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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2005

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getting information to you....do you agree/disagree with this    article?

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c palmer - 04 Nov 2005 10:35 GMT
the statement that tony blair made is pretty strong.  "Prostate cancer
is now the most common cancer diagnosed in men in the UK, and at least
one man every hour dies from the disease"

~ curtis

===================

Prostate cancer charity wants better information for patients

About one in four men in the United Kingdom with prostate cancer are
dissatisfied with their care, a survey of more than 1000 men with the
disease shows.

The Prostate Cancer Charity's survey of 1143 men who had the disease
diagnosed in the last three years showed that more than a third did not
have access to a specialist nurse to discuss their diagnosis and 43%
were not given any written information about the disease or its
treatments and side effects. Nearly a quarter of men who said they were
alone when their diagnosis was broken to them wished they had had
someone with them.
The charity believes that men should be better informed about the
disease, including treatment options.

The respondents said they found all types of information useful, but
they ranked information on monitoring the disease, on warning signs when
cancer gets worse, and on treatment choices as well as general
information on prostate cancer as more important.

Many men had initially presented to their GP with some kind of urinary
symptom, and many had undergone their first prostate specific antigen
test at that time.
But 40% of the men had "not enough" or "no" information about the test
when it was first carried out. Only 36% said their GP fully discussed
the test and gave them written information about it. This was despite
the NHS's introduction of the prostate cancer risk management programme
in 2002, which aimed at ensuring that men concerned about the risk of
prostate cancer get clear information on the test and on treatments for
prostate cancer.

Twenty per cent of the men did not think it was clear which treatment
choice was best for them, and 15% did not think they had made informed
choices.

"This is not a good result," said the charity, "but we do not have to
await a body of evidence to change that situation." It said,
"Information and communication would go a long way to reduce this
total."
Some of the men also felt they had not been given a full explanation of
the side effects of treatment. Nearly half (47%) of men with continence
problems and 56% with difficulties with erection said they felt
inadequately supported by health professionals.

"Not all side effects from treatment can be resolved, but it is
important that health professionals ensure that all men are supported to
live with them as best they can. This is an area of patient support that
can clearly be improved," the report says.

Several political leaders have supported the charity's campaign to
improve information. "Prostate cancer is now the most common cancer
diagnosed in men in the UK, and at least one man every hour dies from
the disease—it is a priority for us to tackle," said the prime
minister, Tony Blair.  

The Real Man's Prostate Cancer Journey: The First National Survey is
available at www.prostate-cancer.org.uk.
    

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc
James A. Honeychuck - 04 Nov 2005 12:34 GMT
I live in the UK now.  An excerpt of Blair's statement was on the BBC
News.  He said that 30,000 men a year are diagnosed with PCa in Great
Britain, and a third of them die from it.  (I know that's not worded
right.  It's not a third of that 30,000, it's a third of the cumulative
total.)

Anyway, that's 10,000 deaths, and there are 8,769 hours in a year, so it
is about one per hour.

Ironically, this complaint is about treatment, not early detection.  The
National Health Service does not accept that there is a benefit to early
detection.  Some GP's look for PCa in men over 40, some just wait for
symptoms to show up.  The NHS policy is no routine screening of PSA.

The other day my wife mentioned to an NHS nurse that I had surgical
treatment for prostate cancer before I left the States.  The nurse
asked, "Why?"

My wife dropped the subject.

jimhoney
standard RRP age 52, cured, no significant aftereffects

> the statement that tony blair made is pretty strong.  "Prostate cancer
> is now the most common cancer diagnosed in men in the UK, and at least
[quoted text clipped - 68 lines]
> invariably fatal. Prostate cancer is only sometimes so."
> http://community.webtv.net/PALMER_ENT/doc
Pops - 04 Nov 2005 16:45 GMT
After visiting their website I sent this email to them. As yoou might
suspect I hate this statistical juggling of the usefulness of a test
that can't possibly give one anything but life-improving information...

It amazes me how a bunch of seemingly intelligent people can make
something so simple so complex.

LOOK...

> The PSA test is a simple, non-invasive blood test. It takes all of 5 minutes from the patients perspective and would be an inperceptible change in a yearly physical exam.
> The measurement of PSA is extremely accurate.
[quoted text clipped - 4 lines]
> The next step IS invasive, but minimally so. The biopsy is outpatient, usually painless (although uncomfortable) and has no lasting SE's.
> A negative biopsy DOES NOT MEAN you don't have Prostate Cancer. A positive biopsy DOES!

OK

So far we've performed a few simple tests, with no SE's or significant
discomfort and, in a significant number of cases, we may have
discovered a cancerous organ in symtom free males.

NOW YOU'RE GONNA TELL ME THAT KILLING THE CANCER ISN'T NECESSARY
('cause PCa is slow growing, or because killing it can't be proven
"statistically" to extend life expectancy - in effect you're saying
that treatment to kill PCa may do more harm than good so why bother to
find out if you've got it)?

YEP! That's what you're saying when you don't promote regular PSA
testing.

WHY AM I MAD?

Because you are possibly (IMHO probably) contributing to the untimely
death of countless men who refuse the PSA screening because you say it
isn't important or conclusive. That's what you're saying: that ,
because statistical varients aren't yet converged enough to be
absolutely conclusive, you conclude that simple PSA tests as a part of
a males normal yearly checkup aren't necessary. Try to tell that to a
woman regarding those sometimes painful and very personal mamograms.

I hope you can sleep at night...

I neglected having PSA tests until 60 years old. On my second PSA test,
aged 61, my PSA level had increased by an order of magnitude. No
symptoms and a normal DRE. The biopsy confirmed cancer and my organ was
removed. It included two tumors - one about the size of a dime (large
for a prostate tumor). I don't know what will happen to me in the
future but the statistics (yeh, they're not conclusive - PSA testing
hasn't been going on long enough for statisticians to be satsfied)
indicate that I will have a reoccurrance withing 5 year (90%) and  that
I will die of the disease within 10 years (70%). Earlier PSA testing
and a look at the doubling times may have caught my cancer earlier and
increased my chances for a "cure". But the medical ivory tower folks
couldn't agree that it was useful, even though it's simplicity and lack
of ANY negative effects confirm that nothing but positive information
can be gained.

Thanks alot...you've taken an important tool and relegated it to the
"junk drawer" until 20 years of data can be collected, while 20 years
worth of young men with undetected PCa may have needlessly died. Now go
back to your sterile research cubicle and stare though a microscope at
a frozen PCa sample without thinking that it represents a mans life in
jeopardy.

Nope - it's just a statistic...
Alan Meyer - 05 Nov 2005 19:15 GMT
Pops,

I agree with your assessment of the PSA test.

As for your chance of a recurrence, I'm hoping that, if it
does happen, there will be new treatments available by
that time that will keep it from killing you.

Best of luck.

   Alan
 
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