RE: Screening > WAS> Dr Stamey on PSA - May 2004

[Guest guest]

,

My take on screening to a T.

Sammy,

You may recall our exchanging mails elsewhere on this subject. It's good to see you now acknowledging that coins have more than one side. 8¬)

.

-----Original Message-----From: sammy_bates Sent: Friday, May 14, 2004 12:57 PMTo: ProstateCancerSupport Subject: Re: Dr Stamey on PSA - May 2004

Ethical or not, it is a good point I have to admit.

Dr Stamey on PSA - May 2004> >> >> > Most people who have been around PCa will have heard of Dr Stamey> > and his views on over-diagnosis and over- treatment of this disease.> > Three years ago he came out with this statement, which to the best of my> > knowledge has not been challenged:> >> > <snip> I believe that when the final chapter of this disease is written,> > which is unlikely to be in my lifetime, never in the history of oncology> > will so many men have been so overtreated for one disease. After all we> > have a very small death rate from prostate cancer , which is less than> > 1%........Clearly we are overdiagnosing this disease. Uorlogy 58 (2),> > 2001<snip>> >> > He and his team have presented another paper at the AUA conference which> > you can read up here> > http://www.ajc.com/health/content/shared-auto/healthnews/-pro/518850.htm> > l> >> > This is a quote that sums up the article:> > <SNIP> Stanford University researchers say PSA (prostate specific> > antigen) levels bear little relationship to the severity of a cancer> > these days. They presented their finding May 9 at the American Urology> > Association's annual meeting in San Francisco. "We need to recognize> > that PSA is no longer a marker for prostate cancer," said study author> > Dr. A. Stamey, a professor of urology at Stanford University> > School of Medicine. "We urgently need to find a new marker for prostate> > cancer, and that marker must be proportional to how much cancer you> > have." "We have been so thorough and effective in screening for prostate> > cancer over this 20-year period that PSA no longer has a relationship to> > prostate cancer," Stamey said. "Because we all develop the cancer, we're> > now removing prostates from men whose cancer is so small that they do> > not need the procedure. We're finding all these little cancers that are> > never going to be a danger to the patient." "In smaller cancers, the PSA> > test is not relevant anymore," Stamey explained. "You might as well> > biopsy a man because he has blue eyes."<SNIP>> >> > All the best> >> > Terry Herbert> > in sunny Kalk Bay, South Africa> > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No> > conventional treatment. Present PSA 6.25:fPSA 38% My site is at> > www.prostatecancerwatchfulwaiting.co.za> > It is a tragedy of the world that no one knows what he doesn't know, and> > the> > less a man knows, the more sure he is that he knows everything. Joyce> > Carey> >> >> >> >> >> >> >

[Guest guest]

,

At least we can debate these issues on this site in a measured good bantered way. I think the advantages of this is that newbies coming to this site will see that all is not as cut and dried as one thinks when first setting off on the journey through this strange land. I think Sammy, Terry, myself, and a few others are exiles from more moderated sites

,

My take on screening to a T.

Sammy,

You may recall our exchanging mails elsewhere on this subject. It's good to see you now acknowledging that coins have more than one side. 8¬)

.

-----Original Message-----From: sammy_bates Sent: Friday, May 14, 2004 12:57 PMTo: ProstateCancerSupport Subject: Re: Dr Stamey on PSA - May 2004

Ethical or not, it is a good point I have to admit.

Dr Stamey on PSA - May 2004> >> >> > Most people who have been around PCa will have heard of Dr Stamey> > and his views on over-diagnosis and over- treatment of this disease.> > Three years ago he came out with this statement, which to the best of my> > knowledge has not been challenged:> >> > <snip> I believe that when the final chapter of this disease is written,> > which is unlikely to be in my lifetime, never in the history of oncology> > will so many men have been so overtreated for one disease. After all we> > have a very small death rate from prostate cancer , which is less than> > 1%........Clearly we are overdiagnosing this disease. Uorlogy 58 (2),> > 2001<snip>> >> > He and his team have presented another paper at the AUA conference which> > you can read up here> > http://www.ajc.com/health/content/shared-auto/healthnews/-pro/518850.htm> > l> >> > This is a quote that sums up the article:> > <SNIP> Stanford University researchers say PSA (prostate specific> > antigen) levels bear little relationship to the severity of a cancer> > these days. They presented their finding May 9 at the American Urology> > Association's annual meeting in San Francisco. "We need to recognize> > that PSA is no longer a marker for prostate cancer," said study author> > Dr. A. Stamey, a professor of urology at Stanford University> > School of Medicine. "We urgently need to find a new marker for prostate> > cancer, and that marker must be proportional to how much cancer you> > have." "We have been so thorough and effective in screening for prostate> > cancer over this 20-year period that PSA no longer has a relationship to> > prostate cancer," Stamey said. "Because we all develop the cancer, we're> > now removing prostates from men whose cancer is so small that they do> > not need the procedure. We're finding all these little cancers that are> > never going to be a danger to the patient." "In smaller cancers, the PSA> > test is not relevant anymore," Stamey explained. "You might as well> > biopsy a man because he has blue eyes."<SNIP>> >> > All the best> >> > Terry Herbert> > in sunny Kalk Bay, South Africa> > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No> > conventional treatment. Present PSA 6.25:fPSA 38% My site is at> > www.prostatecancerwatchfulwaiting.co.za> > It is a tragedy of the world that no one knows what he doesn't know, and> > the> > less a man knows, the more sure he is that he knows everything. Joyce> > Carey> >> >> >> >> >> >> >

[Guest guest]

,

I think you must be mistaken, and possibly mistaking me for someone else you have corresponded with, who knows !

First, I have never disputed the onerous nature of 'treatment' and the BIG QUESTIONS it raises. That indeed is why I have been OFF all hormone treatment for over a year now, and why I allowed my PSA to rise as high as it liked before stabilising under normal androgen levels. On the other hand I recognise the importance of early detection and appropriate timely treatment, hence screening. The point you have missed is that I argue for an APPROPRIATE TREATMENT following diagnosis, not a 'one size fits all' approach that many take seemingly regardless of individual circumstances (be it surgery or radiation or hormone manipulation or WW, or whatever).

Secondly, I do not recall having a serious debate on screening with you. If you have any old emails on the topic please jog my memory - off list. I do recall having a protracted discussion with you about androgens / estrogens and PC management which failed to find a resolution, but that is a different kettle of fish. Please do not confuse the former with the latter. Here is a good link to get you up to scratch:

http://www.medicalcrossfire.com/debate_archive/2003/JulAug03/PSAscreening_PX.htm

Sammy.

Dr Stamey on PSA - May 2004> >> >> > Most people who have been around PCa will have heard of Dr Stamey> > and his views on over-diagnosis and over- treatment of this disease.> > Three years ago he came out with this statement, which to the best of my> > knowledge has not been challenged:> >> > <snip> I believe that when the final chapter of this disease is written,> > which is unlikely to be in my lifetime, never in the history of oncology> > will so many men have been so overtreated for one disease. After all we> > have a very small death rate from prostate cancer , which is less than> > 1%........Clearly we are overdiagnosing this disease. Uorlogy 58 (2),> > 2001<snip>> >> > He and his team have presented another paper at the AUA conference which> > you can read up here> > http://www.ajc.com/health/content/shared-auto/healthnews/-pro/518850.htm> > l> >> > This is a quote that sums up the article:> > <SNIP> Stanford University researchers say PSA (prostate specific> > antigen) levels bear little relationship to the severity of a cancer> > these days. They presented their finding May 9 at the American Urology> > Association's annual meeting in San Francisco. "We need to recognize> > that PSA is no longer a marker for prostate cancer," said study author> > Dr. A. Stamey, a professor of urology at Stanford University> > School of Medicine. "We urgently need to find a new marker for prostate> > cancer, and that marker must be proportional to how much cancer you> > have." "We have been so thorough and effective in screening for prostate> > cancer over this 20-year period that PSA no longer has a relationship to> > prostate cancer," Stamey said. "Because we all develop the cancer, we're> > now removing prostates from men whose cancer is so small that they do> > not need the procedure. We're finding all these little cancers that are> > never going to be a danger to the patient." "In smaller cancers, the PSA> > test is not relevant anymore," Stamey explained. "You might as well> > biopsy a man because he has blue eyes."<SNIP>> >> > All the best> >> > Terry Herbert> > in sunny Kalk Bay, South Africa> > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No> > conventional treatment. Present PSA 6.25:fPSA 38% My site is at> > www.prostatecancerwatchfulwaiting.co.za> > It is a tragedy of the world that no one knows what he doesn't know, and> > the> > less a man knows, the more sure he is that he knows everything. Joyce> > Carey> >> >> >> >> >> >> >

[Guest guest]

Chuckle ;-)

Dr Stamey on PSA - May 2004> >> >> > Most people who have been around PCa will have heard of Dr Stamey> > and his views on over-diagnosis and over- treatment of this disease.> > Three years ago he came out with this statement, which to the best of my> > knowledge has not been challenged:> >> > <snip> I believe that when the final chapter of this disease is written,> > which is unlikely to be in my lifetime, never in the history of oncology> > will so many men have been so overtreated for one disease. After all we> > have a very small death rate from prostate cancer , which is less than> > 1%........Clearly we are overdiagnosing this disease. Uorlogy 58 (2),> > 2001<snip>> >> > He and his team have presented another paper at the AUA conference which> > you can read up here> > http://www.ajc.com/health/content/shared-auto/healthnews/-pro/518850.htm> > l> >> > This is a quote that sums up the article:> > <SNIP> Stanford University researchers say PSA (prostate specific> > antigen) levels bear little relationship to the severity of a cancer> > these days. They presented their finding May 9 at the American Urology> > Association's annual meeting in San Francisco. "We need to recognize> > that PSA is no longer a marker for prostate cancer," said study author> > Dr. A. Stamey, a professor of urology at Stanford University> > School of Medicine. "We urgently need to find a new marker for prostate> > cancer, and that marker must be proportional to how much cancer you> > have." "We have been so thorough and effective in screening for prostate> > cancer over this 20-year period that PSA no longer has a relationship to> > prostate cancer," Stamey said. "Because we all develop the cancer, we're> > now removing prostates from men whose cancer is so small that they do> > not need the procedure. We're finding all these little cancers that are> > never going to be a danger to the patient." "In smaller cancers, the PSA> > test is not relevant anymore," Stamey explained. "You might as well> > biopsy a man because he has blue eyes."<SNIP>> >> > All the best> >> > Terry Herbert> > in sunny Kalk Bay, South Africa> > Diagnosed '96: Age 54: Stage T2b: PSA 7.2: Gleason 3+3=6: No> > conventional treatment. Present PSA 6.25:fPSA 38% My site is at> > www.prostatecancerwatchfulwaiting.co.za> > It is a tragedy of the world that no one knows what he doesn't know, and> > the> > less a man knows, the more sure he is that he knows everything. Joyce> > Carey> >> >> >> >> >> >> >

[Guest guest]

Sammy,

Thanks for the recap. We are obviously in total accord on this one, and I can only blame my T starved brain for my confusion.

.

-----Original Message-----From: sammy_bates Sent: Friday, May 14, 2004 11:46 PMTo: ProstateCancerSupport Subject: Re: Screening > WAS> Dr Stamey on PSA - May 2004

,

I think you must be mistaken, and possibly mistaking me for someone else you have corresponded with, who knows !

First, I have never disputed the onerous nature of 'treatment' and the BIG QUESTIONS it raises. That indeed is why I have been OFF all hormone treatment for over a year now, and why I allowed my PSA to rise as high as it liked before stabilising under normal androgen levels. On the other hand I recognise the importance of early detection and appropriate timely treatment, hence screening. The point you have missed is that I argue for an APPROPRIATE TREATMENT following diagnosis, not a 'one size fits all' approach that many take seemingly regardless of individual circumstances (be it surgery or radiation or hormone manipulation or WW, or whatever).

Secondly, I do not recall having a serious debate on screening with you. If you have any old emails on the topic please jog my memory - off list. I do recall having a protracted discussion with you about androgens / estrogens and PC management which failed to find a resolution, but that is a different kettle of fish. Please do not confuse the former with the latter. Here is a good link to get you up to scratch:

http://www.medicalcrossfire.com/debate_archive/2003/JulAug03/PSAscreening_PX.htm

Sammy.

RE: Screening > WAS> Dr Stamey on PSA - May 2004

,

My take on screening to a T.

Sammy,

You may recall our exchanging mails elsewhere on this subject. It's good to see you now acknowledging that coins have more than one side. 8¬)

.

-----Original Message-----From: sammy_bates Sent: Friday, May 14, 2004 12:57 PMTo: ProstateCancerSupport Subject: Re: Dr Stamey on PSA - May 2004

Ethical or not, it is a good point I have to admit.

snip