Posts Tagged ‘prostate cancer’

Take On The Prostate

Over a decade ago, I did some research in the area of PSA testing and prostate cancer, so this field is a personal interest of mine. My impression from reading the NY Times article, The Great Prostate Mistake, by the pathologist who discovered the test, is that questions being asked in the nineties are being answered more and more in the negative.   

In the large study I worked on, we found that lowering the threshold level of PSA deemed worrisome in younger men resulted in more positive biopsies, including biopsies with apparently significant higher grade/aggressive cancer, but whether or not treating those cancer had overall beneficial results wasn’t known or determined.  This illustrates a common dilemma in medical science – what happens when detection methods advance before sufficient evidence exists as to the risks and rewards of potential treatment options? The goal shouldn’t be to simply find cancer, but to promote a healthful life.  The words "do no harm" are particularly meaningful.  With that, let’s move on to the thoughts of John Wrenn MD, a practicing urologist who sent me the NY Times article along with his thoughts on the subject.  - Ilene 

My Take On The Prostate

Courtesy of John Wrenn, MD

   As a urologist, I make a lot of my living off of prostate health and certainly have concerns about over testing, over diagnosis and over treatment.  The biggest question remains, in my opinion, who to treat more than anything else. I think PSA screening is probably on par with Mammograms and cholesterol testing as far as questionable value is concerned. Colonoscopy doesn’t seem as dubious largely because colon cancer tends to have fewer gray areas as to who needs treatment, and while invasive, screening for colon cancer doesn’t lead a significant portion of patients with positive findings to treatments that only make a difference in cancer specific survival for a few, while causing life altering functional changes in many. 

 

   I am still not sure that America is ready to return to a medical system where treatment is only given when the disease becomes symptomatic or grossly detectible, although the outcomes would probably be only marginally different
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Top 10 Medical Breakthroughs

Interesting list on medical breakthoughs – with my comments in red. – Ilene

TIME’s Top 10 Medical Breakthroughs

By Alice Park at TIME

stem cell created mouse - TIME And the top ten are:

  1. New Mammography Guidelines
  2. AIDS Vaccine
  3. Funding Ban Lifted on Stem-Cell Research
  4. H1N1 Vaccine
  5. Stem-Cell-Created Mice
  6. Prostate-Cancer Screening
  7. New Research on Autism
  8. New Drug for Osteoporosis
  9. New Alzheimer’s Genes
  10. Brown Fat in Adults 
*****

New Mammography Guidelines

It usually takes a Washington scandal to put the discussion of women’s breasts on political agendas, but in November it was a routine update of breast-cancer-screening guidelines by a government panel of medical advisers that stirred up a furor. Based on new calculations weighing the risks and benefits of routine screening, the U.S. Preventive Services Task Force’s new recommendations advised women to begin routine mammograms at age 50 instead of 40 and to switch from yearly to biennial screenings; it also advised women to eliminate breast self-exams altogether… 

That might be a bit of a relief to those of us who have been less than perfect in following the previous requirements, these new ones may be easier and less guilt-generating.  And we all know stress is unhealthy.  

AIDS Vaccine

In a field that has seen more failure than success, experts received the news of an effective new AIDS vaccine with a fair share of skepticism…

31% effective – but that’s about as good as it gets so far.  

Funding Ban Lifted on Stem-Cell Research

It was eight years in coming — which felt like eons to some researchers — but on March 9, President Obama rescinded his predecessor’s Executive Order prohibiting the use of federal money to fund research on stem cells. A congressional law still prevents scientists from using government funds to create new lines of embryonic stem cells,..

The less politics is involved with science the better, maybe now we can move on? 

H1N1 Vaccine

…In many places around the country, there was not enough vaccine even to cover members of priority groups targeted by the government, including young children, pregnant women, health care workers, parents of infants younger than 6 months and those with underlying conditions such as asthma or diabetes. And yet according to the latest polls, 55% of Americans said they would not get the new vaccine — which was created and tested in record time after H1N1 first appeared last


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