New government report on PSA testing

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Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/5/2008 8:16 AM (GMT -6)   
So in todays paper they are saying no to routine PSA screening for men age 75 and over. Conclusion is that the risks involved in treatment exceed the benefits to this age group,  so why bother to screen. Sound to me like Medicare is looking to save money.
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 8/5/2008 2:01 PM (GMT -6)   
Well, I was 72 when dxed with PCa and had annual routine tests since I was 51. That baseline showed that I was rising which led to a biopsy and hence the dx. I was 73 when dxed with LCa and it was caught early because I had a 2 year old xray to compare to. My point is that in both cases early detection probably will will give me many more years to live.

Now, I could die today from a heart attack or a motorcycle wreck. Does that mean that I shouldn't have been tested for both cancers? Or just not tested for PCa? I think not.

Look, this world contains all kinds of things that can kill us. Saying that we should not take all precautions including PSA testing is ludicrous. If we stop PCa testing at 75, what will be next? We had better not let "studies" determine who we let live...

Jim


Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 7/17/08 0.00. 
Next PSA test on 1/28/09
Lung cancer dxed on 5/16/08.  Surgery on 6/25/08  T1N1M0 - Stage IIA  Start chemo in September 08
"Patience is essential, attitude is everything."


StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 357
   Posted 8/5/2008 6:46 PM (GMT -6)   
Sounds like the HMOs and the insurance companies are trying to save money and treat us like statistics. Of course, we are statistics, but much more, besides...

75 is way too low. Maybe that is approximately the average life expectancy for American males, but a lot of men live well past that (and of course many don't). What the government is suggesting here is that a man that lives to 75, well, it's OK if he develops prostate cancer and dies at 85. To me, that is a crime if he would have otherwise lived to 95.

We should be educating men on how to make intelligent decisions about getting tested and getting treated when necessary, rather than taking the testing option off of the table.

anyhow, here is the article as published in today's Los Angeles Times... definitely of interest to many here, methinks.

_______________________

Stop prostate exams at age 75, federal panel recommends
Side effects of cancer treatments and stress from false positives outweigh any potential benefits, the group says. There's a backlash to the recommendation among some experts.
By Thomas H. Maugh II and Denise Gellene
Los Angeles Times Staff Writers

August 5, 2008

Men over the age of 75 should no longer be screened for prostate cancer because the potential harm from the test results -- both physical and psychological -- outweighs any potential benefit from treatment, a federal panel said Monday.

Most oncologists already argue against treating most men in that age group for prostate cancer because they are more likely to die from some other cause than from their tumor.

The new guidelines go one step further, saying, in effect, why test if the patient is unlikely to be treated?

The guidelines, published in the Annals of Internal Medicine, are only recommendations, but they are relied on by many physicians in determining patient care.

The recommendations could therefore trigger a decline in prostate cancer testing in the elderly.

The recommendations provoked a backlash from some experts.

"It sounds like a regulation promulgated by an HMO" to save money, said Dr. Dudley Danoff, president of Tower Urology in Los Angeles.

"I don't think it is fair to a guy who is 75. Yesterday's 75 is not the 75 of the 1950s. . . . If you stop screening and treating men at 75, you are going to have a lot more people dying of prostate cancer."

Dr. David Penson, associate professor of urology at USC's Keck School of Medicine, called the recommendation "a form of ageism."

"You can't make cookie- cutter recommendations," Penson said, adding that the advice could hurt patients by prompting insurance companies to stop paying for the cancer test, which costs $40 to $60.

Prostate cancer is the most common type of cancer among men after skin cancer. The American Cancer Society estimates that 186,320 new cases of prostate cancer will be diagnosed in the U.S. in 2008 and that 28,660 men will die of the disease this year.

There is controversy about whether to treat prostate cancer, because the tumors can take two forms: a fast-growing, aggressive one or a slowly progressing one that is relatively benign.

Most elderly men have the slow-growing form.

"The problem is that we can't tell which ones are really bad," said Danoff, who had not seen the new guidelines.

The test in question is called the prostate-specific antigen or PSA test, which most men start receiving at the age of 50.

High blood levels of the antigen in the test generally indicate the presence of a tumor. But confirming it requires a biopsy.

Current guidelines from the American Cancer Society and the American Urological Assn. recommend that the test be given to men older than 50 if they have a life expectancy of more than 10 years. But that has been problematic for doctors because gauging life expectancies can be difficult.

The new guidelines were issued by the U.S. Preventive Services Task Force, which was established by Congress to make recommendations about preventive care for healthy people.

In 2002, the Preventive Services Task Force said there was not enough evidence to offer guidelines on prostate screening in the elderly. But there have been at least eight new studies published since then, including a large Swedish study which found that treating men older than 65 did not improve survival.

Increased levels of treatment for prostate cancer in such men, the task force said, was to the serious detriment of their quality of life, with side effects including impotence, incontinence, weight gain, hot flashes and osteoporosis.

Also, the test has a high rate of false positives, leading to unnecessary biopsies, which are painful and carry a risk of infection. Positive tests also upset the patients, the task force said.

"We could not find adequate proof that early detection leads to fewer men dying of the disease," said Dr. Ned Calonge, chief medical officer of the Colorado Department of Public Health and Environment and chairman of the task force. "At this point, we recommend that men . . . make a decision based on their individual risk factors and personal preference."

The panel said the evidence was not conclusive for men younger than 75 and did not issue any recommendations for that group. The National Cancer Institute is now sponsoring a major trial to determine the utility of testing in this group, but results will not be available for years.

"In general, the guidelines make sense," said Dr. Leon Seard, chief of urology at Orange Coast Memorial Cancer Center in Fountain Valley. "We know that prostate cancer is a slow-growing disease and years ago used to say that 70 might be the cutoff. Now that the population is aging and remaining healthy, we are extending that to 75."

The guidelines won't change what he does, he said, because he doesn't routinely screen men over 75 unless they are African American, and thus have an increased risk of having aggressive tumors.

"This is another piece of evidence to present to the patient," he said.

Despite the panel's findings, there is some evidence that treatment is beneficial to the elderly. A 2006 study in about 45,000 men showed that treating tumors in the elderly increased survival by 30%, from an average of 10 years up to 13 years.

"Age, in and of itself, is not a definitive determinant of whether you should be excluded from treatment" for prostate cancer, said Dr. Mark Kawachi of the City of Hope National Medical Center.

Dr. Nick Tomasic, a urologist at Marina Del Rey Hospital, added that the guidelines don't always take into account the complexities of individual cases and the ability of doctors to closely monitor their patients' conditions.

The correct course of action for individual patients, Tomasic said, "is not always so cut and dry."
____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-18 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007); - 3rd post-surgery PSA: 0 (May 2007);
4th post-surgery PSA: 0 (June 2007); 5th post-surgery PSA: 0 (Dec 2007); 6th post-surgery PSA: 0 (June 2008)

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on daily Cialis, L-arginine and pentoxyfylline. Peyronies has stabilized and significantly reversed.

- PGE1 batting average: .364 (4 for 11)
- Bimix #3 batting average: .722 (13 for 18) Bimix #1 batting average (20 for 21) = .952
- Trimix batting average: .500 (1 for 2) Grand total 38 for 52 = .731

"Lost in the valley without my horses, no one can tell me what my remorse is..."


Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/6/2008 1:13 PM (GMT -6)   
Selmer, with all due respect, one's opinion is far more relevent if one has actually been dx'd with cancer. Reality bites hard. It is easy to speculate if one has never been there. I think any man of any age should be free to have his PSA tested. On NBC, they actually said there is a debate over whether PSA testing at any age results in increased survival. To me this is totally stupid. The best chance for survival with any cancer is directly related to early detection. Screening is the most effective way of finding cancer at an early stage. Does a 76 year old man have less justification for having a PSA than a 74 year old man. Not in my book. It may not be necessary for an older person to be screened as often, but if they want it tey should have it.
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.


cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 8/7/2008 12:27 AM (GMT -6)   
I saw this on the news last night. It seems as though some feel that prostate cancer is a 25 year disease between the ages of 50 and 75. Start checking at 50 and quit at 75. I am here to tell you that I am glad that a general practictioner had my psa checked during a routine blood test at 43. If I were 75 I would like to know whether or not I had prostate cancer. I along with my wife and other family members felt that Da Vinci was the way to go based on my circumstances. At 75 I would probably take a different approach to treatment, maybe not.
It just seems to me that the screening shouldn't be limited to the 50 - 75 age group. I see way to many active men in their late seventies and eighties. As a new member of this site, I see way to many profiles that start out with an age listed in the forties...
age:  44
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
gleason 3 + 3 = 6
prostate size 18cms?  not real sure about this
Da Vinci surgery 8/04/8 at Parkview Memorial in FT Wayne, In
 


41diagnosed
Regular Member


Date Joined Jun 2007
Total Posts : 176
   Posted 8/7/2008 12:38 AM (GMT -6)   
with a Gleason 3+4 at age 41, i'm with ya!  glad to be 43 and hopefully cancer free.  hey...that rhymes...will have to continue to use that this year :)

 
42 yo. now
 
5/07 PSA 4.65 at routine physical
6/07 biopsy positive for cancer...Gleason 3+4...diagnosed at 41 y.o.
6/07-9/07 manic research and interviews with physicians across the country in search of the "right" decision.  I went to Mass General in Boston, Loma Linda, University of Chicago and Northwestern.
9/17/07 - Radical Retropubic Prostatectomy Surgery at Northwestern Memorial in Chicago by Dr. William Catalona.  Thankful the father of the PSA test was right here in Chicago.
 
Post op pathology was Gleason 3+4 with negative margins, no seminal vesicale involvement, no lymphatic or vascular invasion, bladder and urethral free and tumor volume was 5% of 27.3g.  
 
9/27/07 - Catheter removal...let the games begin...
 
12/07 - Threw out the pads.  I only had to use 1 pad per day for protection against minor drips. 
 
I started Trimix 8 weeks after surgery with success.
 
I hope someday I won't need injections, but I hope more that my PSA stays at 0 forever.
 
 
 


cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 8/7/2008 7:33 PM (GMT -6)   
Selmer I do not believe I have lost sight as to what the current article was reccomending. I apologize for not being clear. I was just suggesting that maybe the recommendation should not be limited to the the 50 to 75 age group. I was just expressing my opinion.
age:  44
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
gleason 3 + 3 = 6
prostate size 18cms?  not real sure about this
Da Vinci surgery 8/04/8 at Parkview Memorial in FT Wayne, In
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2331
   Posted 8/8/2008 12:11 AM (GMT -6)   
Without getting into the question about an upper age limit for PSA testing, a more important question may be about lowering the recommended starting age for testing to 40. A number of prostate cancer experts recommend a baseline at 40, then every 5 years until 50 if the the PSA is low, every year if a high baseline. 
 

Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/8/2008 8:53 AM (GMT -6)   
Amen Tim. All the young guys on here know this for the truth. I doubt if anyone who has actually been dx'd with cancer at any age would be flippant about who and when testing should be given. I'm all for younger guys being tested for colon/rectal cancer in their 40's as well. Having survived two types of cancer, melanoma and prostate, I am totally in support of screening for early detection.
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.


Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/8/2008 2:18 PM (GMT -6)   
Selmer, in reading your profile I have to wonder why you spend so much time here. Rejoice in your low PSA numbers and get on with your life. Hanging out in a cancer support site is kinda unusual for someone who isn't a patient or a family member/care giver of a patient. Enjoy your life buddy, there's plenty of time to worry and fret if the hammer comes down.
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 8/8/2008 3:09 PM (GMT -6)   
I know this is very emotional for many here. I think we just have to wait for the two major studies with thousands of participants that is due out in the near future.
Diagnosed 10/08/07
Age: 58
3 of 12 @5%
Psa: 2.3
3+3=6
Size: 34g
T-2-A
 
2/22/08
3D Mapping Saturation Biopsy
1 of 45 @2%
Psa:2.1
3+3=6
28g after taking Avodart
Catheter for 1 day
Good Candidate for TFT
(Targeted Focal Therapy)
Cryosurgery(Ice Balls)
Clinical Research Study
 
4/22/08
TFT performed at University of Colorado
Medical Center at Denver Fitzsimmons Campus
Catheter for 4 days
Slight soreness for 2 weeks but afterward
life returns as normal
 
7/30/08
Psa: .32 
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 8/8/2008 4:40 PM (GMT -6)   
Hey Selmer,

Your posts are very wordy and hard to read. However, I think you are saying that you are trying to head off PCa with diet etc. Okay, fine, but saying it again and again in 500 words get old. If playing around with your PSA is your thing then have at it, however, this site works best for those of us who have cancer and want to share our experience, strength and hope...

Jim
Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 7/17/08 0.00. 
Next PSA test on 1/28/09
Lung cancer dxed on 5/16/08.  Surgery on 6/25/08  T1N1M0 - Stage IIA  Start chemo in September 08
"Patience is essential, attitude is everything."


Guy66
Regular Member


Date Joined Jul 2008
Total Posts : 32
   Posted 8/8/2008 5:34 PM (GMT -6)   
Well I'm not trying to pick on Selmer. I think every man should be aware of cancer risks that apply to them. As for friends, neighbors, family members having prostate cancer, just about every man in his late 50's or 60's can lay claim to that. At 6'1, 175 and a 32 waist, I have never been obese in my life. Sure diet and obesity contribute to some men's prostate cancer. But I was a semi professional athelete earlier in life and still maintain a high level of fitness and eat a healthy balanced diet. Did that protect me from cancer? Obviously not. The causes for cancer are varied and complex. I am also aware that some people can harbour an obsession with their health to the extent that it has a big influence on their behavior. Once well informed, I see little to be gained by a healthy person hanging around a cancer forum. I certainly wouldn't be hanging out if I didn't share the misery and loss of patients and their families that goes along with going through actually having this illness and the after effects of treatments. For my brothers dealing with this disease, I know your pain. I know your loss. I grieve for those who have to deal with advanced cancer. I sympathize deeply with those who are dealing with incontinence and impotence. Others can read about it and generally understand. But those of us that have to walk the walk, deserve the right to talk the talk. I'm probably talking too much. But this isn't an interesting hobby for me. Its my freaking life now.
Guy 66
first biopsy was in 1997. Neg. Dx BPH PSA 5.4
second biopsy in 2001 neg again PSA 9.8
passed blood Feb 08 3rd biopsy positive PSA 14.6 Gleason (3+3)=6
Pre op Xrays, CT scans, bone scans all neg
Da Vinci surgery 3/3/08 no complications, nodes clear
Significant post op discomfort for approx one week
Daily improvement 2nd week, near nornal mobility, etc 4th week
Filled pads every 2 hours for first month, gradually improved to not wearing pads after 2 months. Whoopee!
Occasional small leak when sneezing or farting, haha
Total loss of erectile function so far, some loss of rectal muscle function also.
Currently back to 100% physically, working out, etc.
Some lingering attitude issues over lack of function. Anger sometimes, moderate depression sometimes. Feel good physically but lingering changes in emotions. Joi da vie not the same. Feel lucky overall, but emotionally flat. A vague sense of loss, diminished pleasure in life. Hope to rebound as time goes by. Survived melanoma in 2000, pacemaker in 2002. Three time winner? Doesn't feel that way.


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2331
   Posted 8/8/2008 5:47 PM (GMT -6)   
Selmer--How's your PSA?  I notice that you have been getting tested every six months since yours jumped, but don't see any recent results in your profile. What PSA data would lead you to consider a biopsy? My absolute PSA and PSA increase was very similar to yours and I was found to have cancer.
 
As I understand it--correct me if I'm wrong--you seem to be of the opinion that because studies show less-than-conclusive results that the best course is to do nothing except diet modification.  I'm in favor of diet and other lifestyle changes, but do you think that diet alone is the key to beating prostate cancer?   
 
 


Age 59  PSA quadrupled in 1 yr (0.6 to 2.5) 
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 2006 
Organ confined pT2a  Gleason 5   
Cancer-free for 2 years  PSA's undetectable 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/8/2008 8:45 PM (GMT -6)   
Selmer,
Sometimes you dilute your message. You have good points many times. But I sometimes will bypass your posts because they are too long and wander off topic. This thread has those examples ~ The topic for discussion is a government report ~ and I learned from you that you don't watch sports anymore.

please go easy on us cancer guys! We already have too much to digest.

Peace,

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 


FLHW(David E)
Regular Member


Date Joined Nov 2007
Total Posts : 201
   Posted 8/8/2008 8:59 PM (GMT -6)   
Regarding the study, think about this:
There were no urologists or oncologists on that Task Force.
Here's the makeup of the Task Force:

Epidemiologist: 2 One of whom is the Chair, the other Vice Chair
Family Physician: 2
Internal medicine: 2 One who works for the VA
Registered Nurse: 2
Pediatrician: 2
Primary Care: 1 Affiliated with a major health organization
Ob-Gyn: 2
Clinical Psychology: 1
Geriatric Care: 1
Perinatal: 1

Urologist: ZERO
Medical Oncologist: ZERO
Pathologist: ZERO
Biochemist: ZERO
Dx'd 2/18/05
PSA 271, bone mets, lymph node involvement
Gleason Score: 7
Current (6-30-08)
PSA: 53.40
Taxotere + Prednisone + Atrasentan
[started June 9th]
Clinical Trial:
http://www.clinicaltrials.gov/ct2/show/NCT00134056?term=prostate+AND+atrasentan&rank=2
Lupron
Personal Blog:
prostatecancerat42.blogspot.com


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/8/2008 9:12 PM (GMT -6)   
This post lends a bad thought to the "Socialized healthcare" proposition. I already know that some of our foriegn membership is sometimes frustrated by the timelines of care, location of care, and care options that get dictated by protocol that is determined by "councils" and "commitees" like the one that posted this article. The thought that some men won't get tested because these guys sat around a table and made this conclusion will affect many that could benefit by undergoing treatment. As an advocate I am learning a lot these days that precipitate keeping this system competitive. Now I'm not going into the dicussion of if socialized medicine is right or wrong. But rather mentioning this because any changes in healthcare cannot be dictated by these typres of committees alone. I think any 75 year old is quite wise enough to make his own call on this. Right now the standard is 'test at 50 (a discussion I would like to argue) with a life expectancy of 10 years'. There are plenty of 75 year olds that will live longer than 10 years.

Tony


Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 

Post Edited (TC-LasVegas) : 8/8/2008 9:07:49 PM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 8/8/2008 9:17 PM (GMT -6)   

Great point, David,

And others missing in the report:

Prostate Cancer Survivors: Zero

75 Year Old Prostate Cancer Survivors: Zero

 

 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 8/8/2008 9:51 PM (GMT -6)   
The only study or statistic that I care about in the discussion about old guys getting tested and treated is:

Biker 2 - Cancer 0
Age 74. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 7/17/08 0.00. 
Next PSA test on 1/28/09
Lung cancer dxed on 5/16/08.  Surgery on 6/25/08  T1N1M0 - Stage IIA  Start chemo in September 08
"Patience is essential, attitude is everything."


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 681
   Posted 8/9/2008 10:19 AM (GMT -6)   

 

Thanks folks for trying to cool the person to person debate.  The real issue here is the announcment that a government board recommends that doctors not test older men for prostate cancer. Beside the fact that the members of this committee are no more qualified on this issue than you and Me, they are political appointees with questionable motives.

From my prospective this is bad on many different levels.  I am 67 and never had a psa test until I was 64 years old. According to this government committee, I was approaching an age  that they suggest does not require treatment. My wife and children feel differently.

Unfortunately, recent events have given me reason to distrust our own government.  We hear too many reports of government agencies and committees that are doing the work of special interest groups.  It is sad ,but true, that they are no longer our advocate.

Bottom line is that all men should be encouraged to have prostate cancer testing. The insurance companies and special interest groups who "run" our government should stay away.

 


PSA up to 4.7 July 2006 , bump noted during DRE
Biopsy 10/16/06
T2A, Psa 4.7
Gleason  4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8
No extension or invasion found
No continence problems
PSA 90 day -.01  , 6 month -.01 , 9 month +.02 , 1 year +.02
Using Bi-Mix or VED 
 
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/9/2008 10:48 AM (GMT -6)   

Where the rubber meets the road, the first line of the article:

"Men over the age of 75 should no longer be screened for prostate cancer because the potential harm from the test results -- both physical and psychological -- outweighs any potential benefit from treatment, a federal panel said Monday."

Now, I don't really understand what the physical harm from a syringe-drawn blood test is, unless they are lumping in biopsy procedures as part of the process of producing harm. I see that they are saying the potential harm comes from the results, so it is unclear what they are getting at, except for biopsy, and the resulting surgical, radiological, or other treatments they will choose.  

 There is a psychological impact, as I am sure we all will agree, of hearing you have the possibility of PCa.  This part of the equation sometimes carries a greater danger of harm, in my opinion, that testing and biopsy. It's not one that I would avoid, just because of my age, when the end-life age limit is increasing yearly now, and productive living can continue routinely into the 90's. 

This may be a case of the a non-expert panel still playing catchup with old concepts of our disease, like the medical community still behind the curve as far as recognizing the need for earlier testing of men below the now standard 50 age. 


James C.
Co-Moderator- Prostate Cancer Forum

Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07 ED- begin 50mg Viagra and Vacurect pump nightly, Fully continent
1/14/08 Caverject started/stopped, aching. 2/24/08 .5ml Bimix started-success
7/31/08 ED- Viagra, pump continues, no response- Trimix .10ml x 2 weekly continues
Post Surgery PSA's:  3 mts-0, 6 mts.-0, 9 mts.-0.

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