mammograms and PSA testing

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lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 11/19/2009 1:30 PM (GMT -6)   
As you have most likely read in the news a few weeks ago was controversy over PSA Screening. Now the news is on Mammogram screening. Not trying to start a huge debate here but its interesting that this news has come out as the new Health Care plan is being talked about.
 
Once again though it seems that the ladies are making more headlines on this then the men did on the PSA testing.
 
Larry
Age 55 / age at diagnosis 54, PSA 5.1
Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
Final Path report:
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear, Positive Margin Noted in Right Apex
 
First post Surgery PSA - 0


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 11/20/2009 5:55 AM (GMT -6)   
It'd be nice if they'd just say it in ENGLISH:
 
Ladies if you're 47 years old and you've had 7 CLEAR mamograms seven years in a row - odds are really really good that you can skip the test next year.
 
Course the kicker is - if you skip a years AND then find something the next time - you'll always wonder if you could have found it sooner.

LenB
Regular Member


Date Joined Jul 2009
Total Posts : 102
   Posted 11/20/2009 7:39 AM (GMT -6)   
Guys,

Let's remember that skipping a mamogram is much more serious because breast cancer generally grows at a faster pace. I agree with Larry, this is only the beginning. Tighten your safety belts because this ride is going to be rough.

Len
Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09: <0.0
 
 


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 11/20/2009 9:24 AM (GMT -6)   
And the saga continues. Today the newspaper story appeared that these same folks are now recommending an every other year or 3 year schedule for women to get pap smears for cervical cancer.

As the national healthcare reform continues to grow we are going to see more guidelines about lesser tests and treatments continue to grow. Maybe less testing is required, but it certainly seems as though the most upfront factor is the reduction of healthcare coverage for systematic screenings for just about anything.

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


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 11/20/2009 9:30 AM (GMT -6)   
I think I read that both the PAP and Mammogram studies were begun in 2007 and are just now completing and the results being published. If so, then this was just a case of baad timing, rather than any future healthcare plan conspiracy.

From the AP:
"The timing of the Pap guidelines is coincidence, said ACOG, which began reviewing its recommendations in late 2007 and published the update Friday in the journal Obstetrics &"
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN

Post Edited (James C.) : 11/20/2009 8:42:02 AM (GMT-7)


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 11/20/2009 10:04 AM (GMT -6)   
A agree with James that I don't think it is a conspiracy, but I do believe we are seeing the begining of trend that is starting with screening and will eventually move to procedures.and medications. The sad fact is that health care is too expensive and the government will have to find ways to cut costs. The easiest way to get the biggest bang is to limit screeing and go with least cost procedures and meds. The thought is that some people will die, but society in general will be better off. This is nothing new as all countries that have government paid health have limitations on screening, procedures and drugs. We may not like it, but it's a pretty common approach and makes a lot of sense if you are considering the general welfare vs the individual.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 11/20/2009 10:18 AM (GMT -6)   

Those of you who have seen my responses in other threads know I'm generally a pro testing advocate.  At least in the mammogram case, there is some possible validity to an argument for reduced testing because the test itself (which involves radiation) does introduce some negative health risk (i.e. cancers induced by the accumulated radiation dose itself).  So, a relative risk analysis is warranted.  But this seems to get dwarfed by the rhetoric from those who are really just shilling for cost rationing under the guise of 'protecting the public'.  I don't have any facts on the relative risks of the test.  As a result, I'm still on the testing side on this one.

In the PCA case, there is no appreciable risk to testing.  So there's really NO excuse for the nonsense being spouted.  It's just a bad Sci Fi scenario ala 'Logan's Run'.

I reject the notion that says we have to accept the status quo on the sophistication of our health care technology.  We need to continue to research and develop better tests that are more specific with less risk.  The answer to our current problems is MORE technology, not less.  My concern with the rationing philosophy is that it not only throttles the use of the diagnostics we have now, it also greatly reduces the incentive and funding for developing better diagnostics.



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.
 
 

Post Edited (Rolerbe) : 11/20/2009 9:24:51 AM (GMT-7)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/20/2009 10:32 AM (GMT -6)   
I am not impressed by the ACS, USPSTF, and now the ACOG... The clear message is that screening saves lives, just not enough of them. I do not and will not ever stand with them for placing a price on saving lives. As a cancer survivor, I find it very interesting on the timing of these sudden ground breaking announcements about screening. My mother died of cervical cancer last year at 71 and I know there is no study started in 2007 that has definitive results that should change a protocol that has been in place for decades.

I do believe there are outside influences. And I will leave it at that...

Tony
Prostate Cancer Forum Co-Moderator


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/20/2009 12:12 PM (GMT -6)   
Tony, your sentiments are the same as mine on this subject. I will never compromise my conviction on the need for early testing with all these cancer types.
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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
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


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 11/20/2009 1:02 PM (GMT -6)   
The group/organization that did the test have been doing these tests for years....
 
As I  mentioned before - according to the odd/statistics - if you've been cancer free 7 out of 7 tries - odds are you'll be clean next year...This is even better news if you are a low risk person...
 
So I don't this is any sort of conspiracy. On the other hand - I've neer been a car crash but I put on my seatbelt every time...
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