Another BS Study From The UK

[gusgold]

Like the the study posted here about a week ago that Lupron prevents castrate resistance

Gus

yahoo.com/news/prostate-scr...

[Scruffybut1]

Good morning Gusgold. I agree fully with you although I didn't have any symptoms that would have led me to PSA test. Should be performed on all white adult males from 55 and afro Caribbean from 50. Our UK med profession keeps talking about false positives so don't want to do anything. So bloody what! I notice that our current 'stars' are getting air and TV time but talking a load of tosh and not one has referred to DRE as another confirmatory first strike.

[Kiwi-man in reply to Scruffybut1]

The PSA test is one reason that PCa is one of if the most the most over diagnosed and over treated disease.

This is what the developer of the test has to say -

In this edition of Medscape One-on-One, host and Medscape Editor-in-Chief Eric J. Topol, MD, interviews Richard J. Ablin, PhD, DSc (Hon), who first discovered prostate-specific antigen (PSA) in 1970. At the time, Dr. Ablin and colleagues were trying to identify an antigen that was specific to prostate cancer. What Dr. Ablin identified instead was that PSA was present not only in malignant prostates but also in benign prostates. He did agree, however, that elevated levels of PSA might be useful in predicting a recurrence of prostate cancer in men who were thought to be in remission. It was much to Dr. Ablin's dismay that more than 2 decades later, in the mid-1990s, the US Food and Drug Administration (FDA) approved the use of PSA not only to test for recurrence of cancer, but also as a possible predictor of cancer. Since then, Dr. Ablin maintains, the United States spends billions each year administering a preventive prostate cancer screening test to men, using PSA, that produces false positives in the majority of cases. In his interview with Dr. Topol, Dr. Ablin explains why physicians and patients should proceed with caution when using PSA as a marker for preventive screening.

medscape.com/viewarticle/82...

All men DO NOT need to be tested routinely. That just leads to more panic, more unnecessary anguish, treatment and in unnecessary complications and downstream side effects including Urinary Dysfunction. Bowel Dysfunction. Erectile Dysfunction. Loss of Fertility.

Lets face it if the disease tracks your age. If you are 70 there is a 70% chance of PCa. 80 = 80%. But most men die with it not of it.

ncbi.nlm.nih.gov/pubmed/245...

[Stegosaurus37]

I saw the report in the Daily Telegraph. Here's what's wrong with it: They did just a one-shot PSA measurement. There are very few metrics which will tell you anything from a single observation. For most you need a trend and this is definitely true with PSA. Trends will show up the false positives really quick and will also highlight situations that need further looking at. If my primary care provider had been looking at my PSA trend rather than just going with the Standards of Practice that say "no PSA test after age 70" I might not be in the situation I'm in.

Yes, I know PSA isn't a magic bullet and has its problems, but what else is there? I think part of it is that in large organizations such as Britain's NHS and our large systems, doctors can't take the time to really look beyond the surface. They keep talking about "treating the individual", but they don't see me as an individual. I'm a 75 year old hunk of meat with stage 4, Gleason 9s. That's it. It's up to us to educate our brothers who don't have prostate cancer. If we don't do it, no one else will.

[Desanthony]

Yes, All this has really annoyed me. Especially coming on the heels of the news that PC has now overtaken breast cancer in the mortality stakes in the UK. Take everything with the thought of how much money they are saving today by not giving a baseline PSA test to all 45 to 50 year olds and then testing them every 1 or 2 years to see any trends. With more testing as you age. However, when you think of the cost of PC treatment years later there is no saving! My Dad died at 88 with prostate cancer, my 1st wife died of ovarian cancer at 57, - her sister has been successfully treated for the same, her brother died of prostate cancer at 64 and I have just had successful treatment (so far) for prostate cancer and implore my two sons to get a regular PSA check. My sons are 50 and 55. Thankfully they have not had their GP say to them that PSA tests are useless as they had said to me. The PSA blood test is a tool and if that is explained to men when they have the test we understand that a higher than average PSA or a rising PSA are not always indicative of PC but it does mean that other investigations need to be done to find out if there is PC or some other benign condition is to blame. Too many men do not know anything about PSA or the PSA blood test and all this is likely to put them off asking for the test when they need one. Yes, granted we need a better test but we do not have one so have to use what we have. When I was finally diagnosed I was told to tell all my male relatives and friends to have a PSA test - what I also told them was to have a test every year and explained to them that the PSA needs to be watched not just tested once.

[j-o-h-n in reply to Desanthony]

me ---------------------> FIST BUMP <------------------ Desanthony

GOOD LUCK AND GOOD HEALTH.

j-o-h-n Thursday 03/08/2018 10:14 PM EST

[FCoffey]

The study itself is sound. One may not like the particular method (one PSA test) but that's what they did and what they reported on. The authors were careful and professional in their choice of language and their conclusions.

I personally know several men who had radical prostatectomy and/or radiation on the basis of a single PSA test. It destroyed their lives. Incontinence, impotence, divorce, depression, suicide, it is a long list.

One man I know had a PSA of 2.4. His urologist bullied and rushed him into a radical, insisting that the situation was urgent and he didn't have time for a second opinion or second test.

If one only counts the positive benefits of any treatment, it is much more likely to look like a good and effective treatment. An informed decision requires tallying and balancing both the positive outcomes and the negative results.

Those negatives are pretty clear. Long-term studies consistently show that the number of men needed to treat to keep one additional man alive after 10-15 years ranges from 12 to 33. Put another way, that means 11 men to 32 men got all the many, devastating problems associated with treatment but did not benefit.

Did all those treatments save lives? Certainly. On average, there is roughly a 4% chance that it will keep a particular man alive an extra year or more after 10 years. Cut or burn 100,000 men and that means 4,000 benefited. But flip that around and there is a 96% chance that it did no good and grievous harm.

The PSA test is deeply flawed, and the man who developed it has expressed his regrets on how it has come to be used and abused. The study's authors call for development of more nuanced forms of testing that can more accurately identify men who might actually benefit from treatment. Drop the number needed to treat from 25 or so down to 2 or less, and maybe the risks would be worth it.

Historically and to this day, the PSA test results in a lot of treatments with great harm and no benefit. This study offers strong evidence in support of that statement.

[Desanthony]

The problem is that most people will not read further than the first paragraph or the heading gusgold. We have enough problems with getting men to have PSA tests and for many the thought of a DRE would and does put them off going to the Docs even when they have symptoms! Years ago I started going for checks because I already had prostitis and had a TURP 14 years ago and this came up in conversation with a garage owner who told me he had gone to the Doc with similar symptoms once and had been referred to a urologist but told me I will never go again and go through "that experience" (he meant DRE). For that reason he never kept his appointment with the urologist although he still had worsening symptoms. Whenever I visited his garage I tried to encourage him to go but he was adamant he would not go. I am sorry to say he died of advanced prostate cancer less than 5 years after at 61. The thing is today with social media - and this has been on facebook people are bombarded with so much information which they don't actually read and possibly don't understand correctly without the help of a medical professional - and quite often GPs haven't the time and in depth knowledge to help.