Having prostate cancer test an individual choice

Full story: Connecticut Post

Q: I am a healthy man in my late 60s. I go to my regular doctor for checkups and take my medication for blood pressure religiously.

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R Lee Smith

Syracuse, NY

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#1
Apr 20, 2009
 
Would you give the same advice to women re mammograms. DCIS is being detected more and more, is non invasive, and sometimes leads to invasive breast cancer. Many women with DCIS are chosing double mastectomies just to reduce the chances of invasive breast cancer. PSA testing is not dangerous, biopsies have quite limited morbidity, and once the data are in men have a chance to go over the statistics for their particular brand of prostate cancer. Certainly one should avoid jumping to treatment, which could well be over treatment, without taking a deep breath, consulting with several physicians, doing one's best to understand the odds facing you. But invasive cancer is horrible whether it starts in the prostate or in the breast, and I can't understand the move against screening. We should have screening AND education, and avoid being driven by fear -- either fear of knowing or fear of over reacting.
steve

Russia

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#2
Apr 21, 2009
 
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If this sounds like a lot of work, then you probably don’t have a serious problem with the strength of blood flow into your sex organs. If like 1 in every 5 men and a slightly smaller number of women in the world today you can be found wanting in the arousal department come bedtime, the recent discovery of Butea Superba is important news. Available on the internet in pill form under the brand name HealthyED this non chemical herbal solution has been tested in clinical trials and proven to improve performance in over 80% of all those that take it.
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R Lee Smith

Syracuse, NY

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#3
Apr 21, 2009
 
If you look at the recent US study you quote, I think you would find that many in the "non-tested" control group ended up with PSA testing because they initially had other symptoms --- presumably such as frequent urination.
Joel T Nowak MA MSW

East Norwich, NY

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#4
Apr 21, 2009
 
I have to agree with most of your article, but your description of prostate cancer left out one often forgotten fact, prostate cancer kills 28,000 men each year! To just characterize it as a slow growing cancer in which most men who have it will die of something else is only part of the picture.
Prostate cancer, even though it is slower growing than many other cancer's does kill, it is the second biggest cancer killer of men in the United States.
The real issue about prostate cancer is not its testing and diagnosis, but is in fact about over treatment. Not all diagnosed prostate cancer needs invasive and expensive treatment, active surveillance is the proper "treatment" for many men.
All men should know what is going on in their bodies and then be given the proper support to make intelligent and reasoned decisions on how to deal with any potential concern, including prostate cancer.
Joel T Nowak MA, MSW
Director of Advocacy and Advanced Prostate Cancer Programs
Malecare, Men Helping Men with Cancer
Madashell

Saint Paul, MN

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#5
Apr 21, 2009
 
I had my prostate removed one year ago and it was the worst decision I was ever sold and I do mean sold. I am 53 years old and was told this week that my incontinence is going to be with me until I die and I will assure you, it is not worth it!
The surgeons will tell you whatever you want to hear to SELL you their services, it's all a crap shoot and unless you have an aggressive, do not have yours removed. Besides, they don't mention that they have no control over the prostate cancer that you may find in your body after you have your prostate removed......Urologists are jerk offs!
R Lee Smith

Syracuse, NY

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#6
Apr 21, 2009
 
Madashell: I am truly sorry that things haven't worked out for you. Perhaps you could tell us a bit more about what lead you to having your prostate removed and how you chose your surgeon so that others can learn from your experience. I had my prostate removed 12 years ago, have virtually no PSA readings, relatively dry underwear, somewhat reduced sexual functioning, and glad to be alive and enjoying life and my family. Certainly everyone needs to have the agressiveness of their cancer evaluated and needs to know the likely side effects of treatment. However the odds are against incontinence if you have the right surgeon. If you have an agressive cancer, as I did, and investigate several surgeons to find an experienced successful one, as I did, you can increase the odds that you will live to a ripe old age without any further cancer. It obviously doesn't always work but I know lots and lots of men who were rather successful. You are indeed right --you have minimal control if the cancer gets out of the prostate -- thats the ratioinale for PSA screening, biopsies, and, if cancer is found, careful analysis of the odds you face. The data are all out there, you need to find the right MD and it may mean traveling to one of the major centers if the local surgeons don't seem up to par. Again the worst can happen but to me the worst would have been cancer spreading throughout my body for the last 12 years, and PSA, biopsy, and prostate surgery may have prevented that. It is a crap shoot since there are not certainties, but you can weigh the odds in your favor through screening, information, investigation, and careful decision making.
Rabbi Dr Ed Weinsberg

Sarasota, FL

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#7
Apr 21, 2009
 
I think Dr. Skudlarska has offered a very comprehensive response in the space provided as to why PSA tests are not mandatory for most men: the cancer grows slowly and treatment side effects can be more harmful than the prospect of prostate cancer itself.
However it should be noted that 38% of newly diagnosed prostate cancer cases a year are found among Boomers (men ages 45 to 64). Even though the average life expectancy for men is currently 78 (versus 83 for women), many Boomers will live at least 15 to 30 years. Even some "seniors" - including men age 76, may well live another 20 years due to increasing longevity, and in that time, a slow growing cancer could easily metastasize.
In my case I was 62 when my PSA test led to a biopsy with a Gleason 6 score, indicative of moderately aggressive but localized prostate cancer. Had I not gone ahead with surgery, to extract the cancerous prostate, my surgeon would not have known for certain that my bladder was impacted and that I needed a second surgery on the spot to replace the bladder neck. So I had two surgeries for the price of one, to my good fortune!
In other words the symptoms the reader asked, such as frequent trips to the men's room can indeed be much more than a benign prostate enlargement, and to assume otherwise without further testing is to court danger. In my case I would have become a urologic cripple had I not elected prostate surgery and then had the good fortune of getting a newly constructed bladder neck as a bonus!
In writing about this in my new book (Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life) and online ( www.ConquerProstateCancer.com ), I emphasize how robotic surgery is generally pain-free, not only with the help of mind-body techniques anyone can learn, but because it is laparoscopic and doesn't require the 4" to 7" cut that precedes standard open surgery.
Besides,I would hope that patients consider not only the cure rate of various treatments versus watchful waiting, aka, "active surveillance". Consider too what Dr. Skudlarska amply underscores: Are you prepared to take a chance that you won't be one of the unlucky minority who are among the 28,000 men a year who die of prostate cancer?
Quite simply there's more than a cure rate that needs to be considered. when deciding if a PSA test followed by a more precise, but still random biopsy is best or not. Anxiety about a slow growing cancer, dealing effectively with pain and stress due to minimally invasive surgery and other treatments, and recognizing that currently there is no effective way to determine if your prostate cancer is aggressive or slow-growing: all these are factors to be considered before ruling out or insisting on taking a PSA test.
Besides one of the lead authors of the USA study himself has admitted that the results of the study are still inconclusive. As a result any conclusion about PSA - nay or yea, must be left up to each individual in consultation with his doctor...and his spouse or partner.
Yes as the title to Dr Skudlarska's article indicates, "Having a PSA is an individual choice," but it's one that should be seriously considered before assuming it's not needed.
Ben Ong

Birmingham, UK

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#8
Apr 22, 2009
 
May I recommend my FAQ resource to anyone with concerns about PSA, BPH (enlargement) Biopsy, Flomax, proscar, Prostate cancer. etc. There is a great deal of misinformation from interested parties like Urologists and Pharmaceutical corporations as is evidenced by the sad tale posted by Madashell. That is not an isolated instance, I get emails all the time with similar stories. My site provides clear unbiased information based on the latest research. go to http://PSA.cure-prostate.com
R Lee Smith

Syracuse, NY

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#9
Apr 22, 2009
 
Mr. Ong: Can you quote some statistics re the unfortunate situation of Mr. Madashell, the many unfortunate men who suffer, live with and die from prostate cancer, and the many many successful stories. All men need to know the numbers from their physicians and from those critical of the physicians.
Ben Ong

Birmingham, UK

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#10
Apr 23, 2009
 

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R Lee Smith wrote:
Mr. Ong: Can you quote some statistics re the unfortunate situation of Mr. Madashell, the many unfortunate men who suffer, live with and die from prostate cancer, and the many many successful stories. All men need to know the numbers from their physicians and from those critical of the physicians.
Its all on my website and in my book.
http://PSA.cure-prostate.com
R Lee Smith

Syracuse, NY

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#11
Apr 23, 2009
 
Mr. Ong: how about a quick summary leading of course up to 30,000 deaths a year!
How many men have which kinds of prostate cancer
How many will be detected by PSA
How many by DRE
How many when it's too late to stop
How many will need treatment to keep them alive due to spreading cancer
etc
Lets start with some facts and numbers and go from there
Anonymous

West Palm Beach, FL

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#12
Feb 4, 2012
 

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I would like to hear from some of the thousands of men, Ben Ong claims to have helped with his advice, supplements, diets, etc. I can't seem to find anyone in the USA, who has ever heard from him, or used his products.

Since: Aug 10

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#13
Feb 4, 2012
 

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Never heard of the man.
R Lee Smith

New York, NY

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#14
Feb 4, 2012
 
January 6, 2012 New longer-term follow-up from the American Prostate, Lung, Colorectal, and Ovarian Cancer Screening (PLCO) Trial
continues to indicate that annual prostate-specific antigen (PSA) screening for 6 consecutive years does not provide men with a mortality benefit.
The massive study now has 13-year data on 57% of the men who originally enrolled. The updated data are reported online today in the Journal
of the National Cancer Institute.
Despite this conclusion, the study's senior author said in an interview with Medscape Medical
News this week that "maybe there is a benefit."... the 76,000-men trial "didn't have a pure control group," that many of men in the control group underwent PSA testing,
and that some might have gained a mortality benefit from the testing and subsequent biopsy and treatment.....In the end, the PLCO study lost its statistical power, he noted. "It's a dataset that you cannot make any conclusions about,"....
Dr. Kantoff summarized what he believes is the current state of thinking about prostate cancer
screening. "The jury is still out on the efficacy of the whole process," he said. That process
includes not only PSA testing but subsequent biopsies, monitoring, and the many decision points
that lead to treatment.
J Natl Cancer Inst. Published online January 6, 2012.
Medscape Medical News 2012 WebMD, LLC
Send comments and news tips to news@medscape.net.

Since: Aug 10

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#15
Feb 4, 2012
 

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America Gentleman Samuel wrote:
Never heard of the man.
It is bedtime for Tippy and her fish and myself, and to all, a good night.
peter

Katy, TX

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#16
May 17, 2012
 
Has anyone heard of HIFU for prostate cancer treatment?
Charles - Chuck - Maack

Wichita, KS

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#17
May 17, 2012
 
You can find out much regarding High Intensity Focused Ultrasound (HIFU)by typing those words in the search box on the internet. HIFU apparently is still in trials here in the U.S. but not yet approved for treatment.
richard

Auburn, CA

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#18
Jun 25, 2012
 
I have been using Ben Ong's products, bought his book AND did his APCRA.$5,800 plus in expenses later I have not gotten any answers from him. He called me to get my money for the APCRA but no follow up call, no answers, no help. I finally ended up going to an Imaging Clinic in Palm Dessert, had an MRI and then an MRI-DIRECTED biopsy, only four samples of tissue were taken directly where they saw a concern. Gratefully, they found no cancer and now I know how I am doing in that regard but no thanks to Ben! In fact, I would recommend to all to go through this route as apposed to Ben Ong's APCRA or the "doctors", even at places such as Stanford, for random poking, prodding and stabbing for numerous random samples (15-20 random biopsy stabs.
richard

Auburn, CA

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#19
Jun 25, 2012
 
Anonymous wrote:
I would like to hear from some of the thousands of men, Ben Ong claims to have helped with his advice, supplements, diets, etc. I can't seem to find anyone in the USA, who has ever heard from him, or used his products.
I have been using Ben Ong's products, bought his book AND did his APCRA.$5,800 plus in expenses later I have not gotten any answers from him. He called me to get my money for the APCRA but no follow up call, no answers, no help. I finally ended up going to an Imaging Clinic in Palm Dessert, had an MRI and then an MRI-DIRECTED biopsy, only four samples of tissue were taken directly where they saw a concern. Gratefully, they found no cancer and now I know how I am doing in that regard but no thanks to Ben! In fact, I would recommend to all to go through this route as apposed to Ben Ong's APCRA or the "doctors", even at places such as Stanford, for random poking, prodding and stabbing for numerous random samples (15-20 random biopsy stabs). RICHARD
Andy

Des Plaines, IL

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#20
Oct 6, 2012
 
So you had APCTRA test done but you didn't get results
He is offing this test now for $2700 in Texas or Arizona
Please advice. andy1410@comcast.net

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