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Advanced Prostate Cancer

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More men diagnosed with advanced prostate cancer as PSA testing drops

cesces profile image
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More men diagnosed with advanced prostate cancer as PSA testing dropsnbcnews.com/health/cancer/m...

The rise in cases of deadly prostate cancer may be partly linked to recommendations against prostate-specific antigen, or PSA, screening for healthy men, experts suggest.

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cesces
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Seasid profile image
Seasid

My PSA was for years between 5 and 6 and my GP said it is only a slightly elevated PSA, i didn't take it seriously and inside one year my PSA was 20 and they said I just have a prostate infection and wanted to treat me with antibiotics.

In 5 months my PSA went from 20 to 40 and I had a sciatica nerve pain. They still thought that I just have an infection and for the sciatica nerve pain they assured me that it will go away in six months as it is very common at my age.

I believed to the doctors until the CT scan of my spine didn't show that I have multi metastatic prostate cancer up to my neck in my spine.

PSA testing alone is not enough.

MJCA profile image
MJCA in reply to Seasid

I’m sorry to hear. With a PSA of 20, my first urologist kept telling me I had prostatitis for months I was on Cipro. I stopped going to him. A couple years later another urologist diagnosed me at Stage IV with a PSA of 43. These days, I have learned to investigate my doctors. I definitely emphasize with you. Be a warrior and fight. Be strong and I hope your pain will be managed.

StePeteMN profile image
StePeteMN

May be related. Experts suggest.100 percent, that's the reason.

cesces profile image
cesces in reply to StePeteMN

Of course. It was predicted at the time.

What it did was save insurance companies money in the short term.

Because of churn, they never lose money in the long term.

StePeteMN profile image
StePeteMN in reply to cesces

I'll have to disagree. It was a sh*t decision for insurance. My insurance company is, I figure, out about a million on me in only five years. Churn or no churn, advanced cancer patients go somewhere for insurance. And there are usually only three or four (?) providers in a market.

cesanon profile image
cesanon in reply to StePeteMN

"And there are usually only three or four (?) providers in a market."

Not for most of the population in the US which is concentrated in urban centers. Most of the population = most of the money.

In the short term all they care about is their quarterly performance.

In the long term, their underwriters protect them. Every year they adjust their rates to the risks. They know what your risk is, and they have adjusted their rates to cover you.

You may not be paying for your risk. But neither is the insurance company. They are sort of like a casino. They make sure the odds favor them and they never lose.

And they reset the odds every year.

The one exception to this is large self insured companies with stable employee forces. But they have disappeared pretty much with the manufacturing jobs we have exported to China over the last 30 years, along with unions that have pretty much been evicerated during that same period.

Pretty much with the widespread churn of insureds, insurance companies have no material monetary interest in your long term health. It's pretty much just a year to year thing with them. All they want to do is pay less money this year... and raise premiums next year to cover increases in cost.

StePeteMN profile image
StePeteMN in reply to cesanon

You probably know a lot more about the insurance business than I do. I suppose you're right that there's a reinsurance market for health coverage with companies like AIG underwriting in the background. As for number of insurers, in a market, I was thinking of greater Minneapolis (not small, not huge), where I live, where all the health insurance companies (per state law) must be either non-profits or government agencies. I'm fortunate that nothing my docs have prescribed has been turned down, or questioned beyond requiring a prior authorization, as far as I know. To your main point, of course. Had I known then what I know now, I'd have picked a different primary care doctor who took prostate cancer seriously instead of simply reading the guidelines and swallowing their advice hook, line and sinker (as we say in Minnesota).

JohnInTheMiddle profile image
JohnInTheMiddle

CESCES: Bravo highlighting what is coming to light now, which is the large number of men who are diagnosed with prostate cancer but where the prostate cancer is already metastasized.

And why wasn't the cancer caught earlier? Because a decade ago policy makers around the world, starting in the United states, made poor and lazy decisions, possibly confused by bad economics, that mass PSA testing was a bad idea. (Urologists were the exception and by and large were never on side on this policy.)

Here is my own experience and discussion of this topic, in a recent and popular post on this forum (lots of great replies too):

healthunlocked.com/advanced...

cesces profile image
cesces in reply to JohnInTheMiddle

My recollection is that Dr. Snuffy Myers estimated that this policy would cause the early death from cancer of 250,000 men per year I think.

He called it the equivalent of a war crime.

JohnInTheMiddle profile image
JohnInTheMiddle in reply to cesces

I just learned that Dr. Myers was in fact a leading prostate cancer researcher and physician. It would be great to track down this quote.

cesanon profile image
cesanon in reply to JohnInTheMiddle

My recollection of the 250,000 number was at a PCRI conference where the author of this then new standard gave a talk and answered criticisms about the standard.

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