You have made some great distinctions in your first post. I generally agree with much of what you are saying. My key question in my first post was whether cancer was better off monitored than undetected. I fully respect your opinions and value them as counterpoint. But here is one point you made that indicates that we don't understand the criteria to respond in kind.
In your first post you said...
· The ACS “…does not advocate testing for all men.” I don’t either. Here’s a couple of realistic scenarios. An 85-year old with congestive heart failure probably and no prior prostate problems would be one example of a man no longer needing testing. Nowhere does the ACS imply (advocate) that a 50-year old with a family history shouldn’t be tested. Anybody disagree with these?
First, no one said test 85 year old men in poor health. In fact, controversial as it is, current screening guideline are 50 to 75 in the ACS guidelines. 45 to 75 in cases with known family history. This is the population demographic that is being referred to in the term "population based".. LOL, No new born baby boys in the group, thank you. The fact is however, that most men don't know the risk factors. I know I did not. The AUA, PCF, and ASTRO have all lowered their guidelines 35 with family history, and 40 without to get a baseline. If a man is 44 and has risk factors, ACS provides no guideline for him to be screened. I firmly disagree with that position.
Simply put, the ACS use of the term "population based" screening is unclear and provides misconceptions for all reporters to report, for all insurance carriers to use against the patient, and for many men to excuse themselves from the screening conversation at the dinner table.
As a patient advocate, I will not support these changes by the ACS.
Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1
My journey is at: www.caringbridge.org/visit/tonycrispino
My InfoLink page is at Tony's Prostate Cancer InfoLink Page
Post Edited (TC-LasVegas) : 10/22/2009 6:00:01 PM (GMT-6)