Comments on: Testing for prostate cancer http://www.medrants.com/archives/1947 Contemplating medicine and the health care system Mon, 15 Mar 2010 21:13:31 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Prostatitis London http://www.medrants.com/archives/1947/comment-page-1#comment-529575 Prostatitis London Mon, 09 Nov 2009 10:12:19 +0000 http://medrants.com/archives/2004/05/27/testing-for-prostate-cancer/#comment-529575 Very well written off post about testing of prostate cancer treatment. Thanks for sharing this informative article with all the users. :) Very well written off post about testing of prostate cancer treatment. Thanks for sharing this informative article with all the users. :)

]]> By: FP http://www.medrants.com/archives/1947/comment-page-1#comment-3836 FP Fri, 28 May 2004 12:11:55 +0000 http://medrants.com/archives/2004/05/27/testing-for-prostate-cancer/#comment-3836 I read the full article. The authors should have included a ROC curved. When I graphed it using the data in table 2, the line approached "worthless". I do think the article has some good data re: natural history. I read the full article. The authors should have included a ROC curved. When I graphed it using the data in table 2, the line approached “worthless”.
I do think the article has some good data re: natural history.

]]> By: RGL http://www.medrants.com/archives/1947/comment-page-1#comment-3831 RGL Thu, 27 May 2004 14:42:57 +0000 http://medrants.com/archives/2004/05/27/testing-for-prostate-cancer/#comment-3831 Doubts have been cast for sometime on the need for routine screeing of prostatic ca with PSA, and those doubts are now validated with this latest study. Shoud we or shouldn't we? As the old cliche says, it puts physicians in the horn of a dilemma. One thing we know is the large number of negative biopsies in those with a marginal elevation of the PSA, particularly in those with values between 4 to 8 ng. In practice, I feel the best thing to do is to discuss the availability of the test to those over 50 years of age, discuss its limitations, and then make a mutual determination on the need for a biopsy, perhaps in tandem with other findings and the personal wishes of patients. Such full disclosure probably would protect physicians legally. In sum, these new doubts reinforce the need to revamp our old thinking about the routine use of PSA, although that may not quell the arguments of those who feel it's the best we have available at present. Doubts have been cast for sometime on the need for routine screeing of prostatic ca with PSA, and those doubts are now validated with this latest study.

Shoud we or shouldn’t we? As the old cliche says, it puts physicians in the horn of a dilemma. One thing we know is the large number of negative biopsies in those with a marginal elevation of the PSA, particularly in those with values between 4 to 8 ng.

In practice, I feel the best thing to do is to discuss the availability of the test to those over 50 years of age, discuss its limitations, and then make a mutual determination on the need for a biopsy, perhaps in tandem with other findings and the personal wishes of patients. Such full disclosure probably would protect physicians legally.

In sum, these new doubts reinforce the need to revamp our old thinking about the routine use of PSA, although that may not quell the arguments of those who feel it’s the best we have available at present.

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