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	<title>Comments on: How screening for prostate cancer can be a gamble, and why either screening or not has consequences</title>
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	<link>http://www.kevinmd.com/blog/2009/04/how-screening-for-prostate-cancer-can.html</link>
	<description>medical blog</description>
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		<title>By: Brendon</title>
		<link>http://www.kevinmd.com/blog/2009/04/how-screening-for-prostate-cancer-can.html/comment-page-1#comment-90744</link>
		<dc:creator>Brendon</dc:creator>
		<pubDate>Tue, 07 Apr 2009 20:23:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/04/how-screening-for-prostate-cancer-can-be-a-gamble-and-why-either-screening-or-not-has-consequences.html#comment-90744</guid>
		<description>Kevin, what an amazingly balanced response and summary of the debate.  You leave room for discussion and seem to recognize that there will be some patients for whom the risks of adverse outcomes from potentially unnecessary surgery (or treatment) are acceptable in light of their understanding and fear of prostate cancer.&lt;br/&gt;&lt;br/&gt;Cerebrum,  I will wait with you for the USPSTF to change their recommendations; they&#039;ve always been pretty close to the fence on this one.  I predict they&#039;ll advise a &quot;discuss the pros and cons with your patient&quot; approach within a year.</description>
		<content:encoded><![CDATA[<p>Kevin, what an amazingly balanced response and summary of the debate.  You leave room for discussion and seem to recognize that there will be some patients for whom the risks of adverse outcomes from potentially unnecessary surgery (or treatment) are acceptable in light of their understanding and fear of prostate cancer.</p>
<p>Cerebrum,  I will wait with you for the USPSTF to change their recommendations; they&#8217;ve always been pretty close to the fence on this one.  I predict they&#8217;ll advise a &#8220;discuss the pros and cons with your patient&#8221; approach within a year.</p>
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		<title>By: Cerebrum</title>
		<link>http://www.kevinmd.com/blog/2009/04/how-screening-for-prostate-cancer-can.html/comment-page-1#comment-90743</link>
		<dc:creator>Cerebrum</dc:creator>
		<pubDate>Tue, 07 Apr 2009 17:32:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/04/how-screening-for-prostate-cancer-can-be-a-gamble-and-why-either-screening-or-not-has-consequences.html#comment-90743</guid>
		<description>I agree! We should use only the screenings which have proen to be more effective such as colonoscopies for colon cancer. PSA and DREs even over several years have not been able to establish relevance. Yet they are included in screening recommendation by US PTF. That itself pushes us into defensive medicine. How could you argue with an attorney in the court who touts that the USPTF recommends it but you as a physician do not agree with it!!!</description>
		<content:encoded><![CDATA[<p>I agree! We should use only the screenings which have proen to be more effective such as colonoscopies for colon cancer. PSA and DREs even over several years have not been able to establish relevance. Yet they are included in screening recommendation by US PTF. That itself pushes us into defensive medicine. How could you argue with an attorney in the court who touts that the USPTF recommends it but you as a physician do not agree with it!!!</p>
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