Men's Health Qantas CEO and prostate cancer advice.

[simsalabim]

Just heard the CEO interviewed on the Ray Hadley radio programme on 2GB talking about his recent prostate removal and espousing the virtue of men in their 40's being checked for prostate cancer. Like all the spin and bluster he comes up with in his role as CEO of Qantas the argument for men's PC screening also has an opposite view . At the risk of being deemed heretics , three Sydney University researchers have a different approach to the popular view. Before listening to the CEO on this ( or any other matter ) it pays to hear both sides . I encourage all readers of Pprune , esp males, to check out this site, download the free study and think long and hard BEFORE getting tested.

http://ses.library.usyd.edu.au/bitstream/2123/6835/3/Let-sleeping-dogs-lie.pdf

[das Uber Soldat]

righto......

[Wallsofchina]

Trying to eliminate the competition simsalabim?

I read the novel by Chapman, Barratt, Stockler, and it proves there's always someone trying to put a different spin on something.

I've had prostate cancer, could have had a much reduced treatment with less side effects if the family doctor had bothered to do blood tests for PSA as well as physical checks.

Sure there are emotional highs and lows - certainly more than I ever expected but you may well be making a choice between life and death.

I would compare the thoughts of these people with not doing a magneto check in case the result worries you.

We have approx. 1500 road deaths each year in Australia - both men and women, and there are strict, almost draconian laws to try and prevent this, including such things as speed cameras.

Yet we have approx 3300 deaths prostate cancer every year, and that's men only, so the rate is well over double.

And about 20,000 men are diagnosed each year.

What we do know is the earlier you find out and start some form of treatment, the less invasive it is and the better the chance of survival.

[SpannerTwister]

WOW !!!!

Talk about changing the subject !!!

A long time ago, shortly after my father died of prostate cancer, I was talking to my doctor about it and how it was going to affect my life.

I asked her about "routine" screening, and what should I do if cancer was found. I've never forgot her answer, "If I had a cancer inside of me, I'd sure want to know about it, and I'd certainly want it out".

So many years ago that sounded like good advice to me, and I have yet to see anything that could change my mind.

From all of my reading of all of the literature that I have read, I can see the argument (but don't agree) that screening the male population as a whole for prostate cancer may be counter-productive, but no matter which way the numbers are thrown, I firmly believe that screening the individual WITH prostate cancer is necessary...........However finding that individual with cancer who DOES need screening requires screening everybody !

I believe that the anti-screeners should more focus their efforts on informing the men with a positive result what this means for them individually and what their options are so that they may make an informed and personal decision as to what they want to do.

ST

[Pappa Smurf]

When i had prostate symptions everyone said i was too young.When finally had blood test was 284psa.Specialist said damage already done and recomended the "town halls" removed or the hormone needle once a month.
This was to make the source to be put on hold which it does very well.Also bladder control better than ever.
Led a normal life since except for the chasing women part and getting slight man boobs.
That was 16 years ago bust must admit a bit worried now as blood test shows my white blood cell count up like crazy so further follow up tests needed.
Wouldnt have known if not for blood tests so i recommend the full test once a year.

Its the outcomes that worry me as in which doctor says what.I know guys 55 that had it removed,when psa only 5.I know older guys whos psa varies around the low 20 mark and dont worry about it.

They have prostate cancer but its not the aggresive one like i had that just keeps going up.

Most people when they hear cancer want it ripped out(fare enough)but some of the consequences include no erection and having no control over the bladder.At least with needle or no nuts you dont wet your pants but still cant crack a jolly-----never tried viagara as ive lost interest.

[Loose rivets]

I was just qualifying for British medicine again when the Rivetess pushed me to have a PSA check in Texas. It was over 8.

I phoned the practice I'd been with for most of my life, and the GP said 'Watchful Waiting' at your age.

Mmmm . . .

I found a wonderful Doctor some 5 hours away who gave this old Brit a heck of a deal on the biopsy. I got a Gleason of 7. But it was the bad way around. 4+3 or 3+4, can't remember, but it was the one I didn't want.

Told my GP, and he said he'd refer me as a cancer patient immediately. I was seeing the first specialist the day after my feet hit British soil. The next phase was rather confusing, but I plumped for Brachytherapy. I'm not sure where I am now, but I was left with most functionally, once I got used to the lack of flow. I'm finding some symptoms I don't like some 3 years after the procedure, but the GP here doesn't think it's cancer related - well, not from the prostate, anyway.

I still love sex. Wouldn't be much use to a randy twenty-year-old, but there, such is the way of things.

[teresa green]

They reckon most of us by the time of 75 have prostrate cancer anyway, but most die of other cancers or heart or whatever. In my last year of flying and at QF (the oldest S/O ever, I am sure, due to that year we don't mention) I used to get very concerned about the amount of time I would spend in the head, because the plumbing just was not working to well, and worry the skipper would wonder what the hell I was doing. All tests were normal, and after I gave up flying all returned to normal, and touch wood has stayed that way. I still enjoy a romp in the cot (my kids would freak if they read this) and hope this goes on for some time to come. Ah, old age, but it does have its comforts, no wake up calls, no endless hotel rooms, no 0400 sign ons, no uniform, no nights at 30,000 ft, just a pleasant walk with the dog, a spot of fishing, talking to the grandkids, its not to bad is it. When I hear a aircraft overhead late at night somtimes I wish...... then I go back to sleep.:ok:

[gingernut]

It's an awful disease.

The question I have to ask, is this:

Does screening (ie using the "PSA" test) save lives or cause more harm than good?

The answer, for all sorts of different reasons, is the latter.

The biggest problem is the poor specificity and sensitivity of the test. Different answer if you are a bloke with urinary symptoms-go and see your GP.

[Wallsofchina]

Watchful waiting is a euphamism for a decision to die, and gambling that you will get a few years, or that you will die of something else.
Something for gambling fans.

Prostate Cancer feeds on testotserone, and Hormone injections kill the testosterone throughout the body, and would have been used in my case if the cancer had escapes from the prostate, which they suspected, but the side effects are huge, you finish up with bleeding and you only get a few years.

I have a friend who has had Brachytherapy (internal radiotherapy by inserting "seeds" into the tumor, which is usually associated with an early stage tumor, but this is a pathway of no return. If the cancer escapes, they can't take the prostate out.

My thinking is if you don't have a prostate the main source of the cancer production is gone.

Once you get into the cancer system you realise there are many forms and stages of the disease, and a big variety of effects on erectile and incontinence levels from zero effect on.

The PSA test does not exclusively report cancer, there are several other causes if high PSA, such as an infection, so of course no one relies on it alone, but I would have just a few months to live if I hadn't had one. That's why I recommended both tests. A high PSA reading may decide the specialist to do a biopsy, then there is no doubt.

Disclaimer. This has been a bush amateur's summary, but you are better off by far getting to a specialist in prostate cancer fast, having the diagnostics, and taking charge of your life. Do it early and most of you will get good news.

[gingernut]

Watchful waiting is a euphamism for a decision to die, and gambling that you will get a few years, or that you will die of something else.
Something for gambling fans.

It's easy to bring emotion, and sometimes anger into what is an awful disease, but we have to scientific.

The bottom line is, screening asymptomatic men for prostate cancer doesn't work-unfortunately.

Please don't shhot the messenger:)

[Wallsofchina]

Being mindful of your need for us to be scientific Gingernut, how are you going to find out if someone has cancer if you don't screen?

I had no symptoms, no pain, no inkling for years. A Doctor shocked by my PSA reading found no abnormality in a physical check, the specialist found no abnormality in his physical check, but the surgeon removed a tumour the size of an orange.

That's why you need both a physical and a PSA, neother are certain, but both together increase the odds of detection.

[gingernut]

It's great that your cancer was dealt with and I wish you all the best.

Unfortunately we can't screen for all cancers, the tool (ie psa) isn't that reliable.

This fella' seemed to get it right, it's a bit dated, Wilson's criteria for screening tests - General Practice Notebook (http://gpnotebook.com/simplepage.cfm?ID=1469710399)
but the later stuff from WHO didn't really add much.

Good Health:ok:

[Wallsofchina]

I said BOTH tests Gingernut

[homonculus]

The problem, gentelemen, as has been said on PPRUNE before, is that the incidence of prostate cancer is very high - 'almost' everyone has it by the age of 80, but in some it is so slow growing that you die of old age decades before it is a problem whilst in others it is rapidly invasive.

Perhaps the best advice is to get tested if you have any symptoms, treat any PSA abnormality with care, and above all try to ensure you are referred to a good urologist who uses all options and does not just reach for the knife

[simsalabim]

As a way to inject some objectivity into the often quoted figure of 3000+ annual deaths in Australia from prostate cancer here is the break up by age at death and the probability of dying from the disease for the year 2007. I post these figures as an example of the need for a balanced approach to the statistics flung out by the Prostate Cancer Foundation which do not break the stats up but merely quote the fact that "each year over 3000 men will die of PC" .Also as an encouragement to please read the Syd Uni study for a better understanding of the issues BEFORE getting screened.


Table 3:

Age group and number of prostate cancer deaths/ probability of death in one year

40–44#: 3 (1 in 250,000)
45–49: 7 (1 in 111,111)
50–54: 18 (1 in 38,462)
55–59: 55 (1 in 11,494)
60–64: 142 (1 in 3759)
65–69: 215 (1 in 1859)
70–74: 315 (1 in 989)
75–79: 567 (1 in 448)
80–84: 713 (1 in 242)
85+: 903 (1 in 125)
All ages: 2938 (1 in 3226)
Source: www.aihw.gov.au/cancer/data/acim_books/index.cfm (http://www.aihw.gov.au/cancer/data/acim_books/index.cfm) (prostate cancer)
# no deaths were recorded in men less than 40

[simsalabim]

Great advice homonculus.

[Loose rivets]

Yes, I agree, probably better to erase the post, but I'm still impressed with Ulysses S Grant's efforts to finish those memoirs while sipping morphine. Created on of the finest works of its kind ever written it seems.