New Book: Let Sleeping Dogs Lie?: what men should know before having a prostate cancer test

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Prof Simon Chapman
New Member


Date Joined Nov 2010
Total Posts : 1
   Posted 11/11/2010 5:01 AM (GMT -6)   
Hello -- with two colleagues, I have just published a book for men facing the decision on whether to be tested. The book can be purchased or downloade free here http://purl.library.usyd.edu.au/sup/9781920899684
Prof Simon Chapman
University of Sydney, Australia


Note from Moderator ~ TC-LasVegas
We have reviewed this post and determined it is not spamming. The author has spoken to our moderators and has no financial interest or other vested interest other than to inform men about prostate cancer screening and the controversy surrounding it. I have posted additional information in a post below...

Post Edited By Moderator (TC-LasVegas) : 11/11/2010 12:21:25 PM (GMT-7)


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 11/11/2010 11:27 AM (GMT -6)   
Hang on a second, guys...this is free. I just verified this by downloading the book in couple of seconds. It's also free of advertising. You don't even have to register.

It's published by a university press in Australia, by reputable authors--3 professors of cancer medicine, epidemiology and public health at the University of Sydney.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/11/2010 11:37 AM (GMT -6)   
I agree with Galileo,
This is not a sales pitch when it's free. i will write the author and find out what gives with this and if he is merely making the information available for free then we just need to have a meeting of the minds. I actually have heard of him before.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 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.

Status:
"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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 11/11/2010 11:43 AM (GMT -6)   
Tony, you are a moderator, looks like an obvious violation of Rule 5, but hey, it's your call. You usually don't let first time posters link anything.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/11/2010 12:04 PM (GMT -6)   
Since it is a pdf, and there are security issues these days, I downloaded it on a "safe" machine and did a McAfee scan. Looks ok. The University link shows as ok as well.
I don't trust at first glance anyone who offers me a pdf file, so this is not intended to be a selective test. And the book looks useful for those new to PCa.
 
He did break the rule about first time poster and links.
 
 

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 11/11/2010 12:08 PM (GMT -6)   
Since I am allowed to post links, here is the link originally provided above:

purl.library.usyd.edu.au/sup/9781920899684

and to go straight to the free PDF, go here:
ses.library.usyd.edu.au/bitstream/2123/6835/3/Let-sleeping-dogs-lie.pdf
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 11/11/2010 12:32 PM (GMT -6)   
the strange part of this whole thing is how does it take three people to write an entire book about just getting TESTED for pc?

Sure, a book about treatment options, but a book that says men should have their PSA checked, and then get a biopsy if its high????

Am I missing something or what?
52 yr old, newly diagnosed. PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.
Da Vinci surgery scheduled for 12/30/10
Hoping that the robot does not become "self-aware" (we all are old enough to get this reference)

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/11/2010 12:46 PM (GMT -6)   
No you nailed it Dave,
I am currently reviewing the document and it's a great read. The ACS should be putting something out like this as opposed to ambiguous statements and comments. My early read is that this is a very educational document that gives a great perspective on screening.


Galileo thank you for the relink, but it isn't necessary if the poster contacts us. The author serves the University of Sydney at a high level. We have allowed posts with links by universities here and abroad to stand.

Tony

Post Edited (TC-LasVegas) : 11/15/2010 9:09:44 PM (GMT-7)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/11/2010 12:47 PM (GMT -6)   
In my quick read, I see more of a review of the question that came out of all the recent bruha about being tested at all. Should one get tested? They are looking at it from the Australian suggestions / point of view.
The useful part in my mind was the 10,000 foot view of tests, treatments, and side effects. I doubt there is anyone who has been a member here for more than a month who would need it, but I could see it being valid for true nubies. It would never replace the Walsh book, but then how many men actually read the Walsh book before treatment?
 
Free, it is interesting. If I had to pay for it, probably would not.
 
Three people required to write it - no, but it does put three names which I am sure are known in Australia on the equivalent of a white paper.
 
Added-
I wish my GP or Uro had given me something like this when my first PCA test came back.

Post Edited (142) : 11/11/2010 10:51:02 AM (GMT-7)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 11/11/2010 2:01 PM (GMT -6)   
The Australian health care system is truly socialized is it not? All the doctors work directly for the government...So the back-stage issues would be different than ours..

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/11/2010 2:17 PM (GMT -6)   
I just had a very nice exchange with the author. His intent is to get feedback on the publication and to reach out to prostate cancer survivors about the challenges we face when being screened and diagnosed. He has also posted on several other locations including the PPML and others. i have posted these links on our UsTOO website and also alerted the InfoLink about the book.

Guys this is good stuff and while it is not generally approved for new posters to provide links, this looks like the exception. Dr. Chapman is well known in the Australian circles and has no intent to profit with this publication. The university does charge for a hard copy but to only cover the costs. The PDF will remain free.

I personally have downloaded the book for use in my UsTOO group and for reference.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 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.

Status:
"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

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/12/2010 7:46 PM (GMT -6)   
I downloaded and read the book. As I had said earlier, I am not sure I would have rushed out to purchase one sight unseen, but then I didn't have the resources to buy Cooper's CDU-guided biopsy either.
 
Having read, rather than skimmed it this time, I am impressed by the work that went into it. For all the statistics and citation folks, it is documented to the extreme. They also show multiple sides of the questions.
 
I read the focus to be more physician oriented - what is the impact / value of broad population screening. It follows up the bruha here about the changes in screening suggerstions here in context for Australia. That is obviously not a question that would provoke me to buy a book, but in the process of explaining pros & cons, there is a great deal of useful information for someone just faced with trying to understand the impact of a high PSA or an abnormal DRE, and where treatment may lead.
 
There appears to me to be a slight bias toward open surgery vs. DaVinci, but based on the machine population and surgeon experience they quote, I can see that. Made me think about the DaVinci arguments.
 
So, for a free download that might help a new patient / interested family, it works!
I did not feel like I wasted my time, which is a comment I can't make about a lot of the Prostate books out there.
 
 

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/12/2010 9:05 PM (GMT -6)   
142,
That is a great observation. I agree with your post entirely. When i first saw this I was ready to block the link, but what caught my eye was that the intent of the author looked sincere. Once I took the time to evaluate the document I was quite impressed with the effort. I do not 100% agree with the complete writing because some is based on opinion ~ opinions of the authors who do not have prostate cancer. But the book gave me some insight that was eyeopening. When i sent this off to Terry Herbert and Mike Scott I did so with the intent of helping Dr. Chapman with his goal of trying to educate ahead of the PSA test. I think the ACS should have this document readily available for anyone asking questions about screening. I also think that every doctor considering a screening should be aware of the information in this document.

Regardless, the document is well written and comes from a prestigious Australian University...from the top scholars there...well done indeed.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 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.

Status:
"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

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/14/2010 5:56 PM (GMT -6)   
Tony,
Would this be appropriate to add to the books/links sticky thread?

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 11/14/2010 11:11 PM (GMT -6)   
Fairwind said...
The Australian health care system is truly socialized is it not? All the doctors work directly for the government...So the back-stage issues would be different than ours..


I could enlighten you about the Australian health system but I feel you would find it of greater value and interest if you googled Australia and health care yourself. There is truly nothing more satisfying than enhancing the depth of your own knowledge. Quite apart from your erroneous perception of how the Australian health system operates, your tone indicates you are also dismissive of all health and treatment discoveries not made by US doctors. How terribly parochial. For instance, you should investigate the latest hormone therapy for PCa (abiraterone)....... a discovery made by medicos working in that evil socialized UK national health service. And it is a discovery that within their system and others like it, is made available to all those with serious stage PCa when they need it regardless of their financial circumstances. Their citizens regard good health care as a right far more important than the right to "other things"
Bill

Post Edited (BillyMac) : 11/15/2010 1:55:47 PM (GMT-7)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 11/15/2010 12:01 AM (GMT -6)   
You have it all wrong Bill.. I don't have anything against Australia or it's health care system..You folks live just as long if not longer than we do..

Here in the States, health care is a fast growing, profit driven business. Treatment recommendations always seem to gravitate towards what is the most expensive possible choice..No effort (yet) has been made to cut costs..If we have insurance, someone else pays the bills (most of it anyway) so we don't care what it costs..Those millions of us without insurance must depend on charity or simply get sick and die..

All I meant by the sentence you quoted is that our doctors are profit driven private businessmen who no doubt look at things differently than a secure public employee who only has to consider the cost / benefit equation when deciding on a patients treatment.

online.wsj.com/article/SB10001424052748703794104575546433109035578.html
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
age 61: 5.2
age 64: 7.5, DRE "Abnormal"
age 65: 8.5, " normal", biopsy, 12 core, negative...
age 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
age 67 4.5 DRE "normal"
age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 11/15/2010 5:26 AM (GMT -6)   
Fairwind,
I do apologize for misunderstanding your post. In effect the system in Australia is a two part system. All tax payers pay a 1.5% with there being further contribution from the general taxation pool. Funds are distributed by the feds to the states who build and staff almost all our hospitals. But almost all doctors are not employees but rather operate within the system on a fee for service basis. In effect the government is the insurer but no public servant has any input on what can or cannot be provided.....this is entirely the domain of the medical practitioner. This system ensures basic health care for all. Overlaid on this is an associated private insurance which can often deliver faster service for non urgent medical needs. Public hospitals here vastly outnumber private hospitals and more often or not the public hospital will provide the better medicine.
regards,
Bill

Post Edited (BillyMac) : 11/15/2010 3:40:50 AM (GMT-7)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 11/15/2010 2:27 PM (GMT -6)   
Mexico has a similar system, with a socialized, free, public health system that's a little rough around the edges but it gets the job done..The doctors who work in the system obtained most of their training paid for by the government in exchange for a commitment to work in the public system for 10 or 12 years..After that they can go into private practice if they wish..

In the parallel private system, including private hospitals that offer first class treatment to those with private insurance or who can afford it (like most Americans) it's strictly a fee for service system. Many Mexican doctors work in the public system and also maintain a private practice. Everyone seems to be happy with that status quo..NOBODY goes without basic health care.

In the States, the doctors, hospitals and drug companies are all VERY happy with the system as it stands. President Obama has run into a buzz saw as these forces unite against him and work to repeal or gut a health care reform bill that was passed by our last Congress..

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 11/15/2010 3:14 PM (GMT -6)   
Even with a peaceful discussion the last few posts are wandering off topic and I would like to invite anyone who wants to continue discussion on the political nature of healthcare to use another venue such as email or instant messaging. We have a rule (Rule 11) in place for these discussions as they do not pertain to supporting one another and can cause unnecessary commotion.

The publication in this thread deals with the pro's and con's of prostate cancer screening. Taking the pro or con position here is probably controversial enough for our site. I am pro-screening but educating a man with the information in this booklet first I would not be against.

Thanks for your cooperation.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 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.

Status:
"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

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 11/15/2010 3:55 PM (GMT -6)   
Apart from the differences in the various health care systems, did anyone else (ok, besides Tony and myself) download and read through the book?
 
I suspect the author was interested in what we thought of it as patients who look back and discuss what we did / did not get in the way of decision-making helps.
My thought is that it is good in that respect - I would have been better prepared if had been handed something like this at diagnosis.
 
It might have been too much for me to care about before getting a PSA, but my first was my only, so, not really relevant for me in that respect.
 
(Sorry Tony - started writing this but got called away before I hit send)

Post Edited (142) : 11/15/2010 2:00:21 PM (GMT-7)


Terry Herbert
Regular Member


Date Joined Sep 2010
Total Posts : 92
   Posted 11/15/2010 5:52 PM (GMT -6)   
Yes, I downloaded the book and will be giving a copy to my GP who is unclear as to what the authorities are recommending now for men regarding PSA and DRE tests - and why. I believe this will help him considerably, as it would every man who took the time to read it, especially if that was before he had a PSA test.

On a parallel but unrelated subject, anyone undergoing HIV testing in South Africa (often a requirment for insurance, employment house loans etc) has to be provided with an informaiton kit which is discussed with a qualified medical person (often a nurse) so that they understand the consequences of the test, specifically if it is positive.

It is unlikely that such a path will ever be followed by the medical profession, voluntarily, for PSA tests, but......maybe it would save a lot of heartbreak and unnecessary treatment if they did.
Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony Metastasis: Aug '07: Intermittent ADT: PSA 2.3 Aug '10

It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 11/15/2010 6:27 PM (GMT -6)   
Personally I feel screening men for PC using the PSA test beginning at age 45 or even 40 is a worthwhile endeavor..But I felt I should read the authors 136 page argument that screening is counterproductive..When I reached page 22 I stopped reading after seeing this sentence:

"Usually prostate cancer grows very slowly (see indolent cancer below)
but what we call “prostate cancer” includes a spectrum of disease
from slow-growing cancers through to rarer cancers that grow and
spread more rapidly."

The word "usually" is simply not correct. At the most, only 40% of biopsies find "indolent" cancer. In the majority of biopsies, 60%, the cancer discovered is NOT "indolent" and if left untreated will result in the death of the victim.

If those who argue against screening have to cook the books to make their point, there is no sense in reading any further than the sentence I quoted above...
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

Terry Herbert
Regular Member


Date Joined Sep 2010
Total Posts : 92
   Posted 11/15/2010 6:34 PM (GMT -6)   
Fairwind, could you give any references to support your contention that only 40% of biopsy procedures find "indolent" cancer? I have never seen such an assertion previously.

I think if you had read on you would have seen demonstrated, yet again some of the relvant data that shows why it is aid that there is over-diagnosis and over-treatment.
Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony Metastasis: Aug '07: Intermittent ADT: PSA 2.3 Aug '10

It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3892
   Posted 11/15/2010 6:54 PM (GMT -6)   
Several links have been posted on this board that show the results of thousands of first-time biopsies. Within a point or two, the findings were:

40% Gleason 6
40% Gleason 7
20% Gleason 8,9,10

The findings change with the age of those sampled..a younger group has slightly more Gleason 6 while an older sampling produces more Gleason 8 and higher..

Another interesting sidebar was when PC victims choose surgery, and the complete organ can be biopsied, quite often, the Gleason score gets upgraded to a higher number. A small number get downgraded, but when a Gleason score is revised, it is "usually" revised upwards..

Terry Herbert
Regular Member


Date Joined Sep 2010
Total Posts : 92
   Posted 11/15/2010 7:03 PM (GMT -6)   
Most studies show about an equal percentage of Gleason Grades down graded, upgraded and the same - somewhere in the region of 33% in each category. After all Gleason Grading is a subjective process. IN a small percentage, according to a leading surgeon no cancer is found after surgery.

A Gleason 7 diagnosis within the current definitions does not mean that the disease is not "indolent".

The point is....ah, well, not much point in continuing. I'd have to refer to the book which you won't read.
Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony Metastasis: Aug '07: Intermittent ADT: PSA 2.3 Aug '10

It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey
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