillance.


I believe the UAB was Urology ****. Birmingham but would have to look back.

active surveillance

hopeful and optimistic said:

Thanks for sharing this information
To be honest, I am surprised by these guidelines, maybe because I have the disease and now I am aware of many who have the disease, I would have hoped that the guidelines would be more stringent, not less.

Tell me what dies UAB stand for.........does this center concentrate on active surveillance protocols.

I am doing the active surveillance protocol at ucla. I've heard that uc san francisco does a very good job.........I'm sure that there are other centers that are recognized as leaders for active surveillance protocol...........however, I don't know which centers are the leaders.......I wonder, do you(or other posters) have any knowledge about this.

Thanks,
Ira

good cancer center
Ira, thanks for all of your good input on all of this.
Check out "Cancer Centers of America" website , mainly located in Tulsa OKLA.
They pay for your flight there for the consult and treatment.
Also have programs for lodging that are inexpensive.

hopeful and optimistic

active surveillance said:

Protocols are under construction for active surveillance
What they are using now is three consecutive PSA rises in a row (not sure what value assigned) and/or DRE with it. They want and need DNA biomarkers that define the cancer as agressive or indolent so the patient will know more accurately when/how to act with treatment.
They currently use more biopsies in their protocol (ugh). Color Doplar ultrasound imaging is on the horizon to establish status of our cancers , that should be well received.
So much seems in the development stage but watch the net for news every day on active surveillance.


I believe the UAB was Urology ****. Birmingham but would have to look back.

Thanks for the good information
I notice that different hospitals depending on resources, have different protocols for active surveillance.

Rising PSA....I've also read about looking at rate for doubling of PSA not to be more than at a three year rate.

The Color Doppler ultrasound is very well received by many here in CA. Thre is a radiologist, duke bahn who does this test, who is considered to be an expert.........basically there is a print out of the biopsy in color, and many swear by this test...they go to ventura to see this doc, and he manages these people(surprising since he is a radiologist)....he is very successful....it is said that this test in the hands of an experienced radiologist can identify "lesions" probable tumors, smaller than 0.5cc.

I spoke to my doctor about getting this test........he tells me, basically that the MRI with the Spectroscopy is preferred. Also that the basic biopsy is preferred....he told me that at ucla , they have the equipment for the color doppler , but they don't use it very often, on occassions when one is not able have an MRI.......he does not think much of the test.......to be honest he went into medical technology which was beyond me to explain this......in a separate meeting I spoke with the Fellow, who told me the same.

Dan33605

New guidelines
I was diagnosed with stage 4 PC at age 48 , If I had followed the current American Cancer Society guidelines I would not be here ,I geuss that makes me expendable . I have been on Hormone therapy four 4 years now , thankfully .
almost 30,000 Men die every year in this country from Prostate Cancer .
I have not seen anything the American Cancer Society has ever done for Prostate Cancer and I will not be donating any more.

bdhilton

This is serious stuff for us
I am not only part of a study at Northwestern (actually 4) now but my father’s medical records along with my brother are part of these studies now… Northwestern is beginning to think that the same DNA issue we have also causes Breast Cancer…. With a father that had prostate cancer, a brother 4 years ago with a PSA of over 400 and 4 sons (28-16) test test test and research research research…

hopeful and optimistic

bdhilton said:

This is serious stuff for us
I am not only part of a study at Northwestern (actually 4) now but my father’s medical records along with my brother are part of these studies now… Northwestern is beginning to think that the same DNA issue we have also causes Breast Cancer…. With a father that had prostate cancer, a brother 4 years ago with a PSA of over 400 and 4 sons (28-16) test test test and research research research…

Albert Einstein Medical Center, nyc
There had been a study done that linked prostate and breast cancer in jewish families.

I am not surprised.........my 91 year old mother , this year was diagnosed and treated for breast cancer.

Ira