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Prostate Cancer Screening

Discussion in 'Everything Else' started by lincoln, Dec 18, 2011.

  1. WorkingClassRugger Mark Ella (57)

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    Hahaha.I'd be tough as a coffin nail though.
  2. lincoln Syd Malcolm (24)

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    WCR, FYI re me choice re PSA testing (fraught with folly?:( ),

    1. Read the article written by the Chief Medical Officer of the American Cancer Council

    "The problem with prostate cancer screening is this cancer has a varied biologic behavior. Many, perhaps even most, men with diagnosed localized prostate cancer have a disease that will never progress and cause harm. Treatment for these men will only cause side effects. They are cured, but do not need to be cured.


    The American Urologic Association in its 2009 "PSA Screening Best Practice" statement recommends that prostate cancer screening be done but says, "Given the uncertainty that PSA testing results in more benefit than harm, a thoughtful and broad approach to PSA is critical. Patients need to be informed of the risks and benefits of testing before it is undertaken. The risks of overdetection and overtreatment should be included in this discussion. "


    A man choosing regular screening might benefit in that his life might be saved. That man might also be harmed by suffering the effects of unnecessary diagnosis and treatment. I say "unnecessary diagnosis" as there are now studies showing that men concerned about a diagnosed prostate cancer have a higher risk of depression and suicide."


    2. I have no family history (a very long/broad male lineage).

    3. I am healthy.

    4. I am married to a doctor who does not recommend PSA testing for someone with my profile.


    The DRE may be a better screening procedure.
  3. WorkingClassRugger Mark Ella (57)

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    Like I said, far be it for me to attempt to influence your decision as I don't know you apart from here, you clearly have put a considerable degree of thought into your reasoning. However, I bet you could ask many a prostate cancer sufferer their perspectives on their health prior to the symptoms emerging and I bet they'd say something similar to that you have stated above bar being married to a doctor.
  4. cyclopath Phil Waugh (73)

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    Lincoln, there is a disconnect between the statement "most, men with diagnosed localized prostate cancer have a disease that will never progress and cause harm"
    and the assumption that they all need to be treated. Many low risk cancers can be managed by active surveillance rather than treatment. This "treatment" option is growing. I personally manage many prostate cancers this way.
    American data does not "fit" perfectly with Oz - Prostate Cancer is significantly over-treated in the USA, and has been for the past few decades.
    The AUA position statement is intelligent -
    "Given the uncertainty that PSA testing results in more benefit than harm, a thoughtful and broad approach to PSA is critical. Patients need to be informed of the risks and benefits of testing before it is undertaken. The risks of overdetection and overtreatment should be included in this discussion. "
    Your second point is the most pertinent - long history of longevity in males without a specific family history of prostate cancer.
    I'm not criticising your choice - you are clearly informed and appraised of the risks / benefits, and this is the message that is most important to get out there. You have made an informed decision.
    The message that is old and less relevant is that it is a disease of old men and one we should not worry about - a significant number of men die from it. They are the ones we need to target, and techniques for doing that are getting better all the time.
    DRE is a crude screening method at best - there have been many scientific papers to that effect.
  5. lincoln Syd Malcolm (24)

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    Thanks Cyclopath - this is precisely what I was seeking - an informed debate, rather than emotive discussion, resulting in more men actively assessing their options and seeking the best outcome for their circumstances. I kind of thought there would be a bunch of knowledgeable folk on this site that could share their wisdom on the topic. Cheers.
    cyclopath likes this.
  6. lincoln Syd Malcolm (24)

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    Cyclo, do you know of any research that either supports or disagrees with the findings of this study (and I accept it is only an epidemiological study)?

    In this recent prostate cancer study, the odds ratio for failure after surgery was 5.68 for the 3rd vs 1st tertile of pre-diagnostic sugar consumption.

    https://www.ncbi.nlm.nih.gov/pubmed/28417914
  7. cyclopath Phil Waugh (73)

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    No, I do not, off the top of my head.
    Vit D is an interesting one - I have certainly noticed a big upswing in GPs testing for Vic D levels on "routine" blood panel tests which many patients seem to get. You rarely see "high" Vit D levels on those, rather more lower levels probably related to reduced sun exposure.

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