Let me simplify this discussion. Here is the front page on the ACS website text about
prostate cancer...Clearly the 43 year old African American that Brawley would test is pre-testing in these guidelines. There was not even pre-conditions such as family history in the discussion and Scardino suggested testing all African American men at age 40 to which Brawley replied that he WOULD test African American males at age 43. Can someone please tell me where you can discern assumptions that this is within the ACD guidelines from the following text at the ACS website:www.cancer.org/docroot/ped/content/ped_2_3x_acs_cancer_detection_guidelines_36.asp
The American Cancer Society recommends that men make an informed decision with their doctor about
whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes that men should not be tested without learning about
what we know and don’t know about
the risks and possible benefits of testing and treatment.Starting at age 50, talk to your doctor about the pros and cons of testing so you can decide if testing is the right choice for you. If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with your doctor starting at age 45. If you decide to be tested, you should have the PSA blood test with or without a rectal exam. How often you are tested will depend on your PSA level. For more information, please see our document, Prostate Cancer: Early Detection.
In the next document which is linked in the above statement at the ACS website, ACS really sets the confusion free by suggesting that doctors should begin talking to men about
prostate cancer screening at age 40, but screening should begin at age 45 only in high risk cases. For an African American male high risk is defined as 45, immediate family history specifically first degree family history that was diagnosed before the age of 65.www.cancer.org/docroot/CRI/content/CRI_2_6x_Prostate_Cancer_Early_Detection.asp?sitearea=&level=
These are documents at the ACS. So no media to blame for the confusion. The person to blame in the media for the confusion just stated he would randomly test a 43 year old African American male in his office.
Now I can beat this message up on numerous levels. And I won't stop until the ACS fixes this. Here is what I find confusing at the ACS website:
1> Why does the ACS suggest begin talking to the male at age 40, but recommends no testing until they are 45 and only very high risk cases? In this statement it misses the mark by a mile. If a 40 year old white male comes to virtually any PCP doctor in the USA and mentions anything about
screening for prostate cancer, the doctor is not going to have this long discussion about
it, they are going to click the PSA test, and likely throw on a glove and lube it up regardless of family history. The only thing that can come out of this is the high risk patient won't even ask about
it and likely won't get the screening the Dr. Brawley said he would do if it was him.
2> The document also states this:If, after this discussion, a man is unable to decide if testing is right for him, the screening decision can be made by the health care provider, who should take into account the patient's general health preferences and values.
I am totally against this statement because it sends the message the our doctors should make these decisions for us. It also suggests in the following paragraph that a PSA of less than 2.5ng/ml may only need to be retested in 2 years. What??? Our members here know that testing a 43 yo African American male with a 2.5 is a HIGH reading that should raise a flag.
I can keep going here, but it's a waste of time if it isn't understood that the ACS standards are controversial. What I saw was a chink the armor from Brawley and it was a very positive step in bringing the ACS back in line with the medical community. The press is confused and perhaps overstating things, but I cannot blame the press when reading the guidelines on the ACS website...
Advanced Prostate Cancer at age 44 (I am 47 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7
LARP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas
Blog : www.caringbridge.org/visit/tonycrispino
Post Edited (TC-LasVegas) : 6/1/2010 1:29:10 PM (GMT-6)