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Posts Tagged ‘American Urological Association’

PR NEWSWIRE: The four main prostate cancer treatment options have similar outcomes – the complications differ vastly, the recent American Urological Association annual conference heard.

The best advice for men and their partners? Don’t take the word of one doctor (who may only know about his/her own speciality). Get more than one opinion and go to the web and do your own research. READ MORE> and HERE>

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URO TODAY: Concerned about recent controversy that disparaged testing for prostate cancer, the American Urological Association has reaffirmed its backing for testing. READ MORE>

The American Urological Association is aware of recent news reports disparaging prostate cancer testing.

We are concerned that these reports are causing significant confusion for patients and we wish to clarify our recommendations on prostate cancer testing with the prostate-specific antigen (PSA) test and digital rectal exam.

The AUA strongly supports early prostate cancer detection and feels it is in a man’s best interest to consider being tested for prostate cancer.

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PROSTABLOG NZ: In view of renewed NZ debate about PSA testing for prostate cancer, it’s useful to take another look at the updated guidelines published by the American Urological Association in July this year. READ MORE>

The key changes were:

  • a recommendation that all men, whether they have symptoms or not, should get their first PSA test when they turn 40;
  • the final decision about getting tested is an individual one for a man, but made in consultation with his doctor. Mass screening was not recommended.

The Australian and NZ Urological Society have followed suit on these guidelines, announcing an update last month. It has reignited the debate about PSA testing in Australia.

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URO TODAY: The common claim that PSA testing leads to high and unacceptable levels of prostate cancer over-detection – and therefore over-treatment – is an exaggeration, according to a presentation at the 107th annual meeting of the New York Section of the American Urology Association. READ MORE>

In this 69-page slide presentation, Dr William J Catalona – the US “father” of the PSA test – analyses a number of studies of PSA testing and seeks to discredit those which show testing leads to over-diagnosis and treatment:

Over-detection is a relatively small issue when considered in the context of the larger issue of preventing suffering and death from prostate cancer, especially when good clinical judgement is used and patients receive appropriate, effective and high quality treatment.

He is critical of what he calls the premature reporting of two big randomised studies of PSA testing earlier this year, saying much more followup time is needed before meaningful results can be obtained.

Notwithstanding that, Dr Catalona – a professor at Northwestern University in the US –  refers to the European study (ERSPC) in making this observation about whether men should choose to be tested:

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THE AUSTRALIAN: “When was the last time the epidemiologists treated a 48-year-old man dying of prostate cancer, surrounded by a young family?” asks David Malouf, president of the Urological Society of Australia and New Zealand: “We are not talking about statistics, we are talking about human beings.” READ MORE>

In a testy debate in Australia, he was replying to critics of the society’s recent decision to follow the American Urological Association recommendation that men over 40 be offered PSA tests.

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KingPROSTABLOG NZ: While it was a good watch for those of us with a direct interest in prostate cancer, last night’s Larry King Live special programme failed to tackle some of the real issues about the disease.

We heard from a range of famous prostate cancer survivors (always the obvious approach for television) about the necessity of getting yourself tested, but nary a word from the medical bureaucracy which declines to buy in.

No government on earth has agreed to population-based testing for prostate cancer, not even for high-risk sub-groups like African Americans, or Maori.

The reasons for that would have been worth debating on a programme like King’s, whose reach via CNN is global and powerful.

Instead, we got a parade of survivors who said what all survivors (like me) will always say: “If I hadn’t had the PSA and the digital exam I wouldn’t be here today.”

That’s useful, of course, because it puts pressure on the authorities who seem to be unreasonably denying the “test them all” lobby. But it’s useful only in the sense of presenting a polemical argument – that is, one-sided.

If that was the sole objective, it would have been more effective for King to host patients for whom testing was either not done or came too late – those who are dying from prostate cancer.

He mentioned some (like the character who went off to his yacht in the Med rather than face treatment, so subsequently died), but he needed to present such heart-breaking stories via live testimony.

An alarming aspect of the show was some of the survivors didn’t know what they were talking about.

Former Secretary of State Colin Powell, for example, said he was still monitored – “but there’s nothing to check”.

Uh oh. The Walter Reed Hospital he so fondly plugged at every opportunity need to tell him something about biochemical recurrence. Not helpful, Colin.

The radiation oncologist on the show, Dr Christopher Rose, was impressive and impassive, but seemed  conflicted about whether he needed to explain some of the issues more thoroughly. The ephemeral nature of TV defeated him.

Joe Torre, the baseball manager, was the best talent, coming across as a modest, avuncular man who was just counting his blessings. His advocacy for changing diet was very helpful.

The boss of the US Prostate Cancer Foundation, Mike Milken, was an articulate speaker who has learned the priceless lesson of short, succinct sound-bites.

We knew why famous John McEnroe was there, and it certainly wasn’t anything to do with the ability to communicate.

I doubt he finished a sentence. It’s now apparent he spluttered and fumed on the tennis court because he couldn’t make himself understood by all those long-suffering umpires.

Larry King seemed well briefed on prostate cancer, probably because he has addressed the subject many times, as shown in clips of past interviews with various celebrity sufferers “coming out”.

The fact he hosted this hour-long show deserves credit, because if nothing else it helped raise awareness.

Just a pity the opportunity was not taken to wrangle some of the real issues, especially the unresolved question of screening.

The programme will probably be searchable on the Larry King Live website soon. SEE HERE>

Just one last point: why do we persist in using the term “digital examination”?

The non-prostate people, the civilians if you like, who endured the programme with me last night (it finished just before the rugby, luckily) kept asking: “What’s this digital thing? Is it something to do with computers?”

Quite. I guess we’ve never had something called an “analogue” examination.

Can we dispense with the euphemisms and start calling it what it is – a rectal examination.

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AUGUST 1: NEW PROSTATE CANCER INFOLINK: The American Urological Association Foundation is developing a new “National Urology Research Agenda”. CLICK HERE> to take a poll on what prostate cancer treatment and research priorities should be.

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