Re: Dr Stamey on PSA - May 2004

[Guest guest]

Hi terry. I think you should read the paper before you make any further

judgements ;-) 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]

Yes I would like to have access. Thank you. Did you listen to the PSA

debate at AUA?

Re: Dr Stamey on PSA - May 2004

Hi terry. I think you should read the paper before you make any further

judgements ;-) 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.h

> tm

> 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, I am not making any judgements. I asked for your help, assuming that

you had read the paper, in dealing with the points I raised. If you have not

done this, and were merely relying on the abstract, I'll try and get hold of

a copy of the paper and do the analysis myself.

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

Re: Dr Stamey on PSA - May 2004

Hi terry. I think you should read the paper before you make any further

judgements ;-) 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]

Sammy, Terry,

I believe thousands of men are undergoing traumatic treatment as a result of PSA screening. I agree it probably is saving some lives, but at what cost? Are those of us with insignificant PCa just collateral damage? Screening picks up indolent cancers which are often latent. These slow growing cancers would not have been found without screening and never caused the men any trouble in their lifetime. Screening is only perceived a success because it increases detection rates, but the important statistic is the mortality rate. This is the main problem for me...the overdiagnosis of latent cancers which increases the cure rate while exposing large numbers of men to over-treatment.

Men are not giving properly informed consent to PSA screening and once diagnosed are set on a course that can alter their quality of life significantly. One could argue that it is worth sacrificing these men with otherwise insignificant PCa for the good of the few who would benefit from aggressive treatment. But is this ethical?

Regards

Terry,I have read much of Labrie's work on screening for PC, it goes back manyyears and he is an innovator and leader in the field. This was the mostrecent of a long list on the subject. He keeps pumping them out but they aresaying basically the same thing: "Screening and timely treatment for PCsaves lives". Full stop. Period. Unfortunately the message is not gettingacross, either here or on the other side of the water / equator. One reasonfor this is that each country USA / UK for example will insist on its ownhome grown study before it acts on screening information, and since thesestudies can take a decade or more to mature, we will not see any movementfor some time to come. Labrie is Canadian, I wonder if Canada hasimplemented screening programmes based on Labrie's work or are they too're-inventing the wheel' ad nauseum?I really would recommend you read the paper because it will help you answersome of the questions you pose. You do not "need my help" as you put it, toanswer these questions, what you need is a deeper insight into the subjectmatter and there is only one way to achieve that - by direct exposure, notsecond hand from anyone else.Cheers,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]

Terry,

I have read much of Labrie's work on screening for PC, it goes back many

years and he is an innovator and leader in the field. This was the most

recent of a long list on the subject. He keeps pumping them out but they are

saying basically the same thing: " Screening and timely treatment for PC

saves lives " . Full stop. Period. Unfortunately the message is not getting

across, either here or on the other side of the water / equator. One reason

for this is that each country USA / UK for example will insist on its own

home grown study before it acts on screening information, and since these

studies can take a decade or more to mature, we will not see any movement

for some time to come. Labrie is Canadian, I wonder if Canada has

implemented screening programmes based on Labrie's work or are they too

're-inventing the wheel' ad nauseum?

I really would recommend you read the paper because it will help you answer

some of the questions you pose. You do not " need my help " as you put it, to

answer these questions, what you need is a deeper insight into the subject

matter and there is only one way to achieve that - by direct exposure, not

second hand from anyone else.

Cheers,

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]

Sammy,

You say, somewhat judgementally perhaps, that what I " ..need is a deeper

insight into the subject matter and there is only one way to achieve that -

by direct exposure, not second hand from anyone else. " I thought that the

idea of these Lists was that they were a forum where discussion between

people who had some knowledge of relevant subjects might lead to others on

the List either learning something to their advantage or intervening to add

their input and thus broaden the information available to the entire group.

It seems that you do not agree with this concept, or at least that you are

not prepared to share your views.

Since you imply that you have read the full report, could you please be so

good as to either make a copy available to me or tell me where I can obtain

one, bearing in mind the restrictions under which I work here in South

Africa e.g. no access to medical libraries.

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

Re: Dr Stamey on PSA - May 2004

Terry,

I have read much of Labrie's work on screening for PC, it goes back many

years and he is an innovator and leader in the field. This was the most

recent of a long list on the subject. He keeps pumping them out but they are

saying basically the same thing: " Screening and timely treatment for PC

saves lives " . Full stop. Period. Unfortunately the message is not getting

across, either here or on the other side of the water / equator. One reason

for this is that each country USA / UK for example will insist on its own

home grown study before it acts on screening information, and since these

studies can take a decade or more to mature, we will not see any movement

for some time to come. Labrie is Canadian, I wonder if Canada has

implemented screening programmes based on Labrie's work or are they too

're-inventing the wheel' ad nauseum?

I really would recommend you read the paper because it will help you answer

some of the questions you pose. You do not " need my help " as you put it, to

answer these questions, what you need is a deeper insight into the subject

matter and there is only one way to achieve that - by direct exposure, not

second hand from anyone else.

Cheers,

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]

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> >> >> >> >> >> >> >