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PSA testing (Prostate info.)

Originally Posted by pudendum
And it’s that crazy attitude follows the oft used statement in medicine that, “Most men die with prostate cancer, not of it.” That’s total bullshit. The pain and suffering from the spread of the cancer beyond the prostate to the bone is so easily averted by early detection, triggering a further workup to determine whether cancer actually exists.

It’s been said that if all men lived long enough we’d all get prostate cancer. We should all get checked to make sure that “our” case gets caught early.

If your health system considers age as a reason to deny health care, you’re going to see this attitude continue and get worse. If we in this country don’t wake up soon and see the primrose path we’re being led down regarding “free” nationalized health care, we’ll all be dying with prostate cancer as well.

As opposed to what there doc? Er, what was the number of uninsured Americans at last count? When you guys go back to being doctors instead of corporate entities, then we will feel happy jumping off the primrose path. ;)

Funny that we are both on the path thing tonight.


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Originally Posted by mgus
pud,

you have something against Sweden’s national healthcare system, or just “free” nationalized health care in general?

Do note that mammography is offered to all over a certain age - so it doesn’t necessarily have anything to do with “‘free’ nationalized health care” but rather with gender (and quite possible the male uncomfortableness to talk about prostrates, impotence etc).


I’m not in favor of bureaucrats who have no idea about medicine or how to run a health care system telling patients (and doctors) what kind of care they can or not get (or give). When health care is “rationed” by government restriction, the first services that are restricted are life-sparing procedures in the elderly. I just don’t see this as the road that even the most ardent advocate of single payer health care wants to see. However it is very frequent in other countries with similar systems. Why do they come here for health care?

I have nothing specific against Swedish health delivery. Some of my my best friends are Swedes….

Mammograms are definitely offered, but the extent of “heroic” measures taken to save a woman with advancing breast cancer are limited, for example bone marrow transplants.

I think the squeamish factor in guys has got to be countered by the same type of education programs as has been used successfully for women (breast exams, mammograms, annual pelvic exams). The incidence of prostate cancer in men throughout their entire life is much higher that breast or cervical cancer in women. We need to help to get the word out. I think that avocet8’s thread here is a perfect way to help our fellow PEers.

Originally Posted by ThunderSS
As opposed to what there doc? Er, what was the number of uninsured Americans at last count? When you guys go back to being doctors instead of corporate entities, then we will feel happy jumping off the primrose path. ;)

Funny that we are both on the path thing tonight.


I treat my patients one at a time. I practiced in a university hospital and got paid a salary (which I guaranty you was a small fraction of what was billed my name). With malpractice insurance (over $150,000), billing, overhead costs and dean’s tax, at the end of the day there’s not a lot left. Before you break out the violins, I will say that my family and I live comfortably, but the hours and the stress were horendous. Sometimes I wonder if it was all worth it. But then I think about the people I helped and get satisfaction from the thoughts. BTW, I am disabled now and do not practice anymore.

I think corporate medicine sucks just as much as a nationalized medicine. There are alternatives.

I think we’re on the same path, however, there’s a little snow on mine. :)

Originally Posted by pudendum
I’m not in favor of bureaucrats who have no idea about medicine or how to run a health care system telling patients (and doctors) what kind of care they can or not get (or give). When health care is “rationed” by government restriction, the first services that are restricted are life-sparing procedures in the elderly. I just don’t see this as the road that even the most ardent advocate of single payer health care wants to see. However it is very frequent in other countries with similar systems. Why do they come here for health care?


Your view about men of medicine running the medicine business is perfect for the general practitioner, but doesn’t work with larger entities. Just like regular companies, military or anthills - people wind up specializing, and those that are good at treating patients generally prefer to do just that. Also, isn’t it a bit of a waste to have someone with 7+ years of schooling and training in medicine sift through medical statistics versus costs to find the most life-per-buck option? Whatever your opinion on bureaucrats, they exist in every society, regardless of size, politics or time era. Because they fill a need. And finding the most life-per-buck option is definitely worthwhile, because as medical advancements go on, we will spend our entire GNP on medical care if one doesn’t draw the line somewhere.

Besides, in a “free” system, at the end of the day it’s the insurance company that draws the line. The only real difference between a nationalized health care system and a “free” insurance based one is that of scale - the nationalized makes an insurance company of the entire population.

Originally Posted by pudendum
I have nothing specific against Swedish health delivery. Some of my my best friends are Swedes….


Whatever that is supposed to mean.

Originally Posted by pudendum
Mammograms are definitely offered, but the extent of “heroic” measures taken to save a woman with advancing breast cancer are limited, for example bone marrow transplants.

I think the squeamish factor in guys has got to be countered by the same type of education programs as has been used successfully for women (breast exams, mammograms, annual pelvic exams). The incidence of prostate cancer in men throughout their entire life is much higher that breast or cervical cancer in women. We need to help to get the word out. I think that avocet8’s thread here is a perfect way to help our fellow PEers.


I don’t disagree with you - I was remarking that I thought it was ironic that there was a gender difference.


regards, mgus

Taped onto the dashboard of a car at a junkyard, I once found the following: "Good judgement comes from experience. Experience comes from bad judgement." The car was crashed.

Primary goal: To have an EQ above average (i.e. streetsmart, compassionate about life and happy) Secondary goal: to make an anagram of my signature denoting how I feel about my gains

Originally Posted by mgus
Your view about men of medicine running the medicine business is perfect for the general practitioner, but doesn’t work with larger entities. Just like regular companies, military or anthills - people wind up specializing, and those that are good at treating patients generally prefer to do just that. Also, isn’t it a bit of a waste to have someone with 7+ years of schooling and training in medicine sift through medical statistics versus costs to find the most life-per-buck option? Whatever your opinion on bureaucrats, they exist in every society, regardless of size, politics or time era. Because they fill a need. And finding the most life-per-buck option is definitely worthwhile, because as medical advancements go on, we will spend our entire GNP on medical care if one doesn’t draw the line somewhere.

Besides, in a “free” system, at the end of the day it’s the insurance company that draws the line. The only real difference between a nationalized health care system and a “free” insurance based one is that of scale - the nationalized makes an insurance company of the entire population.


I personally am not in support of the statist approach. I don’t believe that government is the answer to everything. In the US, at present, I believe we don’t need to cede our decision making to bloated government. I believe there are free market fixes with health savings plans, implementing competition into the system to reduce artificial price fixing, introduce the magnitude of scale to group health insurance to add competition and reduce cost, Require health insurance by all; government can subsidize the disadvantaged as they do now through free market ventures, again using markets of scale.

Has government run health care reduced the ‘run away’ % GNP in any country it is now practice? I guess we differ on who we want to draw the line.

Originally Posted by mgus
Whatever that is supposed to mean.


This was a lame attempt at humor. (“I’m not dissing so & so group, some of my best friends are so & so group.”)


Last edited by pudendum : 01-14-2008 at .

No, I don’t believe government is the answer to all things problematic either. If you have government-run schemes you wind up with wasting, if you have business run the show you wind up with Enron, Worldcom etc. I forget the name of the president (#3?) who said that “Freedom demands constant vigilance.” or something to that effect. Usually a free market with tough “cops” watching is a decent solution.

As to if government run health care reducing “run away” costs, I guess that depends on who you ask. I’ve understood that the numbers, both in absolute numbers and in GNP are the highest in the US.

Who gets to draw the line on life-saving procedures that cost a shitload? That’s what you have philosophers, theologicians and medical people sit down together for. But those sifting through the statistical debris should be those that are good at that (i.e. bureaucrats). But it’s a real tough question. A few years ago, a Norwegian politician was on a board for drawing the line that drew the line at a certain kind of treatment for a certain kind of cancer - and then a year later he was diagnosed with that same cancer.

In my business (the build environment) as in many businesses, being a good “doer” is by no means a guarantee that you are good at commanding the helm.


regards, mgus

Taped onto the dashboard of a car at a junkyard, I once found the following: "Good judgement comes from experience. Experience comes from bad judgement." The car was crashed.

Primary goal: To have an EQ above average (i.e. streetsmart, compassionate about life and happy) Secondary goal: to make an anagram of my signature denoting how I feel about my gains

I think we agree more than we differ.

BTW, I would never want to run health care. I’d rather “do” as well.

Originally Posted by Damfino
I do this every year as well. One important note: be sure to have the PSA test done BEFORE the digital prostate exam. The pressure exerted on the prostate by the doctors fingers is enough to elevate the PSA results and give a false positive reading.

It also follows that any sexual activity involving pressure on the prostate (dildos, fingers, other weapons, objects, etc.) must be avoided for at least three days prior to having the PSA test done.

-damfino

Never had a problem with this. Every year I get a PSA Test, physical prostrate exam and about 50 blood tests ranging from AST, ALT, GGT, hemoglobin, white blood cell counts and the whole nine yards.
Costs $75 for the whole shooting match. It’s a community (state wide) program for those that want to check it all every year.
Doesn’t matter if I get the finger up the butt before or afterwards any blood tests. All my readings are normal and don’t change much from year to year.
I still fuck like a bunny, get off almost every day, and the readings still come back the same.
Excellent health.
To prepare I stop eating 12 hours before the tests and all I drink is water. I take my tests in the morning around 7am.

Falcon


Fire shall reign from above as shards of heated shrapnel hurl savage kisses to mortal flesh and shattered bone below.

For days, the dead hung in the air as dust.


Last edited by falcon : 01-15-2008 at . Reason: Addition

I just thought!

Imagine, waking up at the crack of dawn, during the middle of winter, starving, braving the cold, standing in line while freezing and waiting for some dude with size 12 fingers to shove one of them up your ass in the name of health!

Falcon


Fire shall reign from above as shards of heated shrapnel hurl savage kisses to mortal flesh and shattered bone below.

For days, the dead hung in the air as dust.

Originally Posted by falcon
I just thought!

Imagine, waking up at the crack of dawn, during the middle of winter, starving, braving the cold, standing in line while freezing and waiting for some dude with size 12 fingers to shove one of them up your ass in the name of health!

Falcon


The thought makes my scrotum shrivel, my testicles rise and my sphincter pucker.


Last edited by pudendum : 01-15-2008 at .

“Close your eyes and think of the Queen.”


regards, mgus

Taped onto the dashboard of a car at a junkyard, I once found the following: "Good judgement comes from experience. Experience comes from bad judgement." The car was crashed.

Primary goal: To have an EQ above average (i.e. streetsmart, compassionate about life and happy) Secondary goal: to make an anagram of my signature denoting how I feel about my gains

“DNA test to be evaluated on 100 000 Swedish men

…a Swedish-American research group is introducing a gene-test as a complement to the PSA-test.

…five specific genetic changes that have been connected to an increased risk of prostate cancer.

…Men who have four or more of these genetic changes have a risk that is increased 4-5 times. If they have a close relative that has prostate cancer, the risk is increased by a factor 10.

…This was found in tests carried out on 4800 Swedish men, of which nearly 3000 have gotten prostate cancer. Researchers are now offering the genetic test to all of those in Stockholm that have a PSA-test carried out in a year, roughly 100 000 men…”

http://www.svd.se/nyheter/inrikes/artikel_780651.svd


regards, mgus

Taped onto the dashboard of a car at a junkyard, I once found the following: "Good judgement comes from experience. Experience comes from bad judgement." The car was crashed.

Primary goal: To have an EQ above average (i.e. streetsmart, compassionate about life and happy) Secondary goal: to make an anagram of my signature denoting how I feel about my gains

http://www.nytimes.com/2008/01/17/h…&hp&oref=slogin

$300 to Learn Risk of Cancer of the Prostate

By GINA KOLATA
A combination of common and minor variations in five regions of DNA can help predict a man’s risk of getting prostate cancer, researchers reported Wednesday.

A company formed by researchers at Wake Forest University School of Medicine is expected to make the test available in a few months, said Karen Richardson, a Wake Forest spokeswoman. It should cost less than $300.

This is, some medical experts say, a first taste of what is expected to be a revolution in medical prognostication. The results, they agree, are clear. But the question is what happens next. And will patients be helped or harmed? Because the new test — which will analyze DNA in blood or saliva samples and is to be offered by ProActive Genetics — cannot predict which men will get aggressive cancers, it could lead to more screening and unnecessary surgery and complications. But, proponents say, it could also help men decide whether they want aggressive screening in the first place.

The researchers found that about 90 percent of the men in the study had one or more of the gene variants and more than half had two or more. The cancer risk increased as the number of variants rose and increased substantially when men had four or five of the variants.

Men with four or five variants made up only 2 percent of the study population but had a 4.5-fold increased risk of having prostate cancer compared with men who had none of the variants. If the men also had a family history of prostate cancer, their risk was nearly 10 times higher than that of men with none of those risk factors. Less than 1 percent of the population had all the variants and a family history.

The researchers report that nearly half of the cases of prostate cancer among the roughly 5,000 men in the study could be attributed to the five gene regions and a family history, with some men having one or two of the gene variants and others having all five and a family history.

Prostate cancer becomes more common as men age — autopsies of elderly men find that most had prostate cancer, whether they knew it or not. But the men in this study had an average age of about 65, when the disease is less common and more likely to kill.

William B. Isaacs, a professor of urology and oncology at Johns Hopkins University and an author of the new report, said that if research validates what has been found, men may want to get the new genetic test when they are young, 35, say. Those at high risk because of their genetics might then choose to start prostate-cancer screening earlier than the usual age of about 50, using a blood test that looks for proteins secreted by prostate tumors.

“I think that makes sense,” said Dr. Howard Sandler, a professor of radiation oncology at the University of Michigan and a spokesman for the American Society of Clinical Oncology.

But others worry that more frequent testing could exacerbate what is already a major problem: most prostate cancers grow so slowly that they would have been harmless if left alone. But since doctors cannot tell which are dangerous, they treat nearly all that they find. And treatment has serious side effects, including, often, impotence and incontinence. Nonetheless, researchers say, the test is a harbinger of things to come.

“It’s the boutique medicine of the future,” said Dr. Peter C. Albertsen, a surgery professor and prostate cancer specialist at the University of Connecticut. “We can know what diseases we will have to face in the rest of our lives.”

That worries him, as it does Dr. Edward P. Gelmann, deputy director of the Comprehensive Cancer Center at Columbia University. “Technology today enables us to find out a huge amount of information,” Dr. Gelmann said. “But how does the public deal with this information? How does it help them make decisions? And if they make a decision, does that lead to a day, a week, a month, of life saved?”

The study, by scientists at Wake Forest University School of Medicine, the Karolinska Institute in Sweden, the Harvard School of Public Health, and Johns Hopkins Medical Institutions, will appear in the Jan. 31 issue of The New England Journal of Medicine. It was released online on Wednesday, a journal spokeswoman said, because “it is a very active area of research with a lot of competition.”

Researchers long knew that the disease often runs in families. Though scientists spent years looking for genes, they found none that were reproducibly associated with a marked effect.

With new technology to scan the entire length of a person’s DNA, researchers tried a new approach. They began looking for small variations in tiny DNA regions that were associated with prostate cancer. That resulted in the discovery, by several groups of investigators in Iceland and the United States, of the gene variants, small alterations in gene sequences. Unlike traditional genetic links to disease, the variants are not mutations that destroy a gene’s function. In fact, no one knows what their effect is.

The next step was to ask whether those variants really could predict who had prostate cancer. So Dr. Jianfeng Xu, a professor of epidemiology and cancer biology at Wake Forest University School of Medicine, and his colleagues studied a Swedish population of 2,893 men with prostate cancer and 1,781 men who did not have it. That led to their finding that each of the five variants independently predicted prostate cancer risk.

“Each confers a moderate risk,” Dr. Xu said, adding that the effect of having just one of the variants — a 10 or 20 percent increase in a man’s chance of having prostate cancer — was not enough to justify using a single variant for screening. But, he added, because each conferred an independent risk, the risks added up so that the more men had, the greater their risk. Then they found that family history of the cancer added an independent risk. “That was very, very surprising to us,” Dr. Xu said.

The next step, Dr. Isaacs said, is to look in other populations. “We think that can happen almost instantaneously,” he said, explaining how scientists have blood samples and family histories of thousands of men who were tested for prostate cancer.

But some said that if the test leads to more screening, it is not necessarily a good thing. There is already too much prostate-cancer screening, they say, resulting in too much treatment. “To me, it is a nightmare,” Dr. Albertsen said. “We are just feeding off of this cancer phobia.”

What is needed, and what the new test does not provide, is a way to decide which cancers are dangerous and which are not, Dr. Isaacs said. Still, he said the new test could help patients if it was used with caution. “We may be premature with this idea — everyone has a different way of thinking about this — but it should not take five years to know if we are on the right track. All this can happen very rapidly.”

“We have worked with enough families that have a positive family history to know that people are anxious to know their risk of prostate cancer,” he said.

Good news for me on seeing my urologist. My PSA was 1.40 a year ago, actually a good place to be for my age group. This year it is down to 1.25. No enlargement of the prostate either or suspicious zones.


_______________

avocet8

Congrats avocet :up:

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