MAY 12: DRUGS.COM: Three molecules associated with prostate cancer might provide the long-sought markers that could discern which tumours are life-threatening and need aggressive treatment, a new study indicates. READ MORE>
However, Mike Scott at New Prostate Cancer Info-Link warns it’s relatively easy to identify biomarkers associated with early stage or progressive prostate cancer, but “much, much harder to show definitively that the presence or absence of such biomarkers is a clearly prognostic factor for a specific clinical or biological event in the development or the progression prostate cancer from the first cell to the presence of castration-resistant disease.” READ MORE>
Hi, Jim,
It sounds as if Scott is trying to say – in simpler English, that you can identify prostate cancer easily with the three biomarkers mentioned in place of PSA; but these three biomarkers don’t really indicate what outcomes await a patient in the long-run.
Is that how you interpret is lengthy statement from the “New” Prostate Cancer Info-Link?
-Ed Weinsberg, author Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life (www.ConquerProstateCancer.com)
Yep. Nice translation. It’s one of the challenges of trying to make sense of the “prosta-sphere” – getting to grips with the technical language. Not that I’m criticising Mike in any way – he does a great job of monitoring what’s going on and bringing it to us in accessible form. I find his site the best I’ve seen anywhere.
Hi, Jim,
I just now reread your opening paragraph, which you posted four days ago. There you state that “new guidelines from the American Urological Association say that many men do not need annual screening tests.”
In point of fact at the end of the AUA conference in Chicago on April 27, conference leaders announced that the 2000 standard for all men 50 and over to get the PSA test should now be lowered to age 40 and up. This is an overt endorsement of the PSA test, despite its deficiencies.
It seems to me this reflects the reality that biomarker research advances are still experimental and inconclusive. As such the urologists at the AUA’s spring 2009 meeting in effect concluded that the PSA is still the most reliable test we have. Once the patient’s PSA level is tested, it’s to be determined if a biopsy is warranted, and in turn if some treatment option(s) are called for.
When urging PSA testing at age 40 for all men, and not just those at high risk (such as African Americans or men whose fathers or brothers had prostate cancer), the AUA was careful to point out that men, in conjunction with their urologists, should consider active surveillance as one of several treatment options they might choose.
This new AUA position is a clear endorsement of the PSA test despite the medical dispute that has raged this past month over its value. To me it confirms that not knowing your PSA level is worse tham knowing what it is and determining what treatment is best. In short, if we want to determine that a man might have prostate cancer, we should not contend that “Ignorance is bliss.”
Sure many men will continue to rush into surgery despite a slow-growing prostate cancer, rather than take a wait and see approach. By the same token many others will continue to decry PSA, biopsies and surgery or radiation as blatant overtreatment. Such disagreements are inevitable and will continue as long as scientists don’t come up with better alternatives.
I couldn’t agree more about the value of the PSA, and if I’ve interpreted the AUA statements to mean anything other than an endorsement, then it was not intended.
Can you be more specific about which post you refer to please. I can’t readily locate one with the opening par you quote.
On April 28, I posted this: The American Urological Association (AUA) today issued new clinical guidance – which directly contrasts recent recommendations issued by other major groups – about prostate cancer screening, asserting that the prostate-specific antigen (PSA) test should be offered to well-informed, men aged 40 years or older who have a life expectancy of at least 10 years.
Hi, Jim,
The 2nd paragraph in your May 5th citation states that the AUA looks askance at the PSA. When you cited that comment, it at first appeared that you might concur as you did not state otherwse.
However it is now clear from your 2nd comment in response to my first note, that you agree with the AUA’s stance favoring PSA testing for men 40 as long as their longevity is assessed 10 years or longer.
—Ed Weinsberg, author of Conquer Prostate Cancer: How Medicine, Faith, Love and Sex Can Renew Your Life
(www.ConquerProstateCancer.com)
Jim, please note the double typo on my part: my previous comment referred to your May 12th citation, not May 5th, in reference to men 40 and over – not just 40, who are likely to live ten or more years.
–Ed Weinsberg
No worries Ed. Most of us appear to be on the same hymn sheet with this. If you read Part 19 of My PC Adventure, ( https://prostablog.wordpress.com/2009/05/07/prostablog-19/ ) you’ll see I devote a post to discussing this question.
Cheers
JT