Re: Delayed Treatments for Prostate Cancer


"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:hZpGg.918264$084.242906@xxxxxxxxxxxx

"george conklin" <george@xxxxxxx> wrote in message
news:wFlGg.12184$xp2.9550@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:Mq7Gg.145053$1i1.58488@xxxxxxxxxxxx

"george conklin" <george@xxxxxxx> wrote in message
news:Vb7Gg.11068$0e5.115@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:ms1Gg.5837$aJ.4857@xxxxxxxxxxxx

"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in message
news:eKXFg.6326$Sn3.4645@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:QONFg.143551$1i1.63103@xxxxxxxxxxxx

"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in message
news:ZKNFg.6025$Sn3.3234@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:ZtNFg.912615$084.872210@xxxxxxxxxxxx

"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in message
news:VhMFg.5986$Sn3.2988@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:9pIFg.911937$084.677719@xxxxxxxxxxxx

"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in
message
news:ebCFg.8059$Qf.4958@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:PAtFg.97691$FQ1.49777@xxxxxxxxxxxx

"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in
message
news:iLiFg.10216$0e5.7283@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:9_8Fg.140629$1i1.122040@xxxxxxxxxxxx

"George Conklin" <georgeconklin1@xxxxxxxxxxxxx> wrote in
message
news:_33Fg.5011$Sn3.149@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

"Skeptic" <bcs002b@xxxxxxxxx> wrote in message
news:2fQEg.904055$084.859533@xxxxxxxxxxxx
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.

You are back at your old tricks. It is like saying, "Today's exchange
rate between the Euro and the Dollar is..." and YOU say, "That is not
new information becuase we always knew there IS an exchange rate." It
does not matter if we get the original article and quote it, you always
have some trite comment. I view you as a good example of why cancer
research has taken so long to establish even the basic facts, because as
far as I can tell, you don't want to know. You want to do surgery, and
will never accept any evidence that the benefit is slight at best or no
good at worst, and never mind the FActs. You are like the quacks you
rail aginst, but you are on one side of the fence and they on the other.
Neither group wants facts, just the screaming. Like you.

I want to operate only on those people who I think I will be doing a
service for by either improving the quality of their lives or increasing
the length of their lives.


And that is the problem: personal opinion in place of science.



With prostate cancer, some cases are pretty obvious - such as a high grade
cancer with no evidence of spread in an otherwise healthy man with a life
expectancy well in excess of a decade - you treat him.

Still with only self-selection to show what benefit the treatment is.
That is the whole problem: 100 years of surgery with only the idea that
cutting into something helps a person.


Whether it be with
surgery or XRT, he would be best served with treatment. An older or
sicker man with no evidence of metastasis, you probably use XRT. Cancer
that has spread to distant sites, you go with hormone treatment.

You are just telling me what current practices are. High-dose
chemotherapy for breast cancer was no more effective than regular
treatments, which surprised everyone once the real science was done. Men
have not insisted on such studies for prostate cancer. Sad. But they are
underway now. After 100 years. Sad.



.

Relevant Pages

  • Re: After Diagnosing Prostate C Then The Decision-Making
    ... Fighting Prostate Cancer by Doing Nothing ... Treatment itself can be dangerous. ... So Larry Cano had a prostate-specific antigen, or PSA, test. ...
    (sci.med.diseases.cancer)
  • Re: Delayed Treatments for Prostate Cancer
    ... Your assumption that using data on real-world out comes is ... It is well established that strongest evidence is prospective. ... treatment protocols for millions of men with prostate cancer based ... There are no "treatment protocols". ...
    (talk.politics.medicine)
  • Non-High School Graduates Especially At Risk For Lower Quality Of Life After Prostate Cancer Tre
    ... Non-High School Graduates Especially At Risk For Lower Quality Of Life ... After Prostate Cancer Treatment ... Among men who have received similar treatments for prostate cancer, ...
    (sci.med.diseases.cancer)
  • Re: Totally OT: Good News for Me!
    ... him a PSA as he always waits for other symptoms to appear first!!!!!! ... He had absolutely no symptoms. ... You don't have to have symptoms to have prostate cancer. ... tell them what type of treatment is most likely to save their lives. ...
    (rec.food.cooking)
  • Re: Medical Research-Evidence
    ... The only issue is whether a treatment works. ... men aged 55-59 with diagnosed low-grade disease would die within 15 years. ... Side effects of radical treatment such as surgery and radiotherapy can ... Prostate cancer is the most commonly diagnosed male cancer in the UK. ...
    (talk.politics.medicine)