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Obama’s new cancer Rx is a war on men

cavehobbit

November 29, 2015
77 upvotes
/r/MensRights
http://nypost.com/2015/11/24/obamas-new-cancer-rx-is-a-war-on-men/
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Post Information
Title Obama’s new cancer Rx is a war on men
Author

cavehobbit

Upvotes 77
Comments 26
Date November 29, 2015 3:44 PM UTC
(10 years ago)
Subreddit Posted in /r/MensRights
Original Link https://old.reddit.com/r/MensRights/comments/3upzk0/obamas_new_cancer_rx_is_a_war_on_men/
Archive Link https://theredarchive.com/r/MensRights/obamas-new-cancer-rx-is-a-war-on-men.966120
https://theredarchive.com/post/966120
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Comments

[–]cmumford 6 points7 points8 points 10 years ago (2 children) | Copy Link

This may actually be reasonable. You guys should check out a book titled The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster. There isn't a strong correlation with PSA results and prostate cancer. This was written by the dude that discovered the prostate specific antigen.

[–]TheDude41 0 points1 point2 points 10 years ago* (0 children) | Copy Link

Yeah, that guy is an idiot. Moreover, he's not even a physician, which means he's never even treated a single person with prostate cancer in his entire life.

No doubt, he's spent millions in government money in his lab over the years. Man PhDs complain that this is never enough. But he simply can't tolerate it if a regular guy spends $30 on a PSA test and decides on his own, based on good information collected by medical experts, whether or not to undergo additional diagnosis or treatment.

I know a lot of the PhD guys. Most are pompous idiots who feel that regular people are too stupid to be trusted with their own care. You know, the usual academic elitist horsecrap.

[–]TheDude41 0 points1 point2 points 10 years ago (0 children) | Copy Link

https://theprostatedecision.wordpress.com/about/my-letter-to-the-new-york-times-in-regards-to-richard-albin-discoverer-of-psa/

[–][deleted] 9 points10 points11 points 10 years ago (12 children) | Copy Link

Sometimes screening tests are overused. It's a medical issue. You have to consider not only the risk of missing a case, but also the increased morbidity of treating things that never would have caused any problems. It's really not as simple as this article is implying, and this is written by an outright anti-Obamacare propagandist in the Rupert Murdock owned New York Post.

I'll wait for a more thoughtful and impartial opinion before I pass judgment.

[–]MenandBoysareGood 1 point2 points3 points 10 years ago (0 children) | Copy Link

I'd rather be one of those men the test was "overused" on. Shouldn't the decision be in the hands of men? A $35 blood test can let you know if you have prostate cancer....wouldn't it be best to know if you have it? It shouldn't even be up to debate.

[–]RandyDanderson 0 points1 point2 points 10 years ago (1 child) | Copy Link

Huge difference between removing a prostate and testing for PSA. Testing PSA is the contention in the article. Nothing wrong with testing PSA. Prostate cancer is over treated but as it states in the article

Male patients aren’t pushed into biopsies or treatment on the basis of a single abnormal PSA score anyway, explains Dr. John Williams, a New York urologist. Doctors also consider a patient’s age, his prostate’s size and other factors.

[–]MenandBoysareGood 0 points1 point2 points 10 years ago (0 children) | Copy Link

Exactly. I'd like to know if I have the antigen...and if if I'm at a high risk I.e. if I'm an African American or if someone in my family had it even the more urgent to know.

[–]Alkomb[🍰] 1 point2 points3 points 10 years ago (0 children) | Copy Link

What he/you said.

[+][deleted] 10 years ago* (1 child) | Copy Link

[permanently deleted]

[–]TheDude41 -3 points-2 points-1 points 10 years ago (0 children) | Copy Link

You're entitled to your opinion, as is everyone else.

[–]TheDude41 0 points1 point2 points 10 years ago (4 children) | Copy Link

The USPTF task force that manufactured the recommendation was full of it.

Not only that, but all members have fiduciary conflict of interest, in that all of the receive government payola in some form.

[–]TracyMorganFreeman 0 points1 point2 points 10 years ago (3 children) | Copy Link

Would you care to provide data contrary to their findings?

[–]TheDude41 1 point2 points3 points 10 years ago* (0 children) | Copy Link

http://www.drcatalona.com/quest/quest_spring09_3.htm

The NCI reported the following data on prostate cancer death rates by years:

1975 -1987, an annual increase of 0.9%"

1987-1991, an annual increase of 3.0%"

In 1991, Dr. Catalona first reported in the New England Journal of Medicine that the PSA test could be used as a first-line screening test for prostate cancer.

1991-1994, an annual decrease of 0.6%

In 1994, Dr. Catalona reported on the pivotal multi-institutional study that led to the approval of PSA as an aid to the early detection of prostate cancer with a 4 ng/ml threshold recommendation for prostate biopsy.

1994-2005, an annual decrease of 4.1%

On the misuse of the U.S. Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial data by the USPSTF:

https://en.wikipedia.org/wiki/Prostate_cancer_screening

"This recommendation has been criticized by many prostate cancer experts for an over-reliance on findings of the U.S. Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial... because the [PLCO] study was initiated during a time when PSA screening was already becoming widely adopted [in the US], there were high rates of PSA testing among men who were in the control arm. This rate of contamination was very high: acknowledged by the authors to be 44% before the study started and 52% during the course of study. In fact... over 90% of the prostate cancers found in the 'control' arm were stage T1 or T2, which by definition can only be detected with screening.

... In other words, the USPSTF based their decision heavily on a study performed in the US, where a large fraction of patients in the control arm of the study were already undergoing PSA testing. For ethical reasons, it was not the purpose of this study to prevent men in the control arm from undergoing the PSA tests they would get on their own, only to provide additional testing over above baseline to those in the experimental arm.

The PLCO authors stated in a later publication that the PLCO should not be interpreted as a trial of screening vs. no screening, but rather as a trial of annual screening vs. so-called opportunistic or ad-hoc screening.

In other words, the USPTF intentional misused and misrepresented the results of the PLCO study in order to come to their conclusions.

The USPSTF also based their assessment of the "harms" of screening and treatment based on a biased and out-dated literature review. For just one example, their statement cited a 1:200 risk of dying within 30 days of radical prostatectomy. This number comes from men over the age of 65 treated in the early 1990s; the actual number in contemporary practice is closer to 1:10,000.

Yes, the USPSTF also made a lot of hay over the perceived "harms" of PSA testing to patients. But the PSA test in reality harms no-one. It's just a piece of information. Every patient is given the opportunity to act on those results, or not act. Yes, many will choose to undergo a prostate biopsy procedure, which creates mild discomfort but is otherwise harmless, and based on the results of those tests, even if they do reveal cancer, patients once again have the choice to either undergo or not undergo treatment, depending on the severity of the cancer revealed if present.

The way things work in reality, is that once a PSA test result is elevated, that person is typically referred for a minimally invasive prostate biopsy procedure. If cancer is detected, it is assigned a grade (severity), and depending on that grade, a patient may or may not choose to go on to definitive therapy.

Nowadays, men with low grade cancers typically do not get any specific therapy, but are monitored. It's only those with a high grade cancers that have a high chance of killing the patient, that are recommended to undergo a definitive therapy such as surgery. Sure, there is an argument that some men may over-treat their prostate cancers when they are low grade, but that is a matter of choice worked out in conjunction with the physician. It's not really an indictment of the PSA test per se, it's a discussion that has to be had between a physician a patient regarding a specific case.

[–]TheDude41 0 points1 point2 points 10 years ago (0 children) | Copy Link

http://cisnet.cancer.gov/prostate/comparative.html

[–]TheDude41 0 points1 point2 points 10 years ago* (0 children) | Copy Link

.... and finally, the better designed study from Europe, which was available to the USPSTF authors, which did not suffer from the limitations of the US PLCO trial, but which was not sufficiently taken into account by the USPSTF authors found the following...

... In the European Randomized Study of Screening for Prostate Cancer (ERSPC) initiated in the early 1990s... involved 182,000 men... randomly assigned to a group that was offered PSA screening at an average of once every 4 years or to a control group that did not receive such screening. During a median follow-up of almost 9 years, the cumulative detected incidence of prostate cancer was 820 per 10,000 in the screening group and 480 per 10,000 in the control group.... There were 214 prostate cancer deaths in the screening group and 326 in the control group, a difference of 7.1 men per 10,000 in the tested group compared to the control. The researchers concluded that PSA-based screening did reduce the rate of death from prostate cancer by 20%, but that this was associated with a high risk of overdiagnosis, which means that 1410 men would need to be screened and 48 additional cases of prostate cancer would need to be treated to prevent just one death from prostate cancer within 9 years. However, the number needed to treat to prevent one progression to metastatic disease was only 24, and both numbers are expected to fall as patients in the study are followed for longer periods of time... Furthermore, the benefit for screening was greater (30% rather than 20%) with adjustment for noncompliance and contamination (i.e., men who were randomized to get PSA tests but did not, and those who were in the control arm but actually received PSA tests during the study period)... One recent analysis of the ERSPC data suggested that projecting over a 25-year time horizon, which is more appropriate for a man in his 50s than the 9 years reported to date from the trial, the number needed to screen falls to 186-220, and the number needed to treat to prevent a death falls to between 2 and 5 men.

In addition to the 20 percent reduction in prostate cancer mortality shown by the ERSPC study, a more recent study has shown greater effectiveness in how screening has reduced the prostate cancer death rate. A study published in the European Journal of Cancer (October 2009) documented that prostate cancer screening reduced prostate cancer mortality by 37 percent. By utilizing a control group of men from Northern Ireland, where PSA screening is infrequent, the research showed this substantial reduction in prostate cancer deaths when compared to men who were PSA tested as part of the ERSPC study.

https://en.wikipedia.org/wiki/Prostate_cancer_screening#Clinical_practice_guidelines

[–]icefire54 -2 points-1 points0 points 10 years ago (0 children) | Copy Link

Being anti-Obamacare is a good thing. It forces men to subsidize women's shit. That's not good for men's rights.

[–]TheDude41 3 points4 points5 points 10 years ago* (0 children) | Copy Link

FYI, you don't need a doctor / insurer to gatekeep your access to PSA testing for prostate cancer.

PSA testing can be purchased for relatively low cost direct by consumers, without having to ask your doctor or insurer for "permission."

https://labtestsonline.org/

Your body, your choice!

You would simply forward the results to your family physician or personal doctor, and have him / her interpret the results and recommend additional testing, if necessary.

And if in the process you do find you have prostate cancer and your diagnosis was delayed, feel free to sue the shit out of your accountable care organization (ACO), HMO or other insurer engaging in these practices.

Clearly, if you are male in the western world, your governments are not looking out for your back. So do it yourself.

Gathering together enough similarly situated men should be helpful, as it creates the possibility of banding together in a class action.

Most, if not all of the physicians who participated in generating the USPTF guidelines on PSA testing had one form of fiduciary conflict of interest or another (they all receive federal money in one way or another), and, in so far as time frame is concerned, the policy was born in the crucible of the debate on Obamacare and controlling costs, in this case by treating men in the usual manner of denying services to save big mother the trouble.

[–][deleted] 3 points4 points5 points 10 years ago* (2 children) | Copy Link

This comment has been overwritten by an open source script to protect this user's privacy.

If you would like to do the same, add the browser extension GreaseMonkey to Firefox and add this open source script.

Then simply click on your username on Reddit, go to the comments tab, and hit the new OVERWRITE button at the top.

[+][deleted] 10 years ago (1 child) | Copy Link

[permanently deleted]

[–][deleted] 1 point2 points3 points 10 years ago* (0 children) | Copy Link

This comment has been overwritten by an open source script to protect this user's privacy.

If you would like to do the same, add the browser extension GreaseMonkey to Firefox and add this open source script.

Then simply click on your username on Reddit, go to the comments tab, and hit the new OVERWRITE button at the top.

[–][deleted] 2 points3 points4 points 10 years ago (0 children) | Copy Link

This needs to be more popular, it is too important to ignore

[–]TracyMorganFreeman 0 points1 point2 points 10 years ago (0 children) | Copy Link

Less care can be better when false positives are a thing and spending versus outcome is better allocated elsewhere. Then again the latter is a problem with collective funding.

[–]TheDude41 0 points1 point2 points 10 years ago (0 children) | Copy Link

Looks like we've been brigaded.

[–]TheDude41 0 points1 point2 points 10 years ago* (0 children) | Copy Link

Chivalry is complete shit.

Here's hoping for a massive class action suit to be levied against health systems that have discouraged PSA testing in men.

Hopefully also, the panel that produced the recommendation.

[–][deleted] 0 points1 point2 points 10 years ago (0 children) | Copy Link

Let's not go down the whiny ass feminist road and start calling everything a "war on men" please.

[–]darngooddogs -5 points-4 points-3 points 10 years ago (0 children) | Copy Link

He will never defeat us!

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