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Cancer Screening Change

Monday, October 10, 2011

New York Times reporter, Gardiner Harris, talks about the controversy over widespread screening for prostate cancer and whether it's warranted.

Guests:

Gardiner Harris

The Morning Brief

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Comments [12]

Somehow the idea of "desirous" ignorance grates on an educated mind.
But since "radio talk" turns all manner of human activity into mushy, time constrained, memes lets try to understand.

Am I to understand that there is "zero" relation between 'any' measurable increase or decrease in a person's PSA level and the predictive utility of a minimum follow-up medical procedure?

Is this a viable template for resolving other scientific questions? i.e., let's stop taking temperature readings of the ocean to forestall wasteful reaction to any fears of anthropomorphic global warming?

Isn't it "all about the money"?
Am I also understanding that the subject is devoid of

Oct. 10 2011 11:39 AM
francyne from Pelham Bay

Brian,
You used the phrase of a certain age. What exactly does that mean in the USA where most people have access to their birth certificates and are quite sure of their age. We fill in all sorts of forms asking us that specific question: birthday. Are not most Americans certain about their age?
Francyne Pelchar

Oct. 10 2011 11:26 AM
John A.

So hard to judge... With the test, the science is of an inexactitude as to push people into living with incontinence (2 close relatives) where the cancer may have remained silent for the duration of their lives. Without the test, there is the temptation to say 'gotcha' (or, "Malpractice!") if an aggressive cancer develops. Without the test, there is the temptation to say the government is just looking to save public money.
-
At any rate, the State of PSA science should always be looked at with some degree of doubt.
A new test is needed. Random results were often found after positive PSA tests (my father) and even trendlines (myself; clean).

Oct. 10 2011 11:16 AM
Amy from Manhattan

*Something* is happening before the fact in people who die of sudden cardiac arrest w/o high cholesterol or blood pressure. We need research to find out what that (or more likely "those") something is & how to detect it in & treat it in time to prevent sudden cardiac death.

Oct. 10 2011 11:13 AM
David Cooper from Brooklyn, NY

Mr. Harris does not discuss family history. I am the son of a prostate cancer survivor and am myself a 56 year old prostate cancer survivor. Because of my family history I started getting annual PSA tests when I was 40. At age 54 my PSA score indicated the need for a biopsy which showed one small tumor. A subsequent biopsy six months later showed three tumors, and three months later I underwent nerve sparing robotic prostate surgery. Eight months after surgery I am fully continent, have strong erections, and gratifying orgasms. Because of my relatively young age (prostate cancers in younger men tend to be more aggressive) and family history it is probable that timely screening and treatment has saved both my life and my quality of life.

Oct. 10 2011 11:11 AM

Sorry, David, but while I agree with you that math understanding, in general, is rather poor in our country, your stating this is a "non-issue" is missing the point. Many of us who understand the statistics do not necessarily agree with the inference made by the group who stated the test should not be used.

Oct. 10 2011 11:04 AM
ed from NJ

I am a prostate cancer "survivor". Based on testing, I was told that I should have a prostatectomy. I did that. The tumor that was found was about the size of a bb. Probably wouldn't have killed me. Now I suffer from permanent, severe, incontinence.

Docs are spring loaded to treat. They don't want you to wait.

Here's the numbers I heard recently:
If 50 men are diagnosed, ONE will die from the disease.

Of that 50, each one that is treated has a one in ten chance of suffering severe and permanent side effects.

He

Oct. 10 2011 10:59 AM
Amy from Manhattan

Mr.Harris said prostate cancer is very slow in most cases. But some kinds of prostate cancer are very aggressive & kill men in their 50s. Can this type be detected at an early stage other than by routine PSA testing?

Oct. 10 2011 10:57 AM
Demerest Lloyd


I worked for urologists in New York City for many years. They have been saying for decades, "You die with prostate cancer, not of it" because it is so slow-growing.

Oct. 10 2011 10:55 AM
MichaelB from Morningside Heights

Ask Mr. Harris if having a biopsy is worth having (if PSAs indicate), as opposed to the iffy treatment.

Can they distinguish between fast-growing & slow-growing or extensively-spread cancer?

Oct. 10 2011 10:53 AM
Richard Johnston from Manhattan upper west side

"Preventative" is not a proper English word. The correct word is "preventive."

Oct. 10 2011 10:48 AM
David from West Hempstead

There's nothing "confusing" about evidence-based medicine. If we had an education system that taught people to understand statistics, this would be a non-issue.

Oct. 10 2011 10:46 AM

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