Prostate cancer
Listen to a lecture downloaded from McGill by a urologist. First he declared that he was involved with various drug companies. Later he talk about a particular biphosphonate by name - alarm bells for me. How can they possibly think they aren't influenced by these payments. I belive they don't have to declare unless the sum is above 40 odd grand. How would they feel if a judge was receiving money from their in a court case?
Anyway he talked of the a contolled trial which he said had methodological problems but did show a reduction in deaths from prostate cancer. Then he mentioned rather briefly that there was no over all mortality benefit. Then he told us that there was also a reduction in bony metastases. Then he launched into pretty much promoting aggressive treatments for most prostate cancer - the younger the more aggressive of course.
Then I came across this
Symptoms Worsen After Surgery
Now for the question of quality of life. It's certainly possible that a prostatectomycould improve a man's life without prolonging it. Consequently, the Swedish research team sent questionnaires to the 326 men who had symptoms at the start of the study to see how they fared four years later. The percentage of men suffering the following symptoms was consistently higher among the surgically treated, as compared to the untreated: impotence (80% vs 45%), "distress from compromised sexuality" (55% vs 40%), urinary leakage (49% vs 21%), "distress from all urinary symptoms"(27% vs 18%).
Does anyone remember radical mastectomies and how long it took to stop surgeons doing them even when the evidence was in that they did major harm with no benefit.
I met a friend of a friend the other day. He has an enlarge prostate and a PSA of 4. What would you do? It may be coming my way this problem as my dad died of it. What will I do?
Here in the BMJ is an impressive review with some interesting rapid response.
Can not put url in for some some reason - go to BMJ and search for
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