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Prostate cancer cases worldwide likely to double by 2040, analysis finds

theguardian.com

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Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#41

Post by abalone »

binkHN wrote: post #28
tjpnz wrote: post #23

What steps can one take to increase their chances of it being detected early (and by that I mean all cancers). I live in a country which screens people in their 30s for lung, bowel and stomach cancer but the tests aren't infallible. Same goes for the tumor markers tests you can buy at the clinic which will sometimes lead to unnecessary interventions.

The most cost-effective tool that we have today is the simple PSA blood test. However, I'd argue this is unnecessary at your age.

Agreed, prostate cancer is rare under age 40. 45 to 50 is a good age to get tested if there is no family history.

Other things:

- There is a very new multi-cancer blood test called Galleri that might catch it, but I think you have to be above age 50.

- You could potentially do genetic testing to look for markers but it's probably not worth the expense unless you have family history.

- There's also the old fashioned Digital Rectal Exam that feels for abnormally sized prostates, but chances are your PSA would already be elevated.

Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#43

Post by hn_throwaway_99 »

abalone wrote: post #40
hn_throwaway_99 wrote: post #29

Earlier quoted context omitted.

This article from 2018 argues against widespread PSA testing as a screening tool: https://www.health.harvard.edu/blog/new-study-once-again-cas...

There are conflicting studies. This is common. It's tough to put together randomized trials over a multi-decade period to get the highest quality data. But among oncologists there is very widespread agreement on the benefits of PSA testing. https://mcpress.mayoclinic.org/healthy-aging/the-psa-debate/

I agree to with the other reply to my comment that stated "Also, as an individual, you should make decisions for yourself, not based on some population-wide study."

That is, the tough problem for scientific recommendations like PSA screenings is they essentially need to apply to everyone, and "everyone" has to take into account that most people don't understand how to quantify risk and they usually see things in terms of black-and-white.

That said, I don't think the statement "But among oncologists there is very widespread agreement on the benefits of PSA testing." accounts much for anything. There have been loads of examples of highly trained specialists in the past recommending something based more on "well, logically it makes sense", only to not see it actually play out when studied more closely. I find this especially true that there is a general bias among all specialist professions (not just medicine) to "do something", when sometimes the best thing is to just do nothing.

Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#44

Post by abalone »

hn_throwaway_99 wrote: post #43
abalone wrote: post #40

Earlier quoted context omitted.

There are conflicting studies. This is common. It's tough to put together randomized trials over a multi-decade period to get the highest quality data. But among oncologists there is very widespread agreement on the benefits of PSA testing. https://mcpress.mayoclinic.org/healthy-aging/the-psa-debate/

I agree to with the other reply to my comment that stated "Also, as an individual, you should make decisions for yourself, not based on some population-wide study." That is, the tough problem for scientific recommendations like PSA screenings is they essentially need to apply to everyone, and "everyone" has to take into account that most people don't understand how to quantify risk and they usually see things in term…

Sure but we should still listen to specialists. They aren’t always right but they are wrong less often than the rest of us.

As for “doing something” actually there has been a consistent trend in the prostate cancer fields towards doing less. As the years go by they get better quality data from long term studies supporting “watchful waiting” for many lower grade cancers. I even had a more aggressive one and they let me go several years before surgery, just to maximize quality of life. That’s all due to new data. Data that definitely one needs specialist skills to interpret.

Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#45

Post by pintxo »

breadwinner wrote: post #27
abalone wrote: post #19

Prostate cancer survivor here, AMA. Tips: * I recommend everyone with a prostate get their PSA tested by age 45, or earlier if it runs in the family. It's a simple blood test but sometimes you have to ask for it. * Early detection is key. A biopsy can assess how aggressive it is (the Gleason score). They can even genetically profile the tumor to further gauge risk (the Decipher score). * Most cases are slow growing a…

Is that the lab test? Isn't false positives and false negatives high with PSA?

There is no single threshold above which you’d say it’s cancer.

PSA levels will vary between people, basically depending on the size of the individual prostate and physical activity (they should not take your PSA when you took your cycle to go to the doctor).

Which is why the best course of action is to get a series of (yearly) PSA values starting from you (mid-) forties. Such that you have established your personal baseline and can easily spot a significant uptick.

Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#46

Post by jddj »

abalone wrote: post #19

Prostate cancer survivor here, AMA. Tips: * I recommend everyone with a prostate get their PSA tested by age 45, or earlier if it runs in the family. It's a simple blood test but sometimes you have to ask for it. * Early detection is key. A biopsy can assess how aggressive it is (the Gleason score). They can even genetically profile the tumor to further gauge risk (the Decipher score). * Most cases are slow growing a…

I know it's neither here nor there in the scheme of things, but how unpleasant is the biopsy process?

Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#47

Post by AwaAwa »

relium wrote: post #15
not_the_fda wrote: post #7

You die with prostate cancer, not from it. It has a 95% survival rate.

About 40 years ago my father, an oncologist, told me there were two common types of prostate cancer, the fast growing type that kills you and the slow growing type that doesn't. We've learned a lot about it since then, but that description is still essentially true. It causes 30,000 deaths a year in the US, which is not insignificant - in comparison breast cancer kills 40,000.

IIRC there was also some news a while back (pre-covid era) on the massive funding discrepancy between research into the two. Hopefully not the case any more.

Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#49

Post by Ekaros »

max_ wrote: post #33

But why? Anything that is making these numbers increase?

If we stop other things from killing us, something else will. We are rather good at solving many many things that might kill us. So those that are left claim larger share.

Re: Prostate cancer cases worldwide likely to double by 2040, analysis finds

#50

Post by abalone »

jddj wrote: post #46
abalone wrote: post #19

Prostate cancer survivor here, AMA. Tips: * I recommend everyone with a prostate get their PSA tested by age 45, or earlier if it runs in the family. It's a simple blood test but sometimes you have to ask for it. * Early detection is key. A biopsy can assess how aggressive it is (the Gleason score). They can even genetically profile the tumor to further gauge risk (the Decipher score). * Most cases are slow growing a…

I know it's neither here nor there in the scheme of things, but how unpleasant is the biopsy process?

It’s fine. I did 3 or 4 over the years. They stick a probe up your butt a little, with some numbing gel, which is uncomfortable but fine. There are a few pricks of local anesthesia and then you feel nothing or extremely little, apart from the pressure of the probe. You hear some clicks as they shoot needles in to take samples, but it doesn’t hurt. It takes like 15 minutes. You take an antibiotic and do an enema beforehand to ward off infection.

The worst part for me was you have bloody semen for weeks after. I thought that was so gross. But it’s harmless and resolves completely.

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