“What would YOU do doctor?”

Joseph Smith’s editorial on early detection of prostate cancer in the August issue of the Journal of Urology is now available in full, on line. We recommend this to every member of the patient and professional community.

6 Responses

  1. Good to be able to read the whole article.

    The best part is:

    “The problem is that this [high risk] patient is mixed in with many more who undergo treatment of a less threatening cancer with the potential for life altering quality of life compromises. Thus, we have the risk versus reward conundrum. Is it worth subjecting the majority of men to treatment to cure the minority of a cancer that would be life threatening?”

  2. This article says nothing we didn’t already know and resolves nothing.

  3. Dear Chris:

    The fact that you and I know this should not blind us to the fact that an enormous proportion of the medical community and the population in general do not. And the fact that the Journal of Urology is willing to publish such a strong editorial is valuable within the context of health care reform — where there is a significant risk to coverage of PSA testing as a mean to assess risk for prostate cancer.

  4. I thought that this article stated the conundrum far better than most, and feel that there’s no way for most men to make informed decisions without understanding what it says.

    Until we improve what is offered from screening to treatment, many men will face extremely difficult decisions. Men deserve to know what they are up against.

  5. One thing to remember is that PSA is an indication of more than cancer and the test can lead to treatment for the other conditions also. It can be a valuable adjunct for men’s health. The problem is when we isolate it for just one indication we lose the advantage for the other indications. At least that is what I heard from Dr. Andriole in the CME presentation on Discovery Health.

  6. Kathy: I haven’t heard Gerry’s Discovery Health presentation, but it is worth understanding that we would know quickly enough if someone had significant issues with BPH or prostatitis, even without a PSA test. In those conditions PSA is a helpful tool but doesn’t necessarily help us to assess or define risk. The symptoms of BPH and prostatitis are obvious and evident by comparison with the lack of symptoms of prostate cancer. Furthermore, there is minimal risk that either BPH or prostatitis are going to affect a man’s mortality!

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