I wonder what Insurance company or companies own this thought group?

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/16/2009 6:09 PM (GMT -6)   
 
This is not about prostate cancer, but our sister's cancers: breast cancer, but another source discouraging early testing and self exams for women.  Their logic makes no sense to me.  Interestingly, the ACS rebuked these findings, yet they are the same ones discouraging testing for Prostate Cancer.
 
Just thought it was interesting.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 11/16/2009 7:09 PM (GMT -6)   
Jeez, it reads just about like the releases put out about PCa recently. You could almost insert PCa and Breast cancer in each of the releases and it would read the same.

They both quote that the additional life saved by early detection is not worth the costs of the early screening tests. Although they state it as not worth the mental anguish and unnecessary tests that the screening results in.

If I was a conspiracy theorist (which I am not) it would sound like the insurance companies and the government are joining up to make the costs of the healthcare plan (whatever it is) shrink in preparation of allowing the companies to continue to make a profit while seeming to work with the government.

In my own case, maybe if my doc didn't have his head buried in the sand about the acceptable numbers for PSA and age, I wouldn't be heading to IMRT just 8 weeks after surgery. Don't take me wrong, I am not bitter. Just pragmatic and logical.



IMHO,

Sonny
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

da Vinci 9/17/09 Dr. Mani Menon Henry Ford Medical Institute

Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
ALL NERVES SPARED
Margins: focally positive right posterior mid level
Perineural Invasion: present
Seminal Invasion: absent
Venous Invasion: absent
Angiolymphatic Invasion: absent
Left Internal iliac lymph node: reveals zero
Right Internal lymph node: reveals zero


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 11/16/2009 7:16 PM (GMT -6)   
Once again the data they used only talked about the chances of dying.
"The task force advice is based on its conclusion that screening 1,300 women in their 50s to save one life is worth it, but that screening 1,900 women in their 40s to save a life is not, Brawley wrote.
That stance "is essentially telling women that mammography at age 40 to 49 saves lives, just not enough of them," he said. The cancer society feels the benefits outweigh the harms for women in both groups. "

What about quality of life?!? Any data on breast removal because the cancer was found later rater than earlier?

This sounds just like my Doc telling me he does not order PSA until 55 because of a study that showed only one man in 1000 is saved by it. How long had my PCa been cooking in me for it to be 23? If he did a PSA when I was 50 would I be wearing pee pads and using a VED like I am today?
Nobody knows.
Jeff
DX Age 56. First routine PSA test on April 8th: 17.8.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 10/31 3 months, Still no activity, nada, zip
Incontinence - 8/20 4 full pads per day
. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
9/27 2 months: Still 3 pads per day.
11/14 4 month: Still 3 pads per day. 420ml/day, 91 um leak. At this rate I'll be fine in 2012.
Post Surgery PSA - 9/3 6 weeks- 0.05, 10/13 3 months- 0.04 undetectable.


O Buddy Boy
Regular Member


Date Joined Oct 2009
Total Posts : 106
   Posted 11/16/2009 7:19 PM (GMT -6)   
I just have to wonder what equation they use to determine the value of the life saved vs. the cost of the cancer tests.

What's that formula?

If I'm reading my search information right a mammogram costs $100, and early testing saves one in a thousand. Now if my math is not that rusty, we're talking $100,000 a life. Tony Soprano should be so lucky.

OBB
55 yo
Dx:9/29/09
DRE: Susp
PSA: 3.5
Gleason: 3+4/7
6/12 Cores Positive; Sextants were 1%, 3%, 8%, 15%, 12%, 0%
RALP: 10/09/09
PATH:
Margins: Clear
Lymph Nodes: Clear
Seminal Vesicles: Clear
Gleason: No increase from biopsy 3+4/7
Some perineural and capsule invasion.
T2c,NO,MX
Incontinence: Minor. 1 light pad a day. Some days don't need it.
ED: Natural with encouragement. 20mg Cialis and pump just makes things more fun.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 11/16/2009 7:29 PM (GMT -6)   

Sonny:

 

Can you elaborate about your PSA comment? 3.0 doesn't look that bad. What did the doctor miss?

 

Mel


PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro!
 
History of BPH/prostatitis.
 
Awaiting results of my PCA-3 test which will determine whether a biopsy is in my immediate future


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/16/2009 7:37 PM (GMT -6)   
It's easy for groups and studies to discount lives at the individual level. Certainly would be different if they were talking about their own life, or the life of one of their loved ones.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 11/16/2009 7:53 PM (GMT -6)   
Mel,

3.0 by itself is maybe not so bad, but at 60 maybe a little on the high side. But the rise to 6.4 in 16-17 months is a bit strong. I had no basis for knowing if the PSA had been on the rise before that. When I asked they replied they couldn't find previous PSA results. Now I know I had given that man blood at least once or twice a year just about every year I have been seeing him as the family doc (maybe 20 years).

I think he is one of those that just didn't feel it was worth it to check the PSA box when running blood tests.

Hence my PSA remark. Just a gut feeling.

BTW, it took him 2 years before my wife's cancer was diagnosed. And that only after she demanded a full 1/2 hour of his time with no interruptions and forced him to listen to her about her concerns. Thankfully, that prompted some tests that came back just weird enough to hand her off to some experts in other areas and ultimately lead to her diagnosis. When diagnosed she was stage 3A in a top of 3B world.

Sonny
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

da Vinci 9/17/09 Dr. Mani Menon Henry Ford Medical Institute

Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
ALL NERVES SPARED
Margins: focally positive right posterior mid level
Perineural Invasion: present
Seminal Invasion: absent
Venous Invasion: absent
Angiolymphatic Invasion: absent
Left Internal iliac lymph node: reveals zero
Right Internal lymph node: reveals zero


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 11/17/2009 4:32 AM (GMT -6)   
Just for the record I gave blood to my Doc during my 50 year physical (actually at 52). He checked the standards items: cholesterol, sugar etc but ignored the PSA and enclosed a letter describing why he does not do general PSA screening.
We had a loong talk about this during my last physical. Maybe I changed his mind.

Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 11/17/2009 1:41 PM (GMT -6)   
I just can't understand the arguments. They are basically touting the value of ignorance. Incredible. You can always decide what to do based on information. You can never decide what to do based on ignorance.
51 YO
PSA at Dx: 8.2
DaVinci RALP: 10/31/08 -- Great MD in New Haven, CT
Negative margins, no extra-capsular involvement
One nerve spared
PSA at 0 for just over a year now.
 
 

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