Archived posting to the Leica Users Group, 2011/10/07
[Author Prev] [Author Next] [Thread Prev] [Thread Next] [Author Index] [Topic Index] [Home] [Search]Le 7 oct. 11 ? 21:42, Steve Barbour a ?crit : > > On Oct 7, 2011, at 12:23 PM, Charlie Chan wrote: > >> If I may, I might interject, as my day job is as a cancer surgeon, >> treating breast cancer and melanoma. >> >> The problem is to do with the balance of benefit v risk. Screening >> healthy people is very different to treating people with symptoms. >> One day, healthy people are walking down the street, the next they >> are facing a life threatening diagnosis and all that entails. >> Biopsies, surgery with possible complications etc. Problem with >> prostate cancer is that not all prostate cancers are the same. Some >> people will get an more aggressive form, but many people will have >> a more indolent version of the disease, which doesn?t kill them. >> >> Like all screening tests, there will be ?false positives? ie >> positive test results (eg PSA blood test) in people who don?t have >> cancer, as well as ?false negative? tests - ie a normal PSA in >> someone with cancer (very unusual in prostate cancer). The false >> positive group is the real issue in screening as we can potentially >> do harm to healthy people who don?t have cancer. Even in people who >> do have cancer, not all of them will develop the aggressive type >> that becomes non-responsive to hormone drugs. A radical >> prostatectomy has its problems including urinary incontinence and >> inability to have erections. Sure, you would trade that if you had >> the aggressive prostate cancer type, but maybe not if you had the >> indolent version. Difficult thing is that we can?t tell which >> person has which type yet. >> >> So, it?s not easy. Even breast screening with mammography is not as >> straight forward as it seems. There are many who think (probably >> correctly) that the benefits are far less than that which is >> trumpeted to the public. > > > > thanks very much Charlie, I totally agree...a delicate balance of > benefit-risk, and a dilemma that for the moment is settled by the > current recomendation. > > I read the whole thing on two levels: mass detection -> cost for the health system, potential waste, profit for insurance companies and doctors alike, against benefits for the population, etc. individual detection -> marginal risk, yet risk all the same hence a tough decision for it is unclear what or whom is to be trusted. Better be a woman is that case again ;-) Ph > Steve > > >> >> Best wishes, >> >> Charlie Chan >> Cheltenham, UK >> >> topoxforddoc at btinternet.com >> www.cancer-surgeon.co.uk >> www.charlie-chan.co.uk >> >> >> >> On 7 Oct 2011, at 19:57, Gary Pinkerton wrote: >> >>> At first glance, it's as though they are saying that the screening >>> itself (blood test) can cause problems. >>> But, isn't it more about how the results of the screening are >>> dealt with (unnecesary surgeries, biopsies, etc)? >>> Of course, I'm easily confused, so maybe I'm misunderstanding what >>> they are saying :) >>> >>>> From: steve.barbour at gmail.com >>>> Date: Fri, 7 Oct 2011 11:40:05 -0700 >>>> To: lug at leica-users.org >>>> Subject: [Leica] OT Panel advises against prostate cancer >>>> screening - Yahoo! News >>>> >>>> this subject came up in the recent past... >>>> >>>> >>>> fyi >>>> >>>> >>>> http://news.yahoo.com/panel-advises-against-prostate-cancer-screening-024452851.html >>>> >>>> >>>> _______________________________________________ >>>> Leica Users Group. >>>> See http://leica-users.org/mailman/listinfo/lug for more >>>> information >>> >>> >>> _______________________________________________ >>> Leica Users Group. >>> See http://leica-users.org/mailman/listinfo/lug for more information >> >> >> _______________________________________________ >> Leica Users Group. >> See http://leica-users.org/mailman/listinfo/lug for more information > > > _______________________________________________ > Leica Users Group. > See http://leica-users.org/mailman/listinfo/lug for more information