Wednesday, August 1, 2012

The PSA Debate Continues

Well the PSA debate continues. My readers know what side I am on and here is a piece supporting my work. It is by Dr. Messing of Rochester Medical Center.

The article in Cell states:
The objective of this study was to estimate the total number of patients who would be expected to present with metastatic (M1) prostate cancer (PC) in the modern US population in a given year if the age-specific and race-specific annual incidence rates of M1 PC were the same as the rates in the era before prostate-specific antigen (PSA) testing .... If the pre-PSA era rates were present in the modern US population, then the total number of men presenting with M1 PC would be approximately 3 times greater than the number actually observed.
Simply stated the evidence demonstrates that the use of PSA has reduced the number of M1 cases of PCa by a factor of 3. Messing as a clinician has obviously seen first hand the results of not mitigating against this deadly disease. The bone mets, collapse of the spinal cord, the DIC results to name a few. Bone pain is excruciating. Thus anything that can be done to mitigate this is essential.

On the NIH web site they have a compelling article describing the work.

The article states:

"PSA testing, for all its pluses and minuses and all that . . . permits you to catch the disease earlier," said lead researcher Dr. Edward Messing, chair of urology at the University of Rochester Medical Center in Rochester, N.Y. "These people are all going to die, they are going to die incredibly expensively and die miserably," he said, referring to the many men whose diagnoses would be delayed by not testing. "I don't know that all these people could be saved with PSA testing," but many could, he added. The report was published online July 30 in the journal Cancer.

Messing said the annual number of prostate cancer deaths dropped from about 42,000 in the 1990s to 28,000 now. "The only thing that can explain that is PSA early detection and treatment," he said.
Many cases of prostate cancer are not life-threatening, which is why testing is controversial. The U.S. Preventive Services Task Force (USPSTF) in May recommended against routine PSA screening, saying too many non-lethal cancers were being treated aggressively, exposing men who didn't need treatment to serious side effects such as impotence and urinary incontinence. But Messing disagreed with that advice. Condemning PSA testing "wasn't a brilliant conclusion," he said.

For the new study, Messing's team compared information from the U.S. Surveillance, Epidemiology, and End Results database for the years 1983 to 1985 -- immediately before widespread PSA testing started --- to data from 2006 through 2008. In the 2008 data, 8,000 cases of prostate cancer were diagnosed after the malignancy had spread to other parts of the body. Using these cases as a base, the researchers constructed a model that used data of advanced cancer diagnosed in the 1980s and predicted how many cases of advanced cancer would have been diagnosed in 2008 if PSA testing was not done. Their model showed instead of 8,000 actual cases in 2008, about 25,000 cases would have been diagnosed.

This is consistent with our arguments as well. This is telling especially today since HHS also announced all the "free" stuff for women while the USPSTF denies men equal protection. As I have said again and again, there will be some morbidly obese GS9 controlling the destiny and death of men. Welcome to the world of the ACA.