PCa survival is best in the US

[dockam]

I know it's from 2015, I assume the current stats are similar:

cdc.gov/cancer/dcpc/researc...

Fight on y'all

[tom67inMA]

I find it interesting that if you ignore the "childhood leukemia" column, the US is ahead of the the countries with universal health coverage. Hooray for capitalized medicine?

[BarronS in reply to tom67inMA]

The only main difference is prostate cancer. If what you said is gospel, all other survival statistics should be superior.

It's far more likely that what is happening is what pjoshea13 said. Also, prostate cancer mainly affects those over the age of 60, many of whom would be on medicare - which is socialized medicine. I'm not here to debate the ethics or healthcare systems though.

[tom67inMA in reply to BarronS]

Good points. I've generally been in favor of universal coverage, so the numbers struck me as unexpected, thus the ? at the end.

[BarronS in reply to tom67inMA]

Sorry if that came across as dickish or combative. I live in PA, we have a notorious healthcare provider here known as "commonwealth health". It's one of the worst hospital systems in the country and it's all for-profit. I received "healthcare" there around 3 years ago because I was getting some arrhythmia. The doctor didn't even come in and see me and then ended up hitting me with a surprise out of network bill from Kentucky for 600 bucks, on top of the hospital bill. I know 2 people that were practically slaughtered there.

All I advocate for is the best healthcare possible for people that need healthcare. I don't care what system that's in. Just as long as people who need it, get quality care. Regardless, I truly do wish you the best of luck and am sorry if that came across wrong.

[tom67inMA in reply to BarronS]

No problem, my initial post was vague and this is a hot button issue. What's not included in the data are how many people survive but end up bankrupt in the process.

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

dickish? Searched dictionaries and google no such word. Did you mean prickish?

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/16/2019 5:38 PM DST

[pjoshea13]

There are several things to consider:

- Over-diagnosis is high in the U.S. This inflates survival statistics.

- The U.S. was an enthusiastic adopter of PSA screening. Early diagnosis = early treatment = longer survival. The USPSTF stance against PCa screening has already resulted in more men being diagnosed at a later stage & with a poorer prognosis.

- While it may be comforting to know that almost 100% of U.S. men diagnosed with PCa will survive beyond 5 years, the 5-year mortality for men diagnosed with metastatic PCa is frightening.

-Patrick

[3100connecticut in reply to pjoshea13]

Better over-diagnosis than under. I live in Thailand, where prostate cancer is relatively rare (as in most of Asia). I have been under the care of a doctor who has my blood tested three times a year for cholesterol, sugar and a host of other stuff, in addition to keeping tabs on my COPD. She's a wonderful doctor and has cared for both my wife and myself for over 12 years. But...not once in all those dozens of blood tests did she think to include a PSA scan. It's just not something that registers on doctors' radar here. Then two months ago after I had a negative colonoscopy she for some reason included a PSA screen and it was 22. Went straight to a urologist who ordered a prostate MRI, bone scan and biopsy. But he sent me not to his hospital but to the government's veterans hospital for all of that, saying it was the only place to get reliable results for prostate cancer. Seems the vets hospital treats the vast majority of PCa cases here and is considered specialist in that area. Started on Firmagon three weeks ago. I had loads of questions about all the other drugs I've heard about. The urologist told me -- and this is a true verbatim quote: "Look on Google. They have all the information there." Go figure. So now I'm dealing with hot flashes. Sitting in Starbucks reading the NY Times on my phone and suddenly realize my face is dripping sweat. Thinking all those around me assume I'm watching porn.

[pjoshea13 in reply to 3100connecticut]

You wrote: "Better over-diagnosis than under."

I agree, but over-treatment is the problem.

Medicare (U.S.) should insist on PCa markers in addition to PSA before reimbursing for biopsy. For 30 years, PSA alone has been standard. The developer of the test intended it for identifying biochemical recurrence - not PCa diagnosis.

International survival comparisions should be based on Gleason score.

-Patrick

[monte1111 in reply to 3100connecticut]

Never thought about the porn angle. Geeze. I wonder how many people think I'm a pervert.

[j-o-h-n in reply to 3100connecticut]

Thanks for the tip... Next time I want to watch porn I'll go to Starbucks and when my face is dripping with sweat all those people around me will think I'm on hormones....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 05/16/2019 5:44 PM DST