Join Early Retirement Today
Thread Tools Search this Thread Display Modes
Old 04-02-2009, 04:11 PM   #61
Dryer sheet wannabe
Join Date: Mar 2009
Posts: 17
OH, I didn't realize you were being sarcastic. I guess I'm becoming a little naive in my old age. And I agree with you again 100%. Each patient has to take charge of his own outcome. But it would be hard to take charge agains PCa, if you didn't know you had it, and you won't know you have it, until your screened.

bluescat is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 04-02-2009, 04:42 PM   #62
Dryer sheet wannabe
Join Date: Mar 2009
Posts: 17
Originally Posted by Rich_in_Tampa View Post
What is nice about their recommendations is that they are able to say "we don't know" when applicable.
Thanks for posting the article, Rich. Their recomendation is what jumps out at you:

Current evidence is insufficient to assess the
balance of benefits and harms of screening for prostate cancer in
men younger than age 75 years (I statement).
Do not screen for prostate cancer in men age 75 years or older

(Grade D recommendation


bluescat is offline   Reply With Quote
Old 04-02-2009, 05:09 PM   #63
Thinks s/he gets paid by the post
Join Date: Aug 2002
Posts: 1,322
Originally Posted by Rich_in_Tampa View Post
Finally had a minute to retrieve this article - nice summary of the difficult issues surrounding PSA screening. Good reading for those who want to make a balanced and well-informed decision together with their doc.
I appreciate your posting this type of article. I have a question about the following statement in the article:

"In men younger than age 75 years, the USPSTF found inadequate evidence to determine whether treatment for prostate cancer detected by screening improves health outcomes compared with treatment after clinical detection."

How is PCa clinically detected? I thought it gave no symptoms until it had metastasized to the bones, etc, at which point it was very difficult to treat. But the article seems to indicate that treating it after it's found from screening (when there's a good chance it's still contained) hasn't been shown to be better than treating it after clinical detection. Seems puzzling.

FinallyRetired is offline   Reply With Quote
Old 04-02-2009, 05:51 PM   #64
Moderator Emeritus
Rich_by_the_Bay's Avatar
Join Date: Feb 2006
Location: San Francisco
Posts: 8,827
Originally Posted by FinallyRetired View Post

How is PCa clinically detected? I thought it gave no symptoms until it had metastasized to the bones, etc, at which point it was very difficult to treat.

It is occasionally detected by a hard nodule or irregularity on digital exam (I have picked up a few such patients over the years), by blood in the urine, or by symptoms similar to those of benign prostate problems (weak stream, hesitancy, difficulty initiating urination, etc. which progress and/or don't respond to treatment.

You are right in that the outcomes between the two types (PSA-detected v. clinically detected) are not as different as you might expect. The reasons are not entirely known, but may relate to the fact that many prostate cancers are very slow growing and really never cause problems even when advanced; there are measures to slow down even some advanced cases (Lupron and other hormonal measures) so even many advanced patients live for many good-quality years.

Unfortunately there are still an unfortunate number of patients with very aggressive disease (measured by a Gleason Score, roughly a measure of how aggressive the tumor cells are). They do less well no matter how the tumor is detected. So in the end, the benefit of screening is less dramatic than you might have thought, and thus the potential harm of screening (including to the false alarm cases which vastly outnumber actual cases) must be taken into consideration when determining your preferred screening strategy.
  • Best case: no symptoms, normal PSA (most)
  • Best save: no symptoms, slightly abnormal PSA, higher grade Gleason Score, cured by surgery or radiation, a true "save" (occasional)
  • Little added value: elevated PSA, normal biopsies but no complications except anxiety and cost (fairly common)
  • Worst case: no symptoms, elevated PSA, complications from biopsy, no cancer detected (infrequent but not rare)
  • Bad: detected on PSA but already advanced, with same outcome as if the patient had simply waited for first symptoms (longer time to worry about it due to early detection)


San Francisco Area
ESR'd March 2010. FIRE'd January 2011.

As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
Rich_by_the_Bay is offline   Reply With Quote

Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off

Similar Threads
Thread Thread Starter Forum Replies Last Post
The Sabbatical...the one year "trial" retirement Frugalityisthenewblack FIRE and Money 2 01-08-2009 11:58 AM
PSA haha FIRE and Money 0 06-20-2008 07:55 AM
Headline: American Families Now Save $2,500 a Year, Thanks to Wal-Mart chinaco FIRE and Money 43 09-14-2007 03:54 PM
Seat belts really do save lives... REWahoo Other topics 41 02-22-2007 01:59 PM
I found a 5.22apy 5 year CD.... ShokWaveRider FIRE and Money 17 07-07-2005 07:14 PM


All times are GMT -6. The time now is 02:29 PM.
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2016, vBulletin Solutions, Inc.