Comments on: Should I get a PSA test for prostate cancer? A new study shows that screening for prostate cancer doesn’t necessarily save lives http://www.kevinmd.com/blog/2009/03/should-i-get-psa-test-for-prostate.html medical blog Fri, 19 Mar 2010 19:18:41 -0400 http://wordpress.org/?v=2.8.4 hourly 1 By: doctorj http://www.kevinmd.com/blog/2009/03/should-i-get-psa-test-for-prostate.html/comment-page-1#comment-90380 doctorj Thu, 19 Mar 2009 16:38:00 +0000 http://clients.emmense.com/kevinmd/2009/03/should-i-get-a-psa-test-for-prostate-cancer-a-new-study-shows-that-screening-for-prostate-cancer-doesnt-necessarily-save-lives.html#comment-90380 Even before PSA, false positive pathology results were common. This was based on a DRE. Which is most reliable - PSA or DRE?<br/>Good together? Even before PSA, false positive pathology results were common. This was based on a DRE. Which is most reliable – PSA or DRE?
Good together?

]]> By: Anonymous http://www.kevinmd.com/blog/2009/03/should-i-get-psa-test-for-prostate.html/comment-page-1#comment-90377 Anonymous Thu, 19 Mar 2009 12:53:00 +0000 http://clients.emmense.com/kevinmd/2009/03/should-i-get-a-psa-test-for-prostate-cancer-a-new-study-shows-that-screening-for-prostate-cancer-doesnt-necessarily-save-lives.html#comment-90377 These studies really do not address the current issues facing men who have been diagnosed with early stage prostate cancer. The currently available treatments such as surgery and radiation are really barbaric (impotence, incontinence rectal/bladder radiation damage,secondary cancers due to radiation exposure, etc.). Since prostate cancer is now diagnosed at such early stages, these traditional treatments are "overkill" and more focal treatments such as high intensity focused ultrasound should be move to the forefront as firstline treatment. Research studies should focus more on less invasive therapies such as HIFU. Also, PSA is loosing its effectiveness as a screening study because the screened population has now chnnged, leading to more false positives and negatives. More effective screening tests are needed as well. These studies really do not address the current issues facing men who have been diagnosed with early stage prostate cancer. The currently available treatments such as surgery and radiation are really barbaric (impotence, incontinence rectal/bladder radiation damage,secondary cancers due to radiation exposure, etc.). Since prostate cancer is now diagnosed at such early stages, these traditional treatments are “overkill” and more focal treatments such as high intensity focused ultrasound should be move to the forefront as firstline treatment. Research studies should focus more on less invasive therapies such as HIFU. Also, PSA is loosing its effectiveness as a screening study because the screened population has now chnnged, leading to more false positives and negatives. More effective screening tests are needed as well.

]]> By: Dr. Joe Kim http://www.kevinmd.com/blog/2009/03/should-i-get-psa-test-for-prostate.html/comment-page-1#comment-90376 Dr. Joe Kim Thu, 19 Mar 2009 03:45:00 +0000 http://clients.emmense.com/kevinmd/2009/03/should-i-get-a-psa-test-for-prostate-cancer-a-new-study-shows-that-screening-for-prostate-cancer-doesnt-necessarily-save-lives.html#comment-90376 This is such a confusing topic of patients, especially if they eventually get diagnosed with prostate cancer. On one hand, screening increases disease awareness and patient education. On the flip side, false positives and negatives decrease the value and clinical utility of such tests. I guess once you're over 75, you're in a new category of life. This is such a confusing topic of patients, especially if they eventually get diagnosed with prostate cancer. On one hand, screening increases disease awareness and patient education. On the flip side, false positives and negatives decrease the value and clinical utility of such tests. I guess once you’re over 75, you’re in a new category of life.

]]> By: Anonymous http://www.kevinmd.com/blog/2009/03/should-i-get-psa-test-for-prostate.html/comment-page-1#comment-90375 Anonymous Thu, 19 Mar 2009 02:27:00 +0000 http://clients.emmense.com/kevinmd/2009/03/should-i-get-a-psa-test-for-prostate-cancer-a-new-study-shows-that-screening-for-prostate-cancer-doesnt-necessarily-save-lives.html#comment-90375 doctorj: "I am doing a poll on preventive screening tests until 3/31/09 at http://mypatienthandbook.blogspot.com. I want to see what the public has to say."<br/>Yea? You think the public opinion on a medical matter like this is useful? People seem to think smoking marijuana will cure disease, so why don't we go with that? How about next time a child shows up with a cold we let the public decide if they should let the child be or give them antibiotics. The point Kevin is making, and it's very valid, is that screening tests have complications and on top of that they aren't proven to be useful. Yes, saving one life is fantastic. But what about the slew of people who had normal prostates but now have a poor quality of life due to incontinence or sexual dysfunction? doctorj: “I am doing a poll on preventive screening tests until 3/31/09 at http://mypatienthandbook.blogspot.com. I want to see what the public has to say.”
Yea? You think the public opinion on a medical matter like this is useful? People seem to think smoking marijuana will cure disease, so why don’t we go with that? How about next time a child shows up with a cold we let the public decide if they should let the child be or give them antibiotics. The point Kevin is making, and it’s very valid, is that screening tests have complications and on top of that they aren’t proven to be useful. Yes, saving one life is fantastic. But what about the slew of people who had normal prostates but now have a poor quality of life due to incontinence or sexual dysfunction?

]]> By: doctorj http://www.kevinmd.com/blog/2009/03/should-i-get-psa-test-for-prostate.html/comment-page-1#comment-90372 doctorj Thu, 19 Mar 2009 00:27:00 +0000 http://clients.emmense.com/kevinmd/2009/03/should-i-get-a-psa-test-for-prostate-cancer-a-new-study-shows-that-screening-for-prostate-cancer-doesnt-necessarily-save-lives.html#comment-90372 Every month a new screening test is deemed ineffective especially if you are over 75. I think the PSA and other medical preventive screening tests are valid. False positives do occur, and this can lead to unnecessary testing as Dr. Kevin points out. Or you can choose to follow noncritical incidental findings.<br/><br/>I think screening tests should continue to be done regularly because they do save lives. Surely one life is worth it. Early detection can mean treatment to cure and become disease free. <br/><br/>Screening tests is a way to maintain health. Why wait until disease presents itself? As former Surgeon General, Jocelyn Elders, said in an interview that we are a nation of sickness instead of wellness. I say our doctors are trained to heal after disease is present, instead of maintaining wellness.<br/><br/>I am doing a poll on preventive screening tests until 3/31/09 at http://mypatienthandbook.blogspot.com. I want to see what the public has to say.<br/>I say do what is best for you, and discuss it with your doctors. My life has certainly been saved (more than once) thanks to medical screening. Every month a new screening test is deemed ineffective especially if you are over 75. I think the PSA and other medical preventive screening tests are valid. False positives do occur, and this can lead to unnecessary testing as Dr. Kevin points out. Or you can choose to follow noncritical incidental findings.

I think screening tests should continue to be done regularly because they do save lives. Surely one life is worth it. Early detection can mean treatment to cure and become disease free.

Screening tests is a way to maintain health. Why wait until disease presents itself? As former Surgeon General, Jocelyn Elders, said in an interview that we are a nation of sickness instead of wellness. I say our doctors are trained to heal after disease is present, instead of maintaining wellness.

I am doing a poll on preventive screening tests until 3/31/09 at http://mypatienthandbook.blogspot.com. I want to see what the public has to say.
I say do what is best for you, and discuss it with your doctors. My life has certainly been saved (more than once) thanks to medical screening.

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