Prostate Cancer Survivors

 

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Dr Otis Brawley and How Do Men Arrive At Their Decision

There has been an outpouring of correspondence regarding the ACS position on PSA screening and testing, Dr Brawley has come in for a bit of flak with some implying that he is a tool of the current Government with its perceived aims of reducing treatment for the ageing. Please note I'm not doing anything but commenting on what I have seen.

Against this background I found it interesting to read this quote from "Prostate Carcinoma Incidence and Patient Mortality" written about thirteen years ago by Dr. Brawley when he was in the Office of Special Populations Research, National Cancer Institute. The article can be found in the Nov. 1, 1997 issue of CANCER, pages 1857 through 1863.

DR. OTIS W. BRAWLEY urges truthfulness in explaining to the patient what is known and what is not known about the efficacy of screening for prostate cancer:

"It is ironic that many have embraced prostate carcinoma screening even though the potential harms of screening and resultant treatment are evident and definite but the advantages are not. The aim of this article is not to argue that screening is inappropriate and should not be performed; rather, it is to say that the benefits of screening, although theoretically possible, are unproven, whereas the risks and harms of screening and resultant treatment are well established. It is this author's personal belief that men who are offered screening should be informed of the uncertainties surrounding it. Although it truly may cure a few men who need to be cured, this benefit may be achieved at the cost of causing a large number of men with prostate carcinoma to undergo unnecessary treatment with resultant morbidity.

Truthfully explaining to patients what we know and do not know about screening is most appropriate. It is appropriate to express opinions either for or against screening, but opinions should be labeled as such, and it should be explained to patients that the appropriate studies have not been completed. A patient can then make a logical, informed decision to be screened or not screened using his own values. Once a patient has made his decision, his choice should be accepted and supported by his physician and the medical community."

So....nothing changes, including Dr Brawley's views that men should be fully informed.

I don’t know how many of you subscribe to The “New” Prostate Cancer Infolink. There is an excellent piece there today setting out some of the issues that guide men in their decision making process when they are diagnosed. It makes excellent reading.

All the best

Terry in Australia

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