Archived posting to the Leica Users Group, 2011/10/08
[Author Prev] [Author Next] [Thread Prev] [Thread Next] [Author Index] [Topic Index] [Home] [Search]Hello everyone,A very interesting debate. I happen to be screened (PSA) once a year and I'm very happy with this procedure because the test will reveal - as a first SIGN - that something might be developing, the issue being, as always, how the results are interpreted. I think the real problem is whether you trust the person who's advising you on what to do.Jean-Michel, Strasbourg - a newcomer to this forum> From: philippe.amard at sfr.fr > To: lug at leica-users.org > Date: Sat, 8 Oct 2011 08:41:09 +0200 > Subject: Re: [Leica] OT Panel advises against prostate cancer screening - > Yahoo! News > > > Le 7 oct. 11 ? 21:42, Steve Barbour a ?crit : > > > > > On Oct 7, 2011, at 12:23 PM, Charlie Chan wrote: > > > >> If I may, I might interject, as my day job is as a cancer surgeon, > >> treating breast cancer and melanoma. > >> > >> The problem is to do with the balance of benefit v risk. Screening > >> healthy people is very different to treating people with symptoms. > >> One day, healthy people are walking down the street, the next they > >> are facing a life threatening diagnosis and all that entails. > >> Biopsies, surgery with possible complications etc. Problem with > >> prostate cancer is that not all prostate cancers are the same. Some > >> people will get an more aggressive form, but many people will have > >> a more indolent version of the disease, which doesn?t kill them. > >> > >> Like all screening tests, there will be ?false positives? ie > >> positive test results (eg PSA blood test) in people who don?t have > >> cancer, as well as ?false negative? tests - ie a normal PSA in > >> someone with cancer (very unusual in prostate cancer). The false > >> positive group is the real issue in screening as we can potentially > >> do harm to healthy people who don?t have cancer. Even in people who > >> do have cancer, not all of them will develop the aggressive type > >> that becomes non-responsive to hormone drugs. A radical > >> prostatectomy has its problems including urinary incontinence and > >> inability to have erections. Sure, you would trade that if you had > >> the aggressive prostate cancer type, but maybe not if you had the > >> indolent version. Difficult thing is that we can?t tell which > >> person has which type yet. > >> > >> So, it?s not easy. Even breast screening with mammography is not as > >> straight forward as it seems. There are many who think (probably > >> correctly) that the benefits are far less than that which is > >> trumpeted to the public. > > > > > > > > thanks very much Charlie, I totally agree...a delicate balance of > > benefit-risk, and a dilemma that for the moment is settled by the > > current recomendation. > > > > > > > I read the whole thing on two levels: > mass detection -> cost for the health system, potential waste, profit > for insurance companies and doctors alike, against benefits for the > population, etc. > individual detection -> marginal risk, yet risk all the same hence a > tough decision for it is unclear what or whom is to be trusted. > Better be a woman is that case again ;-) > > Ph > > > > Steve > > > > > >> > >> Best wishes, > >> > >> Charlie Chan > >> Cheltenham, UK > >> > >> topoxforddoc at btinternet.com > >> www.cancer-surgeon.co.uk > >> www.charlie-chan.co.uk > >> > >> > >> > >> On 7 Oct 2011, at 19:57, Gary Pinkerton wrote: > >> > >>> At first glance, it's as though they are saying that the screening > >>> itself (blood test) can cause problems. > >>> But, isn't it more about how the results of the screening are > >>> dealt with (unnecesary surgeries, biopsies, etc)? > >>> Of course, I'm easily confused, so maybe I'm misunderstanding what > >>> they are saying :) > >>> > >>>> From: steve.barbour at gmail.com > >>>> Date: Fri, 7 Oct 2011 11:40:05 -0700 > >>>> To: lug at leica-users.org > >>>> Subject: [Leica] OT Panel advises against prostate cancer > >>>> screening - Yahoo! News > >>>> > >>>> this subject came up in the recent past... > >>>> > >>>> > >>>> fyi > >>>> > >>>> > >>>> http://news.yahoo.com/panel-advises-against-prostate-cancer-screening-024452851.html > >>>> > >>>> > >>>> _______________________________________________ > >>>> Leica Users Group. > >>>> See http://leica-users.org/mailman/listinfo/lug for more > >>>> information > >>> > >>> > >>> _______________________________________________ > >>> Leica Users Group. > >>> See http://leica-users.org/mailman/listinfo/lug for more information > >> > >> > >> _______________________________________________ > >> Leica Users Group. > >> See http://leica-users.org/mailman/listinfo/lug for more information > > > > > > _______________________________________________ > > Leica Users Group. > > See http://leica-users.org/mailman/listinfo/lug for more information > > _______________________________________________ > Leica Users Group. > See http://leica-users.org/mailman/listinfo/lug for more information