PCEC Blog Page
Notes From the PCEC Experts
Please enjoy comments and notes from the PCEC Experts on Hot Topics in Prostate Cancer!
October 18, 2011
The PCEC Position Statement: The Prostate Conditions Education Council (PCEC) opposes the draft recommendations prepared by the U. S. Preventive Service Task Force (USPSTF) on the use of the prostate-specific antigen (PSA) test for prostate cancer early detection.
The PCEC believes that the USPSTF recommendations will do more harm than good. The proposed guidelines will result in an increase in the mortality rate from prostate cancer, which will be most apparent in those at high risk, including African American men.
The PCEC endorses the use of PSA, in conjunction with a physical exam, as the best tool widely available today for the early detection prostate cancer. When interpreted appropriately, the PSA test provides valuable information for risk assessment, diagnosis, monitoring and treatment decisions for prostate cancer patients and physicians.
The PCEC also recognizes the importance of the development of new prostate cancer biomarkers that are more sensitive and specific and encourages the Food and Drug Administration (FDA) to recognize the time sensitive needs for review of the biomarkers currently submitted and those that will be submitted in the future.
It is the belief of the PCEC that Knowledge is Power. The screening and early detection of prostate cancer afford men a great number of treatment options for their disease, one of which is watchful waiting. It is our belief that the men and their loved ones have not only the fundamental right to be informed of a disease while it is survivable but also have the capacity to make intelligent choices when presented with information on the positive and negative aspects of screening, diagnosis and treatment of prostate cancer. We agree with the USPSTF that many men are over-treated for prostate cancer and that we should separate diagnosis of the disease from treatment through informed decision making.
October 16, 2011
Wendy Poage, MHA
Prostate Conditions Education Council
October 15, 2011
Now is the time to be heard! We have only a short window of time to share our concerns with the USPSTF about their prostate cancer screening guidelines. Please click here to visit the USPSTF webpage and help us make a stand!
October 13, 2011
Oklahoma Sen. Coburn opted to have surgery to treat an early stage incidence of prostate cancer this week. He is expected to make a full recovery and we are thrilled that his cancer was found early enough to be treated successfully. Read more about his story athttp://www.politico.com/news/s
October 11, 2011
Now is the time to be heard! We have only a short window of time to share our concerns with the USPSTF about their prostate cancer screening guidelines. Please click here to visit the USPSTF webpage and help us make a stand!
October 11, 2011
Breaking news! Men who took 400 international units (I.U.) of vitamin E daily had more prostate cancers compared to men who took a placebo, according to an updated review of data from the Selenium and Vitamin E Cancer Prevention Trial (SELECT). The findings showed that, per 1,000 men, there were 76 prostate cancers in men who took only vitamin E supplements, vs. 65 in men on placebo over a seven-year period, or 11 more cases of prostate cancer per 1,000 men. This represents a 17 percent increase in prostate cancers relative to those who took a placebo!
The SELECT stands for the Selenium and Vitamin E Cancer Prevention Trial, a prevention clinical trial to see if one or both of these dietary supplements could help prevent prostate cancer.
•In September 2008, SELECT researchers found that selenium and vitamin E, taken alone or together for an average of five and a half years, did not prevent prostate cancer. Men in the study were told to stop taking their study supplements because of this lack of benefit.
•In 2011, updated trial data showed that the men taking vitamin E had a 17 percent increased risk of prostate cancer compared to men taking the placebo.
October 10, 2011
There has been a lot of press recently concerning the proper use of PSA for prostate cancer screening. Part of the concern of the many agencies responsible for making such recommendations is that patients may be subject to over diagnosis and then unnecessarily treated. The treatment, whether prostatectomy or irradiation, can lead to side effects on sexual function and urinary control. It is well recognized that more men die with prostate cancer (perhaps never knowing they had it) than from the disease. How is a patient best able to determine if his cancer is not lethal and thus able to be managed by observation rather than active treatment? A recent article by Kasperzyk et al. published in the November 2011 Journal of Urology on watchful waiting (WW) tried to offer some insight. Treatment information and outcomes were analyzed on 1,230 patients with prostate cancer of whom 125 were initially treated by WW. At a mean of 7 years follow-up 40% remained of watchful waiting while the other 60% had some form of treatment. There was only 1 prostate cancer specific death among these 125 patients. The ones that remained on WW tended to be older and have less aggressive cancers. They also found a benefit in urinary incontinence and sexual status among patients on WW. Active surveillance or WW is being investigated by many centers. As better tools are developed to better identify these individuals, it is hoped that more men in the future will be able to avoid surgery or irradiation. Until that time comes, men are better off knowing if an aggressive prostate cancer is present. As always, each patient should consult their personal physician before deciding on the best treatment for prostate cancer.
Nelson N. Stone, MD
Prostate Conditions Education Council
October 9, 2011
As an organization that helps screen thousands of men annually and more than five million in the last 22 years, we have an up-close perspective: listening to men’s questions, educating them about the current screening tools and hearing about stories of survival,” said Wendy Poage, president of the Prostate Conditions Education Council. “Mortality rates have decreased with the onset of PSA screening and we cannot slip back to an era where all men were diagnosed with advanced disease because no screening was available. While we applaud USPSTF for bringing this issue to a national discussion, we believe that the pendulum has moved too far and that corrections need to be made to help patients navigate this important public health issue.
Wendy Poage, MHA
Prostate Conditions Education Council
October 8, 2011
The Controversy Over Screening. Like many contreoveries, the truth over prostate cancer screening is somewhere in the middle. We should not return to 1989 when advanced disease dominated, we should rather prudently screen men and separate diagnosis from treatment. We should strive to determine who could benefit from treatment. We need new markers of aggressiveness. We need to resist the marketing strategies of companies who mislead the public. We should acknowledge and develop a plan to evaluate to irradicate the pain and suffering from this disease. We need to alter the death rate!
David Crawford, MD
Prostate Conditions Education Council
October 7, 2011
Recently SHANNON BROWNLEE and JEANNE LENZER wrote in the online New York Times Magazine about the controversy surrounding early detection of prostate cancer. In an article titled "DO I Have Cancer" they discussed the use of prostate specific antigen (PSA) for early detection and eventual treatment. Otis Brawley, chief medical officer of the American Cancer Society, has been an outspoken opponent for screening for cancer by PSA for many years. Several prominent urologic oncologists have come out in favor of testing because it leads to finding the more dangerous cancers and their successful treatment. So who is right? Unfortunately the answers may not be fully known yet. Brawley. correctly states that the American prostate cancer screening study did not demonstrate a benefit. However, that study was published prematurely with only an average 10 years follow-up, way too early to truly know any benefits. In addition, almost half of the control patients had PSA testing outside of the study. While surgery and radiation are commonly performed for prostate cancer, watchful waiting and observation protocols are actively being investigated in lower risk cancers to better understand conservative management. Until something better comes along PSA testing along with prostate exam remain the best means to detect early, curable disease. As always, the patient's own personal physician is the best person to determine whether any one absolute PSA value or change in value should be more fully investigated.
Nelson N. Stone, MD
Prostate Conditions Education Council
