RE: US Gov't Panel says Routine PCa Screening is doubtful use - comment

[Guest guest]

The report seems to be presented in different ways depending on how you read it

in terms of the uncertainty; it might be seen as not so strongly opposed as

previously to screening for younger men but still not sure of the benefits.

In my view [FWIW ] the benefits might appear weaker because the different risk

groups have not been separated for analysis but I haven't read the full report

so I'd better be careful! This does of course lead into the question of how you

identify the higher risk, more aggressive PCa before rather than after or during

treatment, as you suggested at the end of your post.

But as regards the development of new technology, the MRSI test (photon magnetic

resonance spectroscopy imaging) has the advantage that it does not risk missing

the tumour, as can happen with a biopsy. It measures choline and citrate levels

throughout the prostate so helping to identify the more aggressive PCa (where

you find more choline and the loss of citrate.) This test is becoming available

at a few centres in the US and provides " a roadmap for treatment " - as reported

by Dr Hedvig Hricak at the annual meeting of the RSNA (Radiological Society of

North America) last week. So there is hope...

PS On a different topic, is there any chance of a report of the PSA meeting in

Leeds (which we missed on account of a family wedding yesterday but may be of

wider interest anyway)?

On Sat, 7 Dec 2002 22:39:46 -0000 " Metcalf "

wrote:

Hi

We had a support group meeting in Leeds this afternoon and we briefly

touched on the subject of screening.

The general opinion of folk there was if they had been found with Prostate

cancer in their 50s most would go for radical treatment (prostatectomy,

brachytherapy or External beam radiotherapy) side effects and all rather

than wait and see or not be tested. The most significant plea for screening

came from a lady whoose husband has a PSA of about 2000 and is now on

desperation treatment paying privately for Taxotere plus another ingrediant

at St Barts, London with Prof Oliver - tried in the states but yet to get

NHS approval here. The comment that screening causes anxiety met with little

understanding from people who had been diagnosed at a time when the cancer

was already in the bones. The general view, I thought, of the small amount

of discussion was that we were in favour of screening and informed choice.

Perhaps we do long for the technology that will differentiate a cancer that

will stay small and not affect the person and the ones that will very soon

cause havoc.

Your thoughts would be welcome for those who follow!

[Circle] Story 12/6/02: Gov't Panel says Routine PCa Screening

I am merely passing this on as a news story, so please don't argue with me

on it. Argue with the panel.

Government Panel: Benefit of Prostate Screening Uncertain

Tests Detect Cancer Early, But Effect on Survival Unknown

December 06, 2002 07:03:11 AM PST, ACS News Today

A government advisory panel stated this week there is not enough scientific

evidence to promote routine prostate cancer screening for all men, and

inconclusive evidence that early detection improves health outcomes.

The statement, released by the US Preventive Services Task Force, was

published in the Dec. 3 issue of the ls of Internal Medicine (Vol. 137,

No. 11).

The Task Force, an independent panel of experts sponsored by the Agency for

Healthcare Research and Quality (AHRQ), reviewed studies on the effect of

screening for prostate cancer using prostate-specific antigen (PSA) tests

and digital rectal exams (DRE) to prevent death in men over the age of 40.

Full story at

http://health.yahoo.com/search/healthnews?lb=s & p=id%3A32445

Abstract with link to full text at

http://www.annals.org/issues/v137n11/nts/200212030-00005.html

Young

Dx'd 11/23/99 PSA 1000+ Stage M1c

Webmaster Phoenix5

http://www.phoenix5.org/

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[Guest guest]

I hoped to get a copy of Liz Hudson's text but forgot in the melee of tea etc. I'll try and make contact.

It was an excellent short talk with a lot of discussion too and fro!

PS I'll let the discussion run on the paper before commenting again.