Free PSA Tests In NYC!

Discussion in 'Et Cetera, Et Cetera' started by HellsKitchenmanNYC, Jun 9, 2009.

  1. HellsKitchenmanNYC

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  2. B_bi_mmf

    B_bi_mmf New Member

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    There is very good scientific evidence that PSA screening does more harm than good. Beware!

     
  3. HellsKitchenmanNYC

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    How can a blood test do harm and what are your sources for that info?
     
  4. B_bi_mmf

    B_bi_mmf New Member

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    It's not the blood test per se, it is what follows a positive result -- unnecessary treatment leading to impotence and incontinence.

    See: New England Journal of Medicine. Even the urologists have acknowledged the problems.
     
  5. HellsKitchenmanNYC

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    I'm sure if a pos. result came back there would be further tests not immediate treatment.
     
  6. nudeyorker

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    My father, grandfather and uncle all died of prostate cancer, I get tested every year, it's one of the most preventable forms of cancer if detected early. Tests don't hurt you, not testing and not treating could kill you.
     
  7. B_bi_mmf

    B_bi_mmf New Member

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    This is not an issue of personal testimony, but of scientific evidence. Read the literature.
     
  8. HellsKitchenmanNYC

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    No thx. If you have a link but otherwise I'm happy getting the (Free) yearly test.
     
  9. nudeyorker

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    Believe me I've read all the literature on this subject. And it's not about personal testimony. Get the test, get the results, get a second opinion and take more tests and make your consideration about treatment if you have cancer. It's important to understand that cancer is as individual to each person as is the treatment. But by telling people not to test and be proactive is ludicrous. Finding the right care and procedures once you have cancer can save your life. Not testing and making the necessary decisions can cost you your life.
    www.mayoclinic.com/health/prostate-cancer/HQ01273
     
    #9 nudeyorker, Jun 9, 2009
    Last edited: Jun 9, 2009
  10. CALAMBO

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    Boys/buddys....have the test....most are negative...those who are higher than normal have many options....not knowing is deadly....i have been thru it recently...negative for C....re-test in 6 months...nudeyorker is right on....EARLY DETECTION is the only way to save your life.....do it for everyone that loves you.
     
  11. B_bi_mmf

    B_bi_mmf New Member

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    Screening: Prostate Cancer

    This is the leading prevention group in the U.S. These are the experts.

    I realize it seems like common sense to test, but it is not.
     
  12. B_bi_mmf

    B_bi_mmf New Member

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    Your indignant recommendation is not consistent with the very article that you cite.

    PSA screening is extremely controversial. The available data do not pass muster. Hopefully, ongoing studies will further clarify the risks and whether there is any benefit, and, if so, how much benefit. We already know for sure that there are serious risks.

     
    #12 B_bi_mmf, Jun 10, 2009
    Last edited: Jun 10, 2009
  13. B_bi_mmf

    B_bi_mmf New Member

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    I am sorry to see Nudeyorker and Calambo dispensing preventive health care advice so uncritically.

    Below is a dialogue with an open-minded friend on LPSG. In it I describe some of the difficulties we face in PSA screening.

    MyBuddy: ok. i read it. naturally, my question is: how should a person be screened if not with a PSA test?

    bi_mmf: There is no available test that has been shown to work. The value of digital rectal exam is also uncertain. The big issue with prostate cancer is that it is generally very slowly progressing. Therefore, early detection may actually be bad, because it will lead to treatment (and possible incontinence and impotence) in men who would never have developed life-threatening cancer within their lifetime.

    MyBuddy: ahhhh. so are you saying "don't get screened" or are you saying if you do get screened, to wait and be screened again at a later time to determine if it is cancer?

    bi_mmf: We need a test that detects aggressive prostate cancer.

    bi_mmf: When they do a biospy as the result of a positive PSA, they might well find cancer cells. Whether these cells would ever travel outside the prostate and become a problem is unknown. We tend to think of cancer as an inevitable progression. For many types that seems to be the norm. But prostate is very different.

    bi_mmf: Once a diagnosis gets made, then the inclination is to treat, not knowing whether the cancer is aggressive or not.

    bi_mmf: Thus we are set up for unnecessarily inflicting incontinence and/or impotence on many men.

    MyBuddy: so its not the test you are opposed to, it's the immediate desire to treat, not fully knowing what it is

    bi_mmf: No, it is the test. I would not, have not, gotten the test.

    bi_mmf: We do not have good evidence that it, in conjunction with subsequent decision-making processes, saves any lives.

    bi_mmf: We do know it inflicts bad quality of life on many.

    bi_mmf: On the other hand, I do get colonoscopy. Even though it is much more of an ordeal and expense to undergo than is PSA (having blood drawn is just a minor inconvenience), colonoscopy has been shown to reduce substantially the risk of dying from colon cancer. I only get cancer screening tests that have been shown to save lives.

    MyBuddy: so how would you know if you had prostate cancer then?

    MyBuddy: and what if you had prostate cancer, an aggressive type and by the time it is discovered it could be too late to treat at all?

    MyBuddy: and those could determine if something is amiss, correct?

    bi_mmf: Without screening, it would be detected through some sort of symptoms.

    MyBuddy: ok. so as long as it is detected then you would consider treatment/what kind, etc.

    bi_mmf: The bottom line is this: Does PSA reduce deaths due to prostate cancer? Studies to date are not convincing. Therefore, I choose not to put myself at risk for incontinence and impotence.

    bi_mmf: Without proven benefit of the test, I will not take those risks.

    bi_mmf: Yes, if I had prostate cancer diagnosed through symptoms, then I would consider all the treatment options. But I am not going to submit to an unproven screening test since it might well lead to treatment of a cancer (and thus to possible incontinence/impotence) that would never become symptomatic over my expected lifespan.

    MyBuddy: ahhh. right. thanks for explaining. sorry to be so dense. i understand where you are coming from now

    MyBuddy: i hope you don't mind when i ask questions, but i ask questions until i understand

    bi_mmf: No, your questions are very good. These concepts are very difficult for those of you not immersed in research to grasp. I do not envy physicians who have to advise patients in an area of such complexity and uncertainty.

    bi_mmf: Sadly, physicians and other health care providers end up caving to defensive medicine (ordering unnecessary or unproven tests because of fear of being sued for malpractice).

    bi_mmf: Once a test exists, even if unproven, it gets used.
     
    #13 B_bi_mmf, Jun 12, 2009
    Last edited: Jun 12, 2009
  14. CALAMBO

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    bi_mmmf...and others....when faced with the problem one has to decide to trust your local doctors...sure information is power...yes PSA is not perfect, but really medicine is a practice...to ignore a simple 50 dollar test and RISK your life...non-sense...i am very confident that those who have been diagnosed with CANCER and survived are very thankful....until something better is the standard in health care, myself i would rather endure a biopsy and know my options than to not and suffer a miserable death...bottom line...been there done that, happy i now know the facts.
     
  15. B_bi_mmf

    B_bi_mmf New Member

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    Of course, people who are diagnosed with prostate cancer and live to die from something else are very thankful. But their survival may have nothing to do with having had PSA screening, even if their cancer was initially found via follow up of an elevated PSA test. It is a scientific question as to whether PSA testing, along with whatever decision-making may follow a positive finding, results in a reduction in deaths due to prostate cancer. Although the results from the most recent U.S. study (N Eng J Med 2009;360:1310-9) are rather discouraging, definitive data are still not yet available. The benefit of PSA remains uncertain.

    If faced with a choice between certain death and certain incontinence/impotence, most of us would surely opt for the latter. But that is not the choice we face when deciding whether or not to get PSA screening. The choice is between a small small probability (quite possibly, based on what we know today, a zero probability!) of the test saving us from dying of prostate cancer versus a much larger probability of unnecessarily living with incontinence and/or impotence.

    As for your "local doctor," if you show her or him any interest in getting the PSA test, it will almost certainly be ordered. But chiefly because of fear of malpractice suits or of losing your business or trust, and certainly not because of good scientific evidence for the efficacy of PSA in preventing death due to prostate cancer.
     
  16. Dave NoCal

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    bi mmf, you appear to have a few horses in this race. What's up with that? The fact that the PSA test is controversial probably means that the risks/benefits are unclear and that having the test or foregoing it can both be justified. Yet you seem to be on a mission about this.
    Dave
     
  17. HellsKitchenmanNYC

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    Get the test. See if something is wrong. If it is get medical help.
    Don't have a test. The cancer grows. Then what.

    Of course statistics may show the test doesn't hep. MOST men don't have a test till a symptom shows up and even then some wait to go to the doctor.
    The fact of the matter is the sooner you have the test the better. I suggested it as my thread title says men can get it in NYC for free once a year. Now as I see it, there's no reason to NOT have it. It's FREE! It could save your life if something is found early enough.
     
  18. B_bi_mmf

    B_bi_mmf New Member

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    Dave -- No horses. I just want folks to be informed about the full picture and what the public health experts have to say on the subject. I note that you are the first one to acknowledge here that what the experts are telling us might actually be something other than utter nonsense. I'm glad to hear that from you! A voice of reason at last.
     
    #18 B_bi_mmf, Jun 12, 2009
    Last edited: Jun 12, 2009
  19. B_bi_mmf

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    The research is directed specifically at PSA testing as applied to men without symptoms. You seem confused about the nature of research on screening.
     
  20. HellsKitchenmanNYC

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    Oh Jeez.....
     
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