Debate on prostate screening

[Lone Star]

I found this while cruising the MSN website:

[align=center:78beef262e]Elderly men shouldn't get prostate screening[/align:78beef262e]

[align=center:78beef262e]Federal panel recommends doctors stop routine procedure after age 75[/align:78beef262e]

NEW YORK - Doctors should stop routine prostate cancer screening of men over age 75 because there is more evidence of harm than benefit, a federal task force advised on a hotly debated topic.

The U.S. Preventive Services Task Force, which made the recommendation Monday, reported finding evidence that the benefits of treatment based on routine screening of this age group “are small to none.” However, treatment often causes “moderate-to-substantial harms,” including erectile dysfunction and bladder control and bowel problems, the task force said.

The new guidance is the first update by the task force on prostate cancer screening since 2002. Its last report concluded there was insufficient evidence to recommend prostate screening for men of all ages.

In recent years, there has been a growing debate about the value of the somewhat imprecise PSA blood test to detect cancer, as well as the value of treating most prostate cancers. A positive result from the test must be confirmed by a biopsy. And even then, there is no foolproof method of identifying aggressive tumors from slow-growing ones. A number of experts contend patients are being overtreated.

Most major U.S. medical groups recommend doctors discuss the potential benefits and known harms of prostate screening with their patients and make individual decisions. And most agree such testing shouldn’t occur before age 50.

The federal task force, which sets the nation’s primary care standards, reviewed past research in reaching its conclusion and “could not find adequate proof that early detection leads to fewer men dying of the disease,” task force chairman Dr. Ned Calonge of Denver said in a statement.

Prostate cancer is the most common cancer in American men — about 220,000 cases will be diagnosed this year. It is the second leading cause of cancer deaths in men. But most tumors grow so slowly they never threaten lives.

Earlier this year, a study found that older men who already had early-stage prostate cancer were not taking a big risk by not treating it right away. The vast majority were alive 10 years later without significantly worrying symptoms or had died of other causes.

Prostate cancer treatments are tough, especially on older men. Some doctors instead recommend “watchful waiting” to monitor signs of the disease and treat only if they worsen, but smaller studies give conflicting views of the safety of that approach.

The new guidelines from the Preventive Services Task Force were published in this month’s Annals of Internal Medicine.

Link

[Just Plain Ruff]

I watched my grandfather go thru the prostate surgery and then chemo for prostate cancer. He was 69 years old or so. From there on out it was downhill but he did live 30 more years so I don't know whether it was a good thing or not but he suffered from associated symptoms throughout the years after that surgery.

Does the benefit of this testing outweigh the risks?

[Doczilla]

I remember something like this from anatomy class: 80-90% of men are found to have a prostate cancer on autopsy. The vast majority (obviously) never metastasize or become clinically relevant.

Treatment for this condition is not fun. For that matter, diagnosis isn't a laughing matter either (let's make dozens of tiny holes through your rectum into your prostate. No thanks.). Trouble is, right now we have a hard time telling the difference between those that will remain harmless and those that will become deadly, so each patient has a difficult decision to make.

'zilla

[Just Plain Ruff]

Lone, don't cancel your prostate exam quite yet. YOu and Terri are the two oldest members here and I don't think Terri qualifies for a prostate exam.

[Lone Star]

DAMN! Here I thought I might be able to dispense with that 'special exam' with the elbow length formal latex glove with only one finger!!!!!

:cussing: :cussing: :cussing: :cussing: :cussing: :cussing: :cussing: :cussing: :cussing: :cussing:

:angryfire: :angryfire: :angryfire: :angryfire: :angryfire: :angryfire: :angryfire: :angryfire: :angryfire: :angryfire: :angryfire: :angryfire:

:pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright: :pukeleft::pukeright:

[Spock]

We were talking about this just the other day in the cysto room. The urologist said he had several patients in his office who were incensed over this. They all were active men in their 70's and 80's and were not ready to just up and die. They wanted the testing because they wanted to know if they had prostate CA and could make an informed decision on treatment options. The jury is still out on this and prostate screening is probably still indicated for most men.

Live long and prosper.

Spock

[emtannie]

They wanted the testing because they wanted to know if they had prostate CA and could make an informed decision on treatment options.

Isn't this the best case scenario? People being proactive with their own health, and making informed decisions.

My father died of prostate cancer - he was 72. He was diagnosed at age 68, and by the time it was diagnosed, it had already metastasized into the bones if his spine, ribs and legs. At the time of diagnosis, he was given 3 months to live. He agreed to be part of an experimental chemo treatment, as he felt that since he couldn't be saved, perhaps he could assist someone else.

He ended up living 4 years and 2 months after diagnosis. And it wasn't always quality living. The last 8 months he was paralyzed from the mid-lumbar region down, as the cancer had damaged his spinal cord. He was in such pain that he was on high doses of painkillers, which affected his mood and temperament.

Had his cancer been caught in a treatable stage, it would have been easier on him, and my mother.

I realize that prostate screening isn't the most comfortable... but it is a small sacrifice when the alternative is considered, and like Spock said - some would like to make an informed decision. (and, a reminder to the guys.... women have their own medical tests that aren't all fun and games.... mammograms and colposcopies are not a barrel of laughs).