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Post by KC on May 22, 2014 10:09:54 GMT -8
The “New” Prostate Cancer Infolink has an interesting “State of the Art” report which was presented this week at the AUA annual meeting. The report provides an excellent, bias-free perspective on the five different PC screening guidelines: ACP, NCCN, ACS, AUA and USPSTF.
Two key take-aways from the final summary paragraph which haven’t sunk in completely with all doctors, and also not with the broad “patient community” who tend (I'm generalizing; thus the use of the work "tend") to anecdotally feel that “screening saved my life, and everything else be damned,” is the following which was quoted from the report (underlining added by me):
1. “No one is suggesting population wide screening, but rather, shared decision making.”
2. “Urologist should reconsider the entire discussion with an open mind, and emotional and anecdotal arguments have no role.”
Read the Infolink posting for yourself, HERE.
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Post by gunfighter on May 26, 2014 15:26:08 GMT -8
KC & Tony,
Although this is not in the public domain, there is the VA's "Prostate Cancer Screening" guidelines provided to the VA's clinical staff. It is applicable to the approximately 9 million men who utilize VA medical facilities.
I found it interesting that in contravention of the task force's "not recommended", the VA makes "no recommendation for or against screening for prostate cancer with psa" for those who may be at increased risk--
Ie., African Americans, those of exposed to Agent Orange, and those with a family
History . Interesting? Both you and Tony have the latest approved document. Your comments please.
Bill
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Post by Tony Crispino on May 27, 2014 10:01:22 GMT -8
Hi Bill,
I am just back from a business trip. What a month of travel and it's not over yet. Leaving Friday for Chicago and ASCO.
I think the VA's position is expected. It leaves it to the patient and the physician. The VA is having big healthcare issues right now and I'd hate to see a deferment away from PCa awareness for the vets. But I will say that the guys in Vegas are screened and treated. It just depends in which district you are in that will determine the VA's attention on PCa.
This needs to get fixed.
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Post by gunfighter on May 27, 2014 15:23:11 GMT -8
Tony,
"This needs to get fixed". As always I appreciate your support of Vietnam veterans who were exposed to Agent Orange and are at "risk". I'm sure that you realize it's a highly emotional issue with me, and as Jerry L stated regarding a proposed senate resolution, "All I know is that I have to do something"; I feel the same regarding fostering "awareness" within the VA which is currently not being done.
The approved VA "Prostate Screening" guidelines state: "Unlike USPSTF, this VHA statement does not recommend for or against screening for men who may be at increased risk of prostate cancer. The reason for varying from the USPSTF is that the VHA serves a different population than the population included in the PLCO and ERSPC trials. Although these men may have an increased risk of prostate cancer, there is insufficient evidence to know if screening improves their outcomes".
In the absence of "evidence", I feel that it is within the prerogative of the Secretary of Veterans Affairs to require "awareness" within the VA. It may require the expenditure of some of our national resources, but our veterans are worth it. It's certainly too late to have a 10-year trial.
Many men in my unit in 1968 Vietnam were African American truck drivers and machine gunners and were sprayed frequently by "crop dusters" while they were convoying supplies from the S China Sea on a 120 mile journey to the Central Highlands, AnKhe, and then to Pleiku and return (240 miles total daily); I feel that these men were at extremely high risk so have provided the VA's guidelines to the president of PHEN (a member of the roundtable). In addition, since these guidelines are not within the public domain, they have also been provided to Dr Catalona and the National Commander of the "American Legion". You are improving the lot of American men and I am trying to do the same in my own way--lol.
Keep on doing what you are doing!
Bill
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Post by gunfighter on Jun 17, 2014 13:42:12 GMT -8
Tony,
UPDATE: I appreciate being allowed to be a member of this forum and to express my advocacy which may be controversial to some. I have received favorable responses from Thomas Farrington, the president of PHEN which is an African American advocacy group, and the American Legion's assistant director for healthcare. Both of these men have expressed their appreciation for the information and materials which I provided. More importantly, they have promised to address the matters which I presented directly to the VA; with the "new blood" that the VA is to have, they may have some success.
Within my limited capabilities, I feel that I have accomplished all that is possible; so, hopefully, I am going to get on with my life and put all matters relating to PCa in the rear view mirror. I wish you and all the advocates the best in your efforts.
Godspeed
Bill
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