Re: Swedish Study

[Guest guest]

Bob Bishop wrote:

> ...

> LONDON – The longest study yet on prostate cancer testing

> provides more evidence that getting screened doesn't cut the

> chances of dying from the disease.

> ...

Here's another study that was just completed in Europe that shows

screening does appear to be useful.

http://www.medscape.com/viewarticle/739926

You will have to fill out a free registration with Medscape to

view it. I think it's worthwhile because their articles strike

me as fuller and more accurate than most web medical sources.

One interesting sentence in the Medscape report was:

> The number needed to screen was 318, and the number needed to

> treat was 16. " These numbers are an important step forward if

> compared to 1410 and 49 in our 2009 [The New England Journal of

> Medicine] paper to prevent 1 prostate cancer death. "

The variation among the reports is surprising. Are the reports

all so poorly conducted that they are not objective?

It seems to me that many commentators pick out the report they

like best and cite it. Those who oppose screening pick out the

reports that say it does little or nothing. Those who like it

pick out the reports that say it works.

So what's the truth?

I have no idea. However it does seem to me that, for screening

to have no value, treatment has to have no value. Surely some of

the prostate cancers that are discovered early will be fatal. Is

it the case that treating them does no good?

Maybe that's true. I don't know. Some people think it's true.

Some don't. IIRC, prostate cancer death rates are lower in the

U.S. than before the screening era, but some people argue that

has nothing to do with screening or treatment.

Alan

[Guest guest]

<snip> I hereby formally request that you blast me if I do this

again. :-)

No! No! – I am all gentleness and lightJ

All the best

Prostate men need enlightening, not

frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html

From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Alan Meyer

Sent: Sunday, 3 April 2011 11:25 AM

To: ProstateCancerSupport

Subject: Re:

Swedish Study

Terry Herbert

wrote:

> Alan you say, again “….. prostate cancer death rates are lower

> in the U.S.

than before the screening era…….” You made a

> similar statement last month and I posted this in response:

....

> An error does not become truth by reason of multiplied

> propagation, nor does the truth become error because nobody

> will see it. -Mohandas K. Gandhi

Indeed!

I retract my statement and humbly apologize for forgetting your

first correction of my error. (As I was typing it I thought,

This came up recently didn't it? What did we say about it then?)

I'm not absolutely convinced that your statistics are definitely

right, but you have convinced me that mine aren't definitely

right either. I hereby formally request that you blast me if I

do this again. :-)

Alan

[Guest guest]

Hi againI was interested to see other people’s reactions before I make my own comments. I have now read reams and reams of stuff about PCa and all I can conclude at the end of it is:1. Some prostate cancers are more dangerous than others.2. There is currently no way of telling which they are.3. Any treatment seems to make little difference to the eventual outcome.However, here are some further thoughts/questions:1. Is this also true of breast cancer? It is very similar in many ways – slow growing (usually), hormone sensitive, some cancers much more aggressive than others, produces micro-metasteses which can remain undetectable for long periods. I have certainly seen articles recently which suggest that doctors think that some breast cancers are not serious enough to be worth treating and that women under 50 should not be screened.2. What does the statement ‘to prevent one death from cancer’ mean? Most treatments for advanced PC aim to prolong life by slowing down the development of the tumours. There seems to be good evidence that this is achieved in many cases though not all. No-one pretends to have a cure.3. In my own case (which proves absolutely nothing) I have had RRP and EBRT, neither of which reduced my PSA below 2, in spite of the fact that the operation revealed no evidence of cancer in either seminal vesicles or lymph nodes and my bone scan was clear – Original PSA 7.2, Gleason 4+3, T3aN0M0. Since the end of radiotherapy my PSA has risen to 10.3 with a current doubling time of about 3 months. I am now on 50mg bicalutamide and start Zoladex on Friday. Obviously I’m hoping for the best but even if my PSA goes undetectable, I’m not sure what that proves. The general conclusion is that my cancer has metastasised but, other than the PSA level, there is no other evidence of this. I get lower back pain and the odd pain in my lower abdomen but then I always did. My doctor says I should stop worrying but the potential effects of hormone treatment are pretty frightening.Keep smiling – I am.Bob

[Guest guest]

Terry, your WHO statistics indicate that prostate cancer deaths increased by 30% in the US after PSA screening was instroduced. This seems to imply that PSA screening increases the rate of prostate cancer deaths. That sounds screwy. Maybe before screening there were a lot of deaths not diagnosed as prostate cancer related, which seems unlikely. Or perhaps new environmental factors have caused a surge in prostate cancer and ultimately PC deaths. That seems unlikely too. Or maybe the numbers are just wrong. Something doesn't add up.

The Swedish numbers seem to suggest that as far as PCA is concerned, treatment makes no difference in the survival rate, and therefore ignorance is bliss as far as PCA is concerned. I guess I find that hard to believe, but maybe that's because I chose treatment. Your thoughts on the 30% increase and what it means?

Mike > ...> LONDON – The longest study yet on prostate cancer testing> provides more evidence that getting screened doesn't cut the> chances of dying from the disease.> ...Here's another study that was just completed in Europe that showsscreening does appear to be useful.http://www.medscape.com/viewarticle/739926You will have to fill out a free registration with Medscape toview it. I think it's worthwhile because their articles strikeme as fuller and more accurate than most web medical

sources.One interesting sentence in the Medscape report was:> The number needed to screen was 318, and the number needed to> treat was 16. "These numbers are an important step forward if> compared to 1410 and 49 in our 2009 [The New England Journal of> Medicine] paper to prevent 1 prostate cancer death."The variation among the reports is surprising. Are the reportsall so poorly conducted that they are not objective?It seems to me that many commentators pick out the report theylike best and cite it. Those who oppose screening pick out thereports that say it does little or nothing. Those who like itpick out the reports that say it works.So what's the truth?I have no idea. However it does seem to me that, for screeningto have no value, treatment has to have no value. Surely some ofthe prostate cancers that are discovered early will be fatal. Isit the case

that treating them does no good?Maybe that's true. I don't know. Some people think it's true.Some don't. IIRC, prostate cancer death rates are lower in theU.S. than before the screening era, but some people argue thathas nothing to do with screening or treatment.Alan