Perhaps different from Compilers meeting tonight, I held our meeting for UsTOO Las Vegas and we had a terrific speaker. Because of all the hype last month Dr. Vogelzang put the presentation down and addressed the doctor that had reused needle guides for prostate cancer biopsies. He came back this month and delivered another great presentation. I usually don't like running guest speakers back to back but since Nick was unable to commit to another third Thursday in 2011 I made the exception and he was there.
Here are some highlight comments:
1> "50% of all doctors are below average". He made the comment on how doctors fail to stay current with new data. In fact he told the group that I, and many in the room, were more current than most doctors because we do continuing education every month. Some doctors don't do it at all.
2> "1 in 48 is wrong and the impression transfers risk to prostate cancer patients unduly." This was in response to ERSPC findings in 2008 as reported in the New England Journal of Medicine that at the time reported that only 1 in 48 lives will be saved by screening. That study at the time had a median follow up of 9.2 years. Nick pointed out to the group that the ERSPC followed up with 12 years median in February and the actual number may be 1 in 24. Or even less with time. As Nick said 10 year is way too short for prostate cancer studies...(LOL No he was not my influence...as everyone knows I have taken that position and it has been my mantra). BTW we discussed it here already...
3> "In 2008 29,000 men died of prostate cancer and 10% found out in the same year" Someone asked how many found out about
their illness and they were determined to be terminal. Here's the reply "10% of men find out that they are dying of prostate cancer. 90% were screened in some way and were fighting the disease for years. This means that very few men die of prostate cancer fast. And those that did neglected to be tested until symptoms were showing". Interesting because Sweden does not screen for prostate cancer and they have the highest mortality rates with the disease.
4>"I wasn't asking you what you thought ~ I was telling you to do it". Actually I said that. Here's the question. "What does a 40-45 year old man tell a doctor who downplays a PSA and DRE" to get a baseline PSA test. Nick said that the doctor is going by guidelines that have either aged or are still denying the value of a baseline test. He said get another doctor. I said to tell him what I quoted...
I spoke for 45 minutes because Dr. V. needed me to until he could get there. I presented the "Levels of Evidence" for clinical trials and studies. I used the USPSTF guidelines along with sample studies in each category.
All in all it went very well.
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
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.