5 ms·

Not routine at age 82: "most organizations recommend stopping the screening around age 70" https://www.mayoclinic.org/tests-procedures/psa-test/in-depth/prostat

• fwip 1y ago
  [flagged]
  • sorcerer-mar 1y ago
    The guideline to stop screening at 70 has nothing to do with financial cost. It’s that detecting it at that point is useless because you’ll generally be dead of other causes by the time it catches you. Compounding the issue, the rate of false positives rises as you get older which then 1) freaks people out and 2) encourages them to get more invasive tests done which are themselves increasingly hazardous (and less valuable) with each passing day. There are a lot of good reasons not to speculate about others' health decisions on the Internet, and avoiding a spotlight on your own basic ignorance is one of 'em!
    • fwip 1y ago
      Yes, because most men won't live to be 82, so on average it's not worth it. But presidents are not "most men." They're also attended by personal physicians who can keep them from freaking out when informed accurately of their health. I would appreciate less condescension about my supposed ignorance, but I guess that's unrealistic.
      • sorcerer-mar 1y ago
        Doctors don't adjust how long they're trying to keep you alive based on your job title. Doctors also don't believe that rich people are somehow immune to the psychological trauma of "you might have cancer → nvm all good → you might have cancer → nvm all good → you might have cancer → nvm all good."
        • rKarpinski 1y ago
          That might be true in a triage/ER context. Doesn't track when we are talking about a slow, years long chronic illness and someone who over the last 4 years has had personalized healthcare to the tune of 8 figures.
          • sorcerer-mar 1y ago
            As mentioned, it is not access to healthcare that determines PSA screening guidelines.
            • rKarpinski 1y ago
              PSA is only one of several diagnostics that would have caught it at the level of care POTUS gets.
        • unsupp0rted 1y ago
          > Doctors don't adjust how long they're trying to keep you alive based on your job title. Of course they do
          • sorcerer-mar 1y ago
            Hmm, must’ve just slipped past me when reviewing the medical guidelines that inform almost all of a doctor’s decision-making.
            • unsupp0rted 1y ago
              Doctors are, unfortunately so far, people. And they're also gatekeepers to care. It's naive to think they don't discriminate on all sorts of factors outside the guidelines, for instance when treating fellow doctors. Not that they'll admit to it. I know doctors who won't even admit to it to themselves. But they still do it: they'll just call it by a different name or make up an outside reason.
              • 1y ago
• marcusverus 1y ago
  I sincerely hope our presidents' care isn't limited common practice.
  • dragonwriter 1y ago
    I don't think being a current or former president materially changes the rationale for that recommendation.
    • fwip 1y ago
      Sure it does. The death or major illness of a sitting president is impactful in a way that the death of an average retiree is not. The cost of performing the test is inconvenience (admittedly of a man whose time is very valuable), but the cost of missing a major health problem has geopolitical consequences. The health recommendations are definitely going to shift toward "better safe than sorry."
      • dragonwriter 1y ago
        > Sure it does. The death or major illness of a sitting president is impactful in a way that the death of an average retiree is not. The recommendation is not based around the public impact of the patient's death, but around the expected utility of the test in improving the length and/or quality of the patient's life, which is fairly low in the best of times for PSA screening.
        • fwip 1y ago
          A president and their team is absolutely going to take a "better safe than sorry" approach. The doctor is not the only person who decides what treatment should be, the patient does too.
          • rfdave 1y ago
            PSA is not fool proof test, and is susceptible to false positives. A substantial fraction of men, in the 40+% range have prostate cancer at death. The treatments for it can be painful and have long recoveries, so there's not obvious solutions.