"PSA Testing - A Failed Medical Experiment"

29000 Men Comment
My thanks to Dr. Dach for commenting on my post concerning the PSA testing controversy, and I encourage everyone to read his excellent article at http://www.jeffreydach.com/2009/10/01/psa-testing-the-failed-medical-experiment-by-jeffrey-dach-md.aspx.

Dr. Dach concludes his article as follows:
"In conclusion, PSA screening for prostate cancer has been a failed medical experiment leaving behind 1 million male victims treated unnecessarily for a type of prostate cancer that was clinically insignificant, providing little or no benefit in terms of lives saved. Leaders in the field are now alerting us to the pitfalls, harms and limitations involved in PSA cancer screening.

Recognizing that there are 30,000 prostate cancer deaths per year, the urgent challenge is to identify and treat the aggressive cancers destined to kill the host, and avoid harming the other 7 million men representing a silent reservoir of biologically insignificant disease. Hopefully, this will be the subject of future NIH funded research, so that another one million men in the future will be spared needless overdiagnosis and overtreatment."

29000 Men Comment
As a prostate cancer survivor who is alive today because of PSA and Free PSA testing and a determined urologist, it is my deeply held opinion [please note that I am not a physician and can not and do not offer medical advice] that the issue is not with too much diagnosis, as approximately 29,000 men continue to die each year from prostate cancer, but with the treatment decisions made following diagnosis. If the current controversy is successful in convincing men that prostate cancer testing is unnecessary and that men that to do seek treatment are destined to have quality of life degradation, will we not in the future see an increase in prostate cancer deaths? I look forward to a lively discussion on this important issue.

PLU Codes - Organic or Genetically Modified?

Do you ever wonder about the meaning of those annoying (at least to me they are) little stickers we find on our produce? Well, here’s some interesting information, especially if you are trying to eat organically or simply trying to avoid “engineered” food.

PLU stands for “Price Look Up” standards, which are published by the International Federation for Produce Standards (IFPS) Board of Directors. You can find the full directory at plucodes.com.

What can be really important is the first digit, if the PLU code sticker on your produce contains five (5) digits. If it has only four (4) digits, it is “normally grown,” whatever that means in the country of origin.

If the first digit of a five (5) digit code is “9,” the produce is organically grown - again, meaning whatever standard that entails in the country of production.

But, if the first digit of a five (5) digit code is “8,” it means that the produce is genetically modified. Caveat emptor.

Tour de USA 2010 for Prostate Cancer Awareness

29000 Men Comment

We are moving forward on our planning for our cross country (and back) motorcycle trip to raise awareness for prostate cancer. If you ride a motorcycle and are interested in the ride of a lifetime, pop on over to the TourdeUSA website and watch our TourdeUSA blog for details.

The PSA Testing Controversy

29000 Men Comment

The medical and medical journalistic community continue to struggle with the issue of PSA testing for prostate cancer. The issue is the treatment of prostate cancer that is slow-growing and not a major threat. The difficulty is that is extremely difficult to determine which prostate cancers are “benign” and which are aggressive and life threatening. It seems a bit ironic that we have this major focus on over testing for prostate cancer but no similar debate about testing for breast cancer, when the two cancers are virtual mirror images in terms of annual new cases and death rates.

The issue, I believe, is not in over testing for prostate cancer, since early detection is essential for effective treatment of aggressive prostate cancer, but with the level of knowledge men have about prostate cancer and the various forms of treatment. Current American Cancer Society statistics show that only 54% of men test annually for prostate cancer and that almost 29,000 men die each year from the disease. My conclusion is that we are undertesting the male population as a whole, and possibly over treating those are identified. I would love to have a dialogue on this issue.

Dr. Mark Scholz, head of the Prostate Cancer Research Institute in Los Angeles, published the following statement that, I believe, succinctly summarizes the dilemma. My suggestion would be to follow Dr. Scholz’s advice; test, but take the time and steps necessary to ensure you have a form of prostate cancer that requires treatment.

Best regards, Robert

Re: Letter to the Editor Regarding a Wall Street Journal Article titled: 
Two Big Studies Tackle Debate on Prostate Test published on Thursday March 19, 2009


The Wall Street Journal recently published a letter to the editor under the heading, “Lifestyle Is Fine, but Cancer Needs Effective Treatment.” The physician writing the letter vilified the idea of using anything but surgery to treat his prostate cancer. Unfortunately, his uninformed convictions are prevalent throughout the medical community. Now definitive, well-performed studies unequivocally prove that overtreatment is the norm (New England Journal of Medicine 2009;360:1310-9 and 1320-8) .


As has been the case for years, the a priori assumption that “all cancer needs treatment” has confused the expert commentators who are interpreting these crystal-clear study results as being part of an ongoing unresolved controversy about PSA testing. The reality is that huge amounts of precious research dollars are being spent to answer a foolish question. Whether or not to do PSA testing is not the issue. The issue is deciding what to do with the information the PSA provides.


Right now the nation is in the grip of 8-billion dollar industry hell-bent on administering treatment to every kind of prostate cancer whether it is life-threatening or not. The solution to the problem of over-treating prostate cancer is not less PSA testing. The solution is educating physicians to forgo recommending immediate surgery or radiation to every last man who gets a diagnosis of prostate cancer.

Newly-diagnosed patients need to research all their options before agreeing to irreversible radical treatment. PSA testing (in conjunction with other means) has a useful role in determining which men harbor the more aggressive types of prostate cancer. Only with a “go slow” approach, ongoing monitoring known as Active Surveillance, can we distinguish men with aggressive disease who need treatment from men with indolent disease who don’t need treatment.


Mark Scholz, M.D. 
Prostate Cancer Research Institute
Los Angeles, California

Male Sling for Incontinence

29000 Men Comment

Often when I talk with men about prostate cancer it quickly becomes clear that the fear of incontinence following treatment is one of the key concerns that prevent men from testing for prostate cancer. While some degree of incontinence is a possible outcome of treatment, it certainly is not an inevitable outcome of treatment. There are numerous methods of dealing with incontinence when it occurs. If this is a concern, take a quick read of the following article or click the link to visit the parent page.


http://www.prostate-cancer.com/coping-with-prostate-cancer/incontinence-male-sling.html



The Male Sling for Incontinence

The male sling is a relatively new procedure to treat men with incontinence as a result of prostate cancer treatment. In most cases this treatment can be done on an outpatient basis or with one overnight stay. The procedure can take less than half hour to one hour and requires a two-inch incision between the scrotum and the rectum.

The male sling is a minimally invasive procedure where a strip of abdominal or synthetic tissue is placed in the pelvis to compress the urethra and prevent urine leakage during stress maneuvers. Six titanium bone screws are placed into the pubic bone after exposing the pelvic bone on each side. Three screws are placed on each side. A permanent suture is attached to each bone screw. The sutures are then passed through the material used to create the sling. On one side of the pubic bone three sutures are passed through one edge of the sling and tied tightly and on the other side three sutures are then passed through the sling and tied to create the closure of the urethra. The incision is then closed. A catheter is usually left in place for a period of 24 hours. Immediately after the catheter is removed most men are able to urinate with better control.

Not all medical establishments have the male sling available. Initial studies have reported 80% incontinence improvement of the men treated. Although still in its infancy, the male sling has become a significant advance in how we treat incontinence, allowing many men to regain their urinary control and improve their quality of life. Patients should consult their physician to determine whether the male sling would benefit them.

Prostate Cancer Research Institute Annual Conference

Over the weekend I attended PCRI’s annual convention on prostate cancer research and treatment. I was particularly struck by Dr. David Heber’s presentation on nutrition and prostate cancer. I’ll be posting more information over the next few days, but PCRI is a very good source of information and support for prostate cancer survivors and those newly diagnosed.

MyBikeInfo iPhone and iPod Touch Application

If you are a cyclist and use MyBikeInfo for iPhone/iPod Touch, just click the link below to receive infrequent updates about improvements and new functionality to MyBikeInfo iPhone/iPod Touch application. You may unsubscribe at any time. By the way, you can use MyBikeInfo to track information on your motorcycle, as well. Plus, with MyBikeInfo’s RSS functionality, you can have real-time feeds from all of your favorite websites in one handy place on your iPhone. Proceeds go to prostate cancer awareness and prevention.

http://29000men.us1.list-manage.com/subscribe?u=95aaf73102f9fd5323096e57f&id=819e716571