Re: Delayed Treatments for Prostate Cancer


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Are you talking about,
"Incidence of Initial Local Therapy Among Men With
Lower-Risk
Prostate
Cancer in the United States " ?

All that that article finds is that we are overtreating
some
men
with
low
grade prostate cancer - something which we all know
already.

A major journal does not publish articles about what is
already
known.

LOL... yes they do - all the time. Confirmational studies.
They're
actually much easier to get published than are novel ideas.
But
hey,
thanks
for expressing your ignorance.

The study cited is based on real-world experience rather
than
from
a
self-selected group of volunteers. That is always a
difference.

Good to know for future reference - so from now on, whenever I
cite
a
study
based on the SEER database, you'll have to accept it as strong
evidence.

You have a real bias against large data bases. You seem want
more
variables and confuse that with moe variables...those of your
choosing.


Oooh, no, I love large databases. I'm merely pointing out that
you
are
stating it is excellent to use the SEER database so when I use it
later
you
will, of course, accept it as great evidence. (yes, I'm setting
you
up
here, so tread carefully).

These are real-world outcomes, not those projected from a
few
hundred
self-selected men in a so-called 'clinical' study.

It was actually nothing more than a retrospective review,
which
is
much
weaker than a randomized control trial would be.

Incorrect.

No, not incorrect. It was a retrospective study. If you
don't
agree
with
that, then you don't understand the terminology being used.


Your assumption that using data on real-world out comes is
WEAKER
(your
term) than some small-scale clinical study with self-selected
volunteers
is
pure BIAS. I know the terms used, but your biases are so
horrid y
ou
cannot
accept anything but what you want.

It is well established that strongest evidence is prospective.
Yes,
even
smaller numbers of a prospective study are generally stronger
than
larger
numbers of a retrospective study. That's not my opinion - it's
an
established fact.

This is your personal bias

no. an established fact.

In fact, it is NOT an established fact. It is just an old wive's
tale
and one accepted in your industry to try to limit authority and
research
dollars. Not keeping track of real-world outcomes is criminal. To
have
treatment protocols for millions of men with prostate cancer based on
a
sample of a few hundred is a disgrace and you know it.

There are no "treatment protocols". Treatment is based on the best
available data. We have excellent long term data on the results of
interventions, including pretty conclusive proof that surgical
intervention
for prostate cancer results in an improved overall and disease specific
mortality.

And that is what the whole point of the PIVOT and other studies are
trying
to prove, but have no done so yet.

Of course not - those studies aren't due to be completed for a few more
years.

The overall decline in the death rate in
general is very strong in UK, for example, but they do not screen
asymptomatic men there for prostate cancer.

England is no different - they operate on a very similar number of T1c
patients which are patients who are diagnosed based on nothing but a
positive biopsy done as a result of an elevated PSA. Thanks for playing.


Once again you ducked the subject completely. Why are you so fearful of
research? Why do you always say, "We already knew that."

Because we did.

What are you afraid of? That some of your practices might be obsolete?

Cutting edge, actually.

Your last statement also ignores the fact that asymptomic men are not
screened as they are here with a PSA.

Prove it. How else do you think prostate cancer is diagnosed?

And PSA was never even approved for screening anyway. That was an
off-label use.

"off label"? It's not a medication.


.

Relevant Pages

  • Re: Delayed Treatments for Prostate Cancer
    ... Your assumption that using data on real-world out comes is ... There are no "treatment protocols". ... interventions, including pretty conclusive proof that surgical ... asymptomatic men there for prostate cancer. ...
    (talk.politics.medicine)
  • Re: Delayed Treatments for Prostate Cancer
    ... Your assumption that using data on real-world out comes is ... There are no "treatment protocols". ... interventions, including pretty conclusive proof that surgical ... patients which are patients who are diagnosed based on nothing but a ...
    (talk.politics.medicine)
  • Re: Delayed Treatments for Prostate Cancer
    ... Your assumption that using data on real-world out comes is ... treatment protocols for millions of men with prostate cancer based ... There are no "treatment protocols". ... interventions, including pretty conclusive proof that surgical ...
    (talk.politics.medicine)
  • Re: Delayed Treatments for Prostate Cancer
    ... Your assumption that using data on real-world out comes is WEAKER ... There are no "treatment protocols". ... including pretty conclusive proof that surgical intervention ... for prostate cancer results in an improved overall and disease specific ...
    (talk.politics.medicine)
  • Re: Delayed Treatments for Prostate Cancer
    ... Your assumption that using data on real-world out comes is ... There are no "treatment protocols". ... positive biopsy done as a result of an elevated PSA. ... And PSA was never even approved for screening anyway. ...
    (talk.politics.medicine)