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Bones Lose Their Autonomy

Paper Chase 1 - Consider the Prostate, Again

Andrew Buelt, DO and Joe Weatherly, DO
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07:47
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No me gusta!

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Tags oncology · Urology

  • Median prostate-related cancer death at 10 years was low, irrespective of treatment assignment, with no significant difference between any of them.

 

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Ian L., Dr -

In the ages 45-65 a many patients wish a 20-35 year survival and one needs include those of AfroAmerican Ethnicity those with FH and Risk factors and BRCA 2 carriers who have a 15% risk of Prostate Cancer often Gleeson 7-10 .
Have to ask the 20-35 year survival for Gleeson 7-10 and more advanced Prostate Cancer with Treatment and with Monitoring .
According to USA SEERS statistics 41.4% of 180,000 patients are diagnosed with prostate cancer between 45-65 .
Ten to Fifteen Percent will be "Aggressive " that is about 6,750 Persons .
Need Choices for these People .

Heidi J., MD -

Hi Ian -

Joe Weatherly from The Paperchase wanted to weigh in here:

This is difficult with the current harms of treatment and even just screening EVERYONE to find the 10-15% of the 41.4% of those with aggressive cancer. (Cancer.org and many others estimate in typical population the LIFETIME risk of prostate cancer is closer to 10-12% and then 10% of those are aggressive.

This is a patient choice. Not a Doctor choice in my opinion. The choice of screening is the first step and they should be agreeable to the long term risks if they want to start the screening. They should also be willing to accept that the MCC of death in men is still heart disease ...even for those that HAVE prostate cancer. Dont strain the gnat and swallow the camel.

World wide pancreatic cancer kills more people each year. In the USA its only 10k fewer people per year that die from pancreatic vs prostate cancer. We aren't screening for pancreatic cancer...and almost ALL of them die quick and miserable deaths. The screening for that is much less risky imo, though significantly less common with 1.2% lifetime risk
The average lifetime risk of pancreatic cancer for both men and women is about 1 in 65 per cancer.org.
Stage IV pancreatic cancer has a 5-year survival rate of about 1%
In prostate cancer the relative 5-year survival rate for distant stage prostate cancer is about 28%

My 2 cents.

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Bones Lose Their Autonomy Full episode audio for MD edition 193:25 min - 91 MB - M4AHippo Primary Care RAP January 2017 Summary 329 KB - PDF