6 ms·

There have been similar issues around prostate cancer and things like "Movember". The jury is still out I suppose, but a number of doctors believe prostate exam

There have been similar issues around prostate cancer and things like "Movember". The jury is still out I suppose, but a number of doctors believe prostate exams are doing more harm than good.[1] [1]: http://www.nytimes.com/2011/10/07/health/07prostate.html http://www.nytimes.com/2011/10/07/health/07prostate.html

hashmymustache 14y ago
Well the PSA test specifically, not prostate exams in general (i.e. rectal exam palpation). And like mammograms it depends on the population of interest and repeated tests. What bothers me is the lack of equal awareness and emphasis of prostate cancer with breast cancer even though it has a greater incidence and more profound negative effects from treatment. When a guy gets prostate cancer and has a prostectomy, he will more often than not experience severe erectile dysfunction. I hear a lot about how women feel disempowered when they get a mastectomy even though it can be replaced without any loss in sexual function, but much less on the scarring effects of prostate cancer on men with permanent sexual dysfunction.
- lucisferre 14y ago
  That may be partly because breast cancer survival rates are shorter and lower. In short breast cancern is far more deadly (I also believe it is more likely to affect younger women but I have no source for that). http://www.cancer.org/cancer/breastcancer/overviewguide/breast-cancer-overview-survival-rates http://www.cancer.org/cancer/breastcancer/overviewguide/brea... http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-survival-rates http://www.cancer.org/cancer/prostatecancer/detailedguide/pr... You should also read the article I linked. The point is not simply that the PSA test is ineffective and treatment can be harmful, but that prostate cancer itself is not a big enough threat to justify treatment in most cases. > not prostate exams in general (i.e. rectal exam palpation). And like mammograms it depends on the population of interest and repeated tests. BTW do you have a source that shows this is true.
  - hashmymustache 14y ago
    They're not as unequal as this says. http://seer.cancer.gov/statfacts/html/breast.html http://seer.cancer.gov/statfacts/html/breast.html http://seer.cancer.gov/statfacts/html/prost.html http://seer.cancer.gov/statfacts/html/prost.html 23.0 deaths per 100,000 women by breast cancer 23.6 deaths per 100,000 men by prostate cancer But, yea often prostate cancer isn't enough to warrant it because more likely than not on autopsy you'll find some kind of prostate cancer on a guy that didn't cause his death.
    - lucisferre 14y ago
      Thanks for that link, it's really interesting data. I noted though the difference in the age distributions. Breast cancer does seem to have significantly higher incidences at younger ages.
      - hashmymustache 14y ago
        yea you're right that there's a big difference in the mean age and a more benign prognosis for prostate cancer in general. I just get uppity with all the focus in society on breast cancer with the high rates of lung (3rd most often, 1st most deadly - no screening procedures), colon, prostate, etc. With regard to your question on the effectiveness of digital rectal exams for prostate screening, I'm not sure about specific studies. From the us preventative services task force site where they suggest against the PSA test for screening they mention: "Periodic digital rectal examinations could also be an alternative strategy worthy of further study. In the only randomized trial demonstrating a mortality reduction from radical prostatectomy for clinically localized cancer, a high percentage of men had palpable cancer." http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostatefinalrs.htm http://www.uspreventiveservicestaskforce.org/prostatecancers...
        lucisferre 14y ago
        I think what's most disappointing is that it seems more effort and money is expended promoting awareness of this cancer or that cancer rather than just investing in medical research that could save lives. Maybe that's just my perception.
- rgejman 14y ago
  Just as an FYI: Women can also have some loss of sexual function, either physically (due to ligation of the 4th intercostal nerve that supplies the nipple), psychologically or both.
  - jacquesm 14y ago
    It is also possible that due to a mastectomy menopause onset is accelerated.
    - rgejman 14y ago
      I wasn't familiar with that. Is that stress-related? Mastectomy without chemo should not induce menopause, as far as I understand the physiological processes at work. If the patients are also being treated with tamoxifen or other estrogen receptor antagonists then the menopause is, I believe, reversible.
    - deleted 14y ago
      [deleted]
  - hashmymustache 14y ago
    certainly, and I didn't intend to minimize it, just to highlight the lack of awareness of the deleterious effects of prostate cancer treatments given the oft cited sense of disfigurement from mastectomies. both are terrible for the patient.
gehar 14y ago
Movember isn't a billion dollar pinkwashing scam like Komen, though. It's grassroots awareness.
- illuminate 14y ago
  Yeah, at least Movember funds don't go directly towards lobbying against using public funds for low-income mens' health. No, I'm not talking about Planned Parenthood. Komen's lobbying wing literally believes public funds should not go to any forms of womens' health, they believe it should be handled entirely by private "charities" like themselves. http://www.southernstudies.org/2012/02/flashback-how-the-komen-foundation-fights-health-reform-and-fails-cancer-patients.html http://www.southernstudies.org/2012/02/flashback-how-the-kom... http://www.dailykos.com/story/2012/02/01/1060885/-Behind-the-Pink-Curtain-Komen-s-Political-Agenda http://www.dailykos.com/story/2012/02/01/1060885/-Behind-the...

hashmymustache 14y ago

Well the PSA test specifically, not prostate exams in general (i.e. rectal exam palpation). And like mammograms it depends on the population of interest and repeated tests. What bothers me is the lack of equal awareness and emphasis of prostate cancer with breast cancer even though it has a greater incidence and more profound negative effects from treatment. When a guy gets prostate cancer and has a prostectomy, he will more often than not experience severe erectile dysfunction. I hear a lot about how women feel disempowered when they get a mastectomy even though it can be replaced without any loss in sexual function, but much less on the scarring effects of prostate cancer on men with permanent sexual dysfunction.

lucisferre 14y ago
That may be partly because breast cancer survival rates are shorter and lower. In short breast cancern is far more deadly (I also believe it is more likely to affect younger women but I have no source for that). http://www.cancer.org/cancer/breastcancer/overviewguide/breast-cancer-overview-survival-rates http://www.cancer.org/cancer/breastcancer/overviewguide/brea... http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-survival-rates http://www.cancer.org/cancer/prostatecancer/detailedguide/pr... You should also read the article I linked. The point is not simply that the PSA test is ineffective and treatment can be harmful, but that prostate cancer itself is not a big enough threat to justify treatment in most cases. > not prostate exams in general (i.e. rectal exam palpation). And like mammograms it depends on the population of interest and repeated tests. BTW do you have a source that shows this is true.
- hashmymustache 14y ago
  They're not as unequal as this says. http://seer.cancer.gov/statfacts/html/breast.html http://seer.cancer.gov/statfacts/html/breast.html http://seer.cancer.gov/statfacts/html/prost.html http://seer.cancer.gov/statfacts/html/prost.html 23.0 deaths per 100,000 women by breast cancer 23.6 deaths per 100,000 men by prostate cancer But, yea often prostate cancer isn't enough to warrant it because more likely than not on autopsy you'll find some kind of prostate cancer on a guy that didn't cause his death.
  - lucisferre 14y ago
    Thanks for that link, it's really interesting data. I noted though the difference in the age distributions. Breast cancer does seem to have significantly higher incidences at younger ages.
    - hashmymustache 14y ago
      yea you're right that there's a big difference in the mean age and a more benign prognosis for prostate cancer in general. I just get uppity with all the focus in society on breast cancer with the high rates of lung (3rd most often, 1st most deadly - no screening procedures), colon, prostate, etc. With regard to your question on the effectiveness of digital rectal exams for prostate screening, I'm not sure about specific studies. From the us preventative services task force site where they suggest against the PSA test for screening they mention: "Periodic digital rectal examinations could also be an alternative strategy worthy of further study. In the only randomized trial demonstrating a mortality reduction from radical prostatectomy for clinically localized cancer, a high percentage of men had palpable cancer." http://www.uspreventiveservicestaskforce.org/prostatecancerscreening/prostatefinalrs.htm http://www.uspreventiveservicestaskforce.org/prostatecancers...
      - lucisferre 14y ago
        I think what's most disappointing is that it seems more effort and money is expended promoting awareness of this cancer or that cancer rather than just investing in medical research that could save lives. Maybe that's just my perception.
rgejman 14y ago
Just as an FYI: Women can also have some loss of sexual function, either physically (due to ligation of the 4th intercostal nerve that supplies the nipple), psychologically or both.
- jacquesm 14y ago
  It is also possible that due to a mastectomy menopause onset is accelerated.
  - rgejman 14y ago
    I wasn't familiar with that. Is that stress-related? Mastectomy without chemo should not induce menopause, as far as I understand the physiological processes at work. If the patients are also being treated with tamoxifen or other estrogen receptor antagonists then the menopause is, I believe, reversible.
  - deleted 14y ago
    [deleted]
- hashmymustache 14y ago
  certainly, and I didn't intend to minimize it, just to highlight the lack of awareness of the deleterious effects of prostate cancer treatments given the oft cited sense of disfigurement from mastectomies. both are terrible for the patient.

gehar 14y ago

Movember isn't a billion dollar pinkwashing scam like Komen, though. It's grassroots awareness.

illuminate 14y ago
Yeah, at least Movember funds don't go directly towards lobbying against using public funds for low-income mens' health. No, I'm not talking about Planned Parenthood. Komen's lobbying wing literally believes public funds should not go to any forms of womens' health, they believe it should be handled entirely by private "charities" like themselves. http://www.southernstudies.org/2012/02/flashback-how-the-komen-foundation-fights-health-reform-and-fails-cancer-patients.html http://www.southernstudies.org/2012/02/flashback-how-the-kom... http://www.dailykos.com/story/2012/02/01/1060885/-Behind-the-Pink-Curtain-Komen-s-Political-Agenda http://www.dailykos.com/story/2012/02/01/1060885/-Behind-the...