Some readers of this blog will recall that I suffer from what I call “Koman Envy”. Every year when I see a giant pink ribbon hanging from the capitol or pink labels all over the grocery store, I wonder why prostate cancer is not an equal opportunity disease. Nevertheless, there can be little doubt that awareness of prostate cancer, and particularly the conundrum around screening has received more attention than at any time in recent memory.
Thus, it was of considerable interest when I came across this article in the BMJ today that has reanalyzed the efficacy of breast cancer screening. As you can imagine, when a woman has an abnormality on a mammogram, it is not always cancer. But the only way to tell is to do a biopsy. And…sometimes the biopsy will reveal a pre-cancerous condition called DCIS that might never progress to invasive cancer. I presume that all sounds familiar to the prostate cancer family. What this article did was add in the potential harms of treatment and analyze QALY’s (quality adjusted life years) saved by screening. When harm was added into the equations, the value of screening became less clear.
Although there will never be a definitive answer of when/who/if various groups of men should be screened or stop screening, the increasing awareness that it is not such an easy decision is worthwhile as we attempt to make our colleagues and patients more a part of the process rather than the “just do it” approach that has characterized screening programs up to now.
One response to “We are not alone.”
I feel screening has received more attention than at any time in recent memory because more breakthroughs in PCa’s research & drug development has occurred in the last year than in the previous 10 years. We now offer a chance for patients to prolong their life or even turn the inevitable terminal PCa into a Chronic disease. More drugs like Provenge, Zytiga, MDV3100, XL184 etc. has brought attention to the need for “Early” detection of PCa. Today, the “just do it” approach that has characterized screening programs for all in the past need to focus on determining the patients with very aggressive forms of PCa, (doubling time every 3 to 4 weeks) and not the very old and non aggressive PCa patients. Advanced PCa patients like myself are willing to give up so much at a chance to extent our life’s. Non aggressive forms of PCa patients need not be subjected to the harmful procedures and drugs that are a must for the PCa aggressive patients.
We all have, “Koman Envy”! As many men each year die of PCa as females die of breast cancer. We all need to get the word out to the world that men need BIG support for our cancer too!