Column left out key info

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Samir Kleif’s column regarding prostate-specific antigen-based testing for prostate cancer (“Know benefits, risks, of prostate cancer testing,” Sept. 9) is disastrously inaccurate.

He states that the U.S. Preventive Services Task Force provided evidence-based recommendations against the PSA test, concluding that the potential benefit does not outweigh the expected harms. Unfortunately, he disregards the fact that the USPSTF relied on the profoundly flawed Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial study – more than 50 percent of the control group received screening during the study!

The largest screening study, the European Randomized Study of Screening for Prostate Cancer, demonstrated a 38 percent survival advantage in screened patients followed more than 10 years, and a recent study published in the American Cancer Society journal Cancer showed that without PSA screening, the incidence of advanced (thereby incurable) prostate cancer would have been 300 percent higher than actually observed.

Both the USPSTF and Dr. Khleif ignored reams of epidemiological data from this country. In the past 20 years, death rates from prostate cancer have declined 44 percent, although the overall incidence of cancer has been stable.

Before screening, 25 percent of men who were diagnosed with prostate cancer already had advanced, inescapably fatal, disease. With screening, that number has dropped by 75 percent. In the PSA screening era, 10-year survival is more than 98 percent, up from 53 percent before widespread screening. More prostate cancers are not being detected. We are detecting cancer earlier, and saving lives.

Dr. Khleif states that screening may cause pain, health problems, anxiety and worry. He confuses risks of screening (which are negligible) with treatment. But screening is not treatment; it is not even diagnosis. To deny men the right to basic information that they can then use to make their own health-care decisions is reprehensible.

This recommendation by the USPSTF was so egregious that something rarer than a hole-in-one at the Masters Tournament happened – bipartisan legislation was introduced by Republican U.S. Rep. Marsha Blackburn of Tennessee and Democratic U.S. Rep. John Barrow of Georgia, calling for significant changes to the USPSTF and the process by which the group makes formal recommendations regarding preventive-care services.

The column left out the most lethal fact about prostate cancer: When symptoms appear, there is no cure.

W. Price Dunaway


(The writer is chief operating officer of the multi-specialty physicians group Integrated Medical Professionals.)

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soapy_725 09/18/12 - 08:18 am
Can this be correct?

"The column left out the most lethal fact about prostate cancer: When symptoms appear, there is no cure. " THERE IS NO CURE?

We believe in the test. Question some points of this article.

PSA numbers can indicate other issues in men like sexual activity or lack of same. But the benefits outway the loss.

We've known several men who had "isotope implants" in Atlanta with 100% recovery over the last twenty something years.

carcraft 09/18/12 - 11:20 am
When I was diagnosed with

When I was diagnosed with prostate cancer it was diagnosed with an elevate PSA and digital exam. I then had biopsies taken and I was diagnosed as a Gleason class 6. There are a multitude of treatment options out there. At the time I chose to have surgical removal of prostate gland and lymph nodes. I chose this course of treatment because other equally effective forms of treatment can results in side effects that would not allow me to continue to work. After the Surgery was performed my diagnosis was increased to a Gleason class 8. Now my point is that PSA aided in my diagnoses. When I read the article by Kleif I knew it didn’t seem correct according to conversations I had with my urologist and the residents that work at GHSU. This is simply a prelude to Obama care. A study , no matter how flawed will be used to cut spending to control costs to the detriment of patient’s. I am glad I had PSA studies and regular checkups. With Obama care marginal studies will be used to control cost and limit treatment..coming to a hospital near you!

soapy_725 09/19/12 - 07:52 am
Across the board we are seeing

more and more studies saying that "diagnostic testing" is no longer necessary or over used. Pelvic exams, pap smears, mammograms and now PSA. Studies are like the wind. They blow in different directions depending on who's blowing the wind. Studies can be produced from one data point and extrapolation. Propaganda, maybe? Definitely designed to influence the flow of MONEY.

And heaven forbid if someone were to actually isolate the cause and find a cure for cancer. It would be like the end of the war on drugs. So many people would lose their government jobs it would send the country into collapse.

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