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Posts Tagged ‘aggressive treatment’

UPI: Magnetic resonance imaging could help assess prostate cancers that need more aggressive treatment, US researchers say. READ MORE>

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AUGUST 6: MSNBC: The value of a widespread prostate cancer screening is questioned by the top medical officer for the American Cancer Society. READ MORE>

“Screening does not clearly save lives and many men who get aggressive treatment clearly do not need aggressive treatment,” Dr Otis W. Brawley said in response to the announcement that US Senator Christopher Dodd has prostate cancer.

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AUGUST 5: AMERICAN CANCER SOCIETY: In an effort to resolve confusion about what men need to be told about prostate cancer screening, the American College of Physicians has published advice to GPs about what they should advise patients. READ MORE>

For patients potentially interested in prostate cancer screening, physicians should engage them in shared decision-making; this is of even greater importance given the outcomes of the recent reports from the US
and European screening studies.

It is difficult for physicians to provide comprehensive and balanced information concerning prostate cancer screening decisions during a brief clinic visit.

The American College of Physicians has published a useful summary of discussion points to consider when counseling patients about prostate cancer screening:

● Prostate cancer is an important health problem.
● The benefits of one–time or repeated screening and aggressive treatment of prostate cancer have not yet been proven.
● DRE and PSA measurements can have both false–positive and false–negative results.
● The probability that further invasive evaluation will be required as a result of testing is relatively high.
● Aggressive therapy is necessary to realize any benefit from the discovery of a tumour.
● A small but finite risk for early death and a significant risk for chronic illness, particularly with regard to sexual and urinary function, are associated with these treatments.
● Early detection may save lives.
● Early detection and treatment may avert future cancer–related illness.

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JUNE 16: NEW PROSTATE CANCER INFO-LINK:  The whole issue of the appropriateness of cancer screening is starting to become a major public health issue, closely and inevitably associated with cancer risk, writes Mike Scott. READ MORE>

“The New Prostate Cancer Infolink believes we can expect strong feelings to be expressed on both sides of this issue over the next few years, and we want to go on record now as stating that the currently available data for and against the appropriateness of screening for almost every form of cancer is generally very poor.

“We are never going to be able to resolve any of these issues until be get a lot better at at least some — and preferably all — of the following:

  • The early differential diagnosis of cancers by clinical risk — in other words, being able to have much better understanding at the time of diagnosis of who really needs aggressive treatment because their cancer may either shorten their life or severely affect its quality.
  • Explaining to individual patients why aggressive treatment may not be  in their best interests if they have every indication of low risk, indolent forms of cancer.
  • Alignment of physicians’ financial reimbursement with truly appropriate medical practice — so that a urologist (for example) is as reasonably compensated for convincing a 70-year-old patient that expectant management is probably an excellent form of care for his prostate cancer, given his particular circumstances, as the urologist would be for carrying out a radical prostatectomy.
  • Teaching society that the vast majority of cancer diagnoses have long since ceased to be a death sentence (although there are still plenty of exceptions to that statement).”

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JUNE 6:  INSCIENCES: Researchers at Brigham and Women’s Hospital in the US have found that older men, who are otherwise healthy, benefit from aggressive treatment for unfavorable-risk prostate cancer, a finding that draws contrasts with a recent US Preventive Task Force recommendation stating that older men should not be screened for prostate cancer. READ MORE>

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