Not long ago the United States Preventive Task Force (USPSTF) trumpeted this message to men: ? No need to get screened for prostate cancer. If you do get it you probably won?t die of it.?? It was a message that went round the world and many listened. Many took it to heart. Many were confused. Many still are.
Who were the experts who made the pronouncement? Certainly not the medical community who had been dedicating themselves for years to treating and curing prostate cancer. They were stunned and outraged at the USPSTF recommendations.
Despite the fact that PSA screening has saved tens of thousands of lives, a group of so-called ?independent scientists? were winding the clock backwards, blacking out years of progress in controlling prostate cancer. The ?independent scientists?, we were told, could more objectively evaluate the literature without bias. With not a single urologist or prostate cancer specialist on the panel? ?
Prostate cancer specialists and researchers at Johns Hopkins Brady Urological Institute immediately called the USPSTF message dangerous and setting a disastrous course. The American Society of Clinical Oncology rejected the recommendations outright, calling instead for a sensible approach to screening: discouraging PSA screening in men with a life expectancy of less than 10 years, but advising men who are expected to live more than 10 years to discuss the benefits and harms of screening with their physicians.
According to the panel, ?healthy men? don?t need screening. There is too much screening. ? Think of the cost-saving if we cut down on screening.? So the mantra goes. ?The recommendations prompt this question:? Are they in place to promote progress or are they in place?far more likely?to save money?
?Prostate cancer is after all, the most common cancer in American men. It is also the second most common cause of cancer death.? It produces no symptoms until? it reaches an advanced stage, but by then it is too late to cure!? It can be diagnosed with a rectal exam (DRE), but it has to be large enough to be felt by a doctor.? The problem is that by the time it has grown this much it could mean it has spread beyond the confines of the prostate gland. That can spell real trouble.? What the PSA test does is signal danger before trouble begins! ?That patient may appear to be ?healthy? but the PSA can say otherwise.
It takes an expert to read and interpret a PSA test. To know at what level it should be in men of every age. To know if it is rising too quickly, requiring an biopsy.? It is not a perfect test but it is the best tool in the tool box?so far.? They are looking for a more perfect one all the time. Before 1991, when PSA testing became widespread, 20 percent of the men with a new diagnosis of prostate cancer had a tumor that had already spread to the bone.? Today that number is less than 4 percent!? In 1991, one out of 5 men had metastases.? Today, it is one out of 25!? Between 1994 and 2004, deaths from prostate cancer plummeted 40 percent. That was more for any other cancer in men or women.
Johns Hopkins reported the age adjusted death rate from 1990 of 39.2 per 100,000 men and applying it to 200, there would have been 59,000 deaths. Because the death rate fell to 23.5, there were 35,000 deaths.? Which means 24,000 fewer men died from prostate cancer in 2007 alone. The National Cancer Institute estimates that 40 to 70 percent of this reduction is due entirely to screening.
Critics of the USPSTF recommendations say while they used at large uncontrolled observations to look at complications of surgery, they did not discuss the number of lives saved since PSA testing was introduce in the U.S.
Important:
?USPSTF has tried to deal with the issues of over-diagnosis and over treatment. For a Johns Hopkins recommendation on these vital issues, the following link to the National Comprehensive Cancer Network (NCCN) Guidelines should be carefully read and studied.? These guidelines are approved by The American Society of Clinical Oncology as well as other national and international prostate cancer experts.
http://www.nccn.org/patients/patient_guidelines/prostate/index.html#/12/
Source: http://www.prostatecancersurvivorspeak.com/psa-screening-vs-pure-smoke-screeing/
patriots vs giants super bowl superbowl halftime show jason wu for target underwood buffalo wings superbowl kick off time 2012 new york giants
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.