Treating or Ignoring Prostate Cancer
http://thedianerehmshow.org/shows/2011-10-11/treating-or-ignoring-prostate-cancer
A new report coming out on Tuesday says a routine prostate cancer test could do more harm than good. It recommends that healthy men should not get the prostate-specific antigen, or P.S.A., exam. Some physicians argue that the test can reduce a man’s chances of dying of prostate cancer, plain and simple. But others argue that on balance, scientific studies do not support the claim that screening healthy men saves lives and in fact may cause them to have unnecessary surgery which could leave them incontinent, impotent or even death. Evaluating the risks and benefits of prostate cancer screening.
Guests
Dr. Gerald Andriole
Chief of Urology at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis
Shannon Brownlee
acting director of the New America Foundation Health Policy Program and co-author of the New York Time Magazine article, "Can Cancer Ever Be Ignored."
Dr. Patrick Walsh
University Distinguished Service Professor, The James Buchanan Brady Urological Institute, Johns Hopkins University and author of "The Patrick C. Walsh Guide to Surviving Prostate Cancer."
Dr. Chiledum Ahaghotu
Associate Professor of Surgery and Chief of Urology at Howard University Hospital.
Comments
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I am a long time fan of the Diane Rehm show but was disappointed with this show. As a student of epidemiology I thought the public health/research perspective was poorly represented on the panel. None of the panelists seemed to be well versed with the evidence that the US Preventative Services Task Force used to make their recommendations or the epidemiology of P.S.A testing and prostrate cancer in general. Anecdotal evidence and confirmation bias as reported by individuals commenting here and through their doctors is of no use when making public health decisions as the Task Force has done. Urologists make a living by removing men's prostates, will have an inherent bias against such recommendations away from testing and should not have been selected to conform the entire panel for this discussion. I feel listeners have been poorly informed regarding the science behind and the current knowledge of PSA testing and prostate cancer.
Very disappointing.
Only urologists and no-one from USHPTF.
Why wasn't the journalist allowed to debate the doctors?
Because it's presumptious for a lay person to dialogue with medical scientists??
Finally, Dr Walsh said that the 2 randomized trials of screening versus not screening were not long enough (7 and 10 years).
I would point out that the subjects of these trials had cancerous tissue in their prostates for a long time before ever being enrolled.
We know this because about 50% (sic) of men age 60 have microscopic and/or macroscopic disease.
The followup was adequate to determine whether screening saved lives.
One last point, finding a very aggresive cancer also does no good because it has flown the coop (into the bones) while the primary is still small and is invariably fatal
So it is only a very small fraction of prostate cancers that are actually worth finding.