The cancer crapshoot

Another chink in the PSA's armor

It's been a year (Daily Dose, 7/18/03) or so since I railed against
the worthless Prostate Specific Antigen (PSA) screening for the
detection of prostate cancer. To recap, in the past I've told you
how this misguided mainstay of the mainstream is useless as a
diagnostic tool because PSA readings can vary dramatically from
test to test in the same person — it's a total crapshoot. However,
that fact doesn't stop a lot of MDs from diving for the scalpel and
anesthesia after just one test even though the odds of a "false
positive" are alarmingly high. But I digress…

I'm revisiting the issue now because I've finally found some
backup in the mainstream press for something else I've been
saying for years about what I call the Perniciously Suspect Assay
— that it isn't even very accurate at detecting REAL, BONA-FIDE
CANCER. Here's what I found: An Associated Press article from
earlier this summer summarized a new study (funded by the
National Cancer Institute) that found fully 15% of men over 62
whose PSA readings fell into the "normal" range had cancerous
prostate tumors — some of which were quite aggressive.

Now, I've commented about these grossly inaccurate PSA readings
before, but it bears repeating every so often because of what's at
stake: On the one hand (in the common case of a false positive),
there's needless prostate surgery and the likely impotence and
incontinence that follows; on the other (a false negative, like in the
study I just mentioned), a missed diagnosis of advanced prostate
cancer that would have been treatable, if detected. 

If only the mainstream would adopt the safe, simple, and hyper-
accurate AMAS (Anti-Malignan Antibody Screening) as a follow-
up to an elevated PSA reading — or as a replacement for the test
altogether. Instead, the medical establishment will probably just
lower the "normal" PSA threshold — sending even more of us
needlessly under the knife, while still missing a relatively large
percentage of tumors.

At least 16% of American men can expect a diagnosis of prostate
cancer at some point in their lives, yet only around 3% will die of
the disease. This means that for the most part, prostate cancer
tumors are relatively static — unless we go poking at and piercing
them with a bunch of biopsy needles after a higher-than expected
PSA test (evidence shows this actually breaks up tumors and cause
their cancerous cells to spread)…

I wonder: Would fewer men die of cancer if we just left their
prostates alone?  

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The end need not be bitter

Everyone spends a lot of time talking about "quality of life," but
no one's talking about the quality of a terminal patient's death.

Maybe it's because we're all programmed by the mainstream to
believe we should fight death to the last bullet, even if it causes us
to be miserable and in agonizing pain. Mind you, I'm not trying to
start a debate about physician-assisted suicide or anything so
extreme, but I am saying this:

When there's nothing more that can be done for someone,
shouldn't the focus (of both doctors and the victim's loved ones)
shift from last-ditch measures to buy them another week or two to
making the patient's remaining day as comfortable as possible?

I touched on this subject last year (Daily Dose, 9/19/03) in an
article about how oncologists that forbade their terminal lung
cancer patients from smoking cigarettes were basically taking
away the only thing that gave these dying souls pleasure in order to
buy them another month or so of misery. And recently, a Reuters
Health online article gave me some ammunition with which to
make my argument stronger.

According to the piece, a recent study of survey data reveals that
most people would trade UP TO 7 MONTHS OF THEIR LIVES if
it meant a more comfortable final month before dying. This finding
supports the modern movement toward hospice care for the
terminally ill instead of the beeping, bustling, soulless and sterile
environment of the Intensive Care Unit…

As long as it's not abused for profit, this is a concept I can get
behind.

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