39 replies to this topic

[Rogerdodger]

Well I went back this year.
This "private" screening was surprisingly public when the local TV station came in as I was preparing to enter the exam room.
I was given coffee and a bagel, a book signed by Dr. Oz, stabbed with a needle, raped by a lady with short fingernails and warm hands, and got on the local TV news, all while in the back of a motorhome!
I've got to get off meth.
LOL!

Here's a fun way to spend an hour in Tulsa: We have a "Bend Over Mobile"

TULSA – For the fifth year in a row, KJRH 2 Works for You has partnered with Saint Francis Health Systems to bring the National Prostate Cancer Coalition's free prostate cancer screenings to Tulsa onboard the Drive Against Prostate Cancer bus. In addition, this year's event will also include free screening services by the Tulsa Downtown Lions Club's Mobile Health Unit (MSU) as well as a blood drive being conducted by the Oklahoma Blood Institute (OBI). The Lions Club will offer free screenings for diabetes, blood pressure, glaucoma, visual acuity, hearing and bone density. The free screenings and blood drive will be conducted on a first-come, first serve basis.



I think it's a great idea.
But I do feel sorry for the doctor.
All day long. Nothing but A-holes!

Edited by Rogerdodger, 20 September 2010 - 03:39 PM.

[stocks]

Cochrane Colloboration -- Screening for prostate cancer

1410 men would need to be screened to prevent one additional death from prostate cancer during a 9-year period, which is also associated with 48 men needing to be treated

Prostate cancer is one of the most prevalent forms of cancer in men worldwide. Screening for prostate cancer requires diagnostic tests to be performed in the absence of any symptoms or indications of disease. These tests include the digital rectal examination (DRE), the prostate-specific antigen (PSA) blood test and the transrectal ultrasound-guided biopsy (TRUS). Screening aims to identify cancers at an early and treatable stage, therefore increasing the chances of successful treatment while also improving a patient's future quality of life.

This review identified five relevant studies, comprising of 341,351 participants in total. Two of the studies were assessed to be of low risk of bias, whilst the remaining three had methodological weaknesses. Meta-analysis of the five included studies demonstrated no statistically significant reduction in prostate cancer-specific mortality (RR 0.95, 95% CI 0.85 to 1.07).

Only a preplanned analysis of a 'core' age group of men from the largest study included in this review reported a significant 20% relative reduction in prostate cancer-specific mortality. Among this 'core' group of men aged 55 to 69 the ERSPC authors report that 1410 men would need to be screened to prevent one additional death from prostate cancer during a 9-year period, which is also associated with 48 men needing to be treated for prostate cancer (RR 0.80, 95% CI 0.65 to 0.98). Harms included high rates of false-positive results for the PSA test (up to 75.9%), infection, bleeding, and pain associated with subsequent biopsy.


PSA testing

The Cochrane Collaboration is an international consortium that evaluates medical research

[stocks]

The Big Scare: The Business of Prostate Cancer

Anthony Horan, M.D. attended Dartmouth College and Columbia's College of Physicians and Surgeons. He completed his four year residency in Urology at Columbia-Presbyterian Medical Center.

This book is a must-read if you have been diagnosed with prostate cancer. Following its advice just might preserve your quality of life--and possibly even save your life. As Dr. Horan so eloquently illustrates, the business of prostate cancer is largely just that--a business and an industry. As The New York Times pointed out in an article recently, this is not only a business, it is big, BIG business. The industry's products range from the $25-a-pop PSA test that can add $10,000 a year in income to a doctor's practice, to the $2500 biopsy, to the $25,000 surgery and/or radiation "options," to the ultimate in prostate cancer treatment--the proton beam generator that is the size of two football fields and costs $100,000 to play. According to the Times article, prostate cancer treatment is one of the two or three things that are leading the way in driving up the cost of health care in the United States right now. Apparently it is completely out of control.

I have read a dozen or so books on prostate cancer and, with the exception of this one, most of them are selling something--one form or another of radical treatment. Celebrity urologists/surgeons/authors (with their celebrity patients) have a lot at stake in preserving the status quo. So do the big university hospitals, the pharmaceutical companies, and the labs that process all those test results. Most of these books downplay the often disastrous side effects of surgery and radiation. But even more dishonestly, what they don't tell you is that more often than not the treatments are entirely unnecessary. As my 90-year-old uncle (and retired doctor) once told me, most men will die WITH prostate but not FROM it. He's known he has prostate cancer for 25 years now and he simply watches it. Same with my 89-year-old father. Both men are still very active.

Prostate

[stocks]

Cochrane Colloboration -- Screening for breast cancer with mammography

The Cochrane Collaboration is an international consortium that evaluates medical research

Screening with mammography uses X-ray to try to find breast cancer before a lump can be felt. The goal is to treat cancer early, when a cure is more likely.
The review includes seven trials that involved 600,000 women who were randomly assigned to receive screening mammograms or not.
The review found that screening for breast cancer likely reduces breast cancer mortality, but the magnitude of the effect is uncertain.

... for every 2000 women invited for screening throughout 10 years:

1 will have her life prolonged
10 healthy women will be diagnosed as breast cancer patients and will be treated unnecessarily
200 women will experience important psychological distress for many months because of false positive findings

Mammography

[maineman]

Cochrane Colloboration -- Screening for breast cancer with mammography

The Cochrane Collaboration is an international consortium that evaluates medical research

Screening with mammography uses X-ray to try to find breast cancer before a lump can be felt. The goal is to treat cancer early, when a cure is more likely.
The review includes seven trials that involved 600,000 women who were randomly assigned to receive screening mammograms or not.
The review found that screening for breast cancer likely reduces breast cancer mortality, but the magnitude of the effect is uncertain.

... for every 2000 women invited for screening throughout 10 years:

1 will have her life prolonged
10 healthy women will be diagnosed as breast cancer patients and will be treated unnecessarily
200 women will experience important psychological distress for many months because of false positive findings

Mammography

While these studies are interesting and worth thinking about, particularly when it comes to setting appropriate policy measures such as "how often" and "at what age" should we be screening, there is no doubt whatsoever that screening saves lives. I have diagnosed and treated around 60-70 men with prostate cancer, catching it early through annual screening. EVERY ONE OF THEM had to undergo minimal treatment relatively speaking. Not one of them suffered and not one of them died from either the treatment or the disease.

There were several "false positive" PSA readings and out of my huge practice several men underwent prostate biopsy several times. They were all good sports and not one of them complained.

Likewise every woman I care for who had abnormal mammograms and had to go back either for repeat, or magnified views or needle biopsies EVER complained. Not one of them became distraught over it, as we always immediately got them fully involved with the process, keeping them fully informed, etc. ALL lived. NOT ONE died of metastatic or late disease. Even my outrageously super-duper healthy 83 year old mother had her mammogram for this year in the late spring. It was abnormal. The time to get the extra views, the biopises, the diagnoses, the lumpectomy and lymph node analysis, to a brief course of radiation and the onto some hormone suppression pills was under a month for the entire process. She walked from her apartment to her appointments and it still didn't interfere with her 3 week summer trip to Europe.

Cancer screening saves misery and saves lives. We are doing somewhat better in Colon Cancer screening but folks are still being a bit too haphazard in routine stool occult blood testing and proper use of colonoscopy. If one follows the accepted guidelines you'll do yourself, your friends and your families a big, big, favor.

mm

[Rogerdodger]

Last night we are sitting in the living room when my grandson says:
"Hey! That's you on TV."
Last year the TV news crew followed me around as I was screened.
They are replaying it this year.
Thankfully, the doctor shut the door just before the full moon came out.
At least it wasn't the VD screening.

Well I went back this year.
This "private" screening was surprisingly public when the local TV station came in as I was preparing to enter the exam room.
I was given coffee and a bagel, a book signed by Dr. Oz, stabbed with a needle, raped by a lady with short fingernails and warm hands, and got on the local TV news, all while in the back of a motorhome!
I've got to get off meth.
LOL!

Here's a fun way to spend an hour in Tulsa: We have a "Bend Over Mobile"

TULSA – For the fifth year in a row, KJRH 2 Works for You has partnered with Saint Francis Health Systems to bring the National Prostate Cancer Coalition's free prostate cancer screenings to Tulsa onboard the Drive Against Prostate Cancer bus. In addition, this year's event will also include free screening services by the Tulsa Downtown Lions Club's Mobile Health Unit (MSU) as well as a blood drive being conducted by the Oklahoma Blood Institute (OBI). The Lions Club will offer free screenings for diabetes, blood pressure, glaucoma, visual acuity, hearing and bone density. The free screenings and blood drive will be conducted on a first-come, first serve basis.



I think it's a great idea.
But I do feel sorry for the doctor.
All day long. Nothing but A-holes!

Edited by Rogerdodger, 16 September 2011 - 08:29 AM.

[stocks]

Why haven’t we cured cancer yet?

When President Nixon launched the “war on cancer” 40 years ago, scientists had no idea how difficult it would be

Saturday was the two year anniversary of the death of my mother-in-law from a particularly nasty form of breast cancer, and, even though I am a breast cancer surgeon, I still wonder why there was nothing in the armamentarium of science-based medicine that could save her from a several month decline followed by an unpleasant death.

I close with the same question with which I opened. Why haven’t we cured cancer yet, anyway? Yes, I know it’s a bit of a misleading question, given that we can actually cure quite a few cancers, including several leukemias and lymphomas, which are curable with chemotherapy and radiation, and solid tumors like breast and colorectal cancer which are curable with a combination of surgery, chemotherapy, and radiation.

Why haven’t scientists cured cancer yet? Leaving aside the trite answer of “Which cancer?” I can say this: Because it’s hard. It’s very, very hard. It’s harder than going to the moon; it’s harder than building the nuclear bomb; it’s harder than wiping out smallpox. All of those were, of course, also very, very hard too, but cancer is a harder nut to crack still. It’s hundreds, perhaps thousands, of diseases. Each type of cancer can be many, even dozens, of different diseases in itself. Each tumor can be many diseases that are constantly evolving, both in response to the environment in which the cancer cells grow and to treatments that are thrown at them.

sciencebasedmedicine

[stocks]

Does chemotherapy work?

What needs to be understood is that chemotherapy is very good for some things.

For instance, it's very good for treating and curing leukemias and lymphomas. For certain cancers, such as breast and colorectal cancer, it's very good at decreasing the chance of relapse after curative surgery. When given before curative surgery, chemotherapy can also make organ-preserving surgery possible.

chemotherapy usually does little for pancreatic cancer, and metastatic melanoma laughs at most chemotherapy (although, fortunately there are newer agents coming into use that provide hope that this will no longer be the case). For all its uses and advantages in various clinical situations, in other situations chemotherapy doesn't work well. For example, chemotherapy alone is not very good at prolonging survival in advanced epithelial malignancies, and it's not at all unreasonable to ask whether oncologist, for whatever reason, overuse it in such patients, who are, for the most part, currently incurable.

buried in that median are "outliers" who derive a huge survival benefit from the chemotherapy and survive many more months than expected, sometimes many more years than expected. Moreover, it does patients no favor to try to use the observation that chemotherapy has at best relatively modest benefits in patients with advanced epithelial malignancies to try to imply that chemotherapy doesn't work for all patients. In particular, patients have to remember that just because chemotherapy doesn't do that well against advanced malignancies does not, as the quacks would have you believe, imply that "alternative medicine" can do better.

Chemo

[Rogerdodger]

Panel Faults Prostate-Cancer Test

The US Preventive Services Task Force will recommend a "D" rating for prostate specific antigen, or PSA, testing.
A "D" rating means "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits," according to the group's website. It also is a recommendation to "discourage use" of test or treatment.
The task force is an influential group whose recommendations can influence coverage decisions by the federal Medicare program and other insurers.

The same group determined that mammograms may not be needed until women reach age 50.
The American Cancer Society voiced its displeasure with the new recommendations. "The task force is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them," Otis Brawley, the society's chief medical officer, said in a statement. About 17% of breast cancer deaths occurred in women who were diagnosed in their 40s, he said.
But a report in last month's Journal of the American Medical Association found that mammograms often miss very aggressive cancers that develop between screenings, while finding slow-growing tumors that may not pose a threat
http://www.usatoday....gram17_ST_N.htm

Edited by Rogerdodger, 06 October 2011 - 09:54 PM.

[stocks]

Panel Faults Prostate-Cancer Test

The US Preventive Services Task Force will recommend a "D" rating for prostate specific antigen, or PSA, testing.
A "D" rating means "there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits,"

“Unfortunately, the evidence now shows that this test does not save men’s lives,” said Dr. Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and chairwoman of the task force. “This test cannot tell the difference between cancers that will and will not affect a man during his natural lifetime.

the devastating consequences of the biopsies and treatments that often flow from the test have become increasingly apparent.

From 1986 through 2005, one million men received surgery, radiation therapy or both who would not have been treated without a P.S.A. test

at least 5,000 died soon after surgery
10,000 to 70,000 suffered serious complications
Half had persistent blood in their semen
200,000 to 300,000 suffered impotence, incontinence or both.

prostate