I worked for a couple years before med school as the database manager at the Center for Prostate Disease Research based out of the now closed Walter Reed Army hospital. From looking at all the data in the database and speaking with the urologists I always new the Prostate Specific Antigen (PSA) test wasn’t a [...]
I worked for a couple years before med school as the database manager at the Center for Prostate Disease Research based out of the now closed Walter Reed Army hospital. From looking at all the data in the database and speaking with the urologists I always new the Prostate Specific Antigen (PSA) test wasn’t a good screening test for prostate cancer. What’s more the surgeons did mention to me that there was no hard evidence that any of the interventions they tried once there was a cancer diagnosis had any effect on survival. It is easy to be very critical and cynical about urologists intervening then, however, these were good people that I worked with I would even say I still look up to them, so why do they do so many prostatectomies, radiation and hormonal treatments? Well, I would just say that late stage prostate cancer is something I hope I would never wish on my worst enemy. It is slow moving and often ends with painful bone metastases and the like. These physicians aren’t looking to make a buck, they are looking to try anything they can even if they don’t have anything that clearly works at the moment. Of course we can hope that some of this is changing now as we learn more about more simple nutritional, micro-nutrient, antioxidant and other alternative therapies, though funding for studies in this area I have to imagine will be scarce in the near future. This is just to say that it isn’t always conspiracy that conventional medicine doesn’t work we sometimes just don’t know what we are doing and don’t have something that works as much as we would like it to be otherwise.
All this is by way of preface for a write-up on a recent study on prostate cancer screening.
Yearly Prostate Cancer Screening Does Not Lower Total Number Of Deaths
“Mass prostate cancer screenings do not lower total number of deaths from prostate cancer, researchers from Washington University School of Medicine at St. Louis reported in the Journal of the National Cancer Institute. They added that mass routine screenings do not even reduce numbers of deaths among males in their fifties and sixties, as well as patients with underlying health conditions.
The authors cited a US study involving 76,000 males that revealed that after six years of aggressive, yearly prostate cancer screening, there were more tumor diagnoses, but the number of deaths from prostate cancer did not drop.
The latest results of PLCO (Prostate, Lung, Cancer, Colorectal and Ovarian), which were published on January 6th, showed that the majority of men do not need to be screened every year for prostate cancer.
Lead author, Gerald Andriole, MD, wrote:
“The data confirm that for most men, it is not necessary to be screened annually for prostate cancer. A large majority of the cancers we found are slow-growing tumors that are unlikely to be deadly.”
In the PLCO study, males aged 55 to 74 were randomly selected to receive routine care or a PSA test once a year for six years plus a digital rectal exam for four years. Routine care means the patient only gets a PSA screening test if the doctor recommends one.Dr. Andriole explained that this report provides updated data on an earlier report published in NEJM (New England Journal of English), 2009, when the team could not find any mortality benefit from routine prostate cancer screening.” Read More
I recall now that one of the residents who rotated through the Center for Prostate Disease Research was one Dr. Finger and so it also occurs to me that a side benefit to this recent study is that the routine yearly finger wave or digital rectal exam of the prostate should now also be a thing of the past. Yet another bizarre and it turns out useless practise brought to you by conventional medicine.
Even back when I was doing database work urologist where trying all sorts of variations on the PSA test to see if things could be improved for instance PSA density, i.e PSA levels/volume of prostate or PSA velocity i.e. rate of change of PSA over time. Actually, I was fortunate enough at that time to help co-author a study looking at using a neural net based system and a number of variables (PSA, Gleason grade, surgical margins etc) to see if prostate cancer occurrence could be predicted. I’ll dig out the paper if anyone is really interested but in a nutshell, while not a huge advance, neural nets are cool and they look to actually work a little better than traditional statistical approaches, on the downside who knows exactly what they are doing or how they are working.
So to sum it up it turns out despite the Prostate Specific Antigen name, PSA just isn’t a very good test for prostate cancer and even when it accurately finds a cancer there isn’t a great home-run type of intervention. Really what the evidence and studies are telling us is that as regards survival (a really good end-point) prostate cancer screening is worthless, but far be it from me to put it so bluntly. With what a slow growing cancer prostate cancer is (which is one of the reasons the traditional kill all fast growing cells approach doesn’t work well) it is probably a great candidate for things like improving anti-oxident levels and the like. Haven’t looked in the literature to see if there is anything on more natural, orthomolecular approaches and prostate cancer will try and do that some time. However, seeing as traditional medicine doesn’t have a great offering, the traditional approaches have very serious to awful side effect profiles and one has time with the slow growing cancer to try alternative approaches I can’t imagine why anyone with prostate cancer shouldn’t look into them.
Source: healthjournalclub.com
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