Vol. 7, No. 1

Summer 2008

 

Jerry Bylander, Editor  jerryby@cableone.net

FEATURE ARTICLES

The Director's Column

 


The Media May Be Harmful to Your Health

I have been remiss in publishing this newsletter for over a year now.  Just burned out.  However several recent articles have rung my bell.  One such follows this letter from your Managing Director and is authored by your Board.  An article this morning (August 5, 2008) on the front page of the Dallas Morning News seems to have gotten the results of a medical panel’s deliberations on the use of PSA all wrong. (Panel: Stop prostate cancer screenings at 75; Task force finds elderly testing risky, unsure if younger men benefit).  Based on a small black box part of the article on page 2, I conclude that the risks of PSA testing arise from incorrect use of the PSA.  My PSA at the time of PC diagnosis was 3.5.  My brother-in-law’s PSA regularly runs over 4 because he has an enlarged prostate and rides a bicycle. 

Here is how you use the PSA correctly:

1)      In the event of a first high reading (I think the guideline is above 4, but your doctor will know), only do a spring biopsy if the doctor feels a cancerous lump in your prostate with his finger.  Yes! The dreaded DRE or digital rectal exam.  Your doctor may prescribe Proscar or Avodart, if I remember correctly, to reduce the prostate and potentially reduce the PSA which is proportional to the prostate size.

2)      After a suspicious PSA and no lump on the DRE, follow the doubling time of the PSA by retesting every 6 months (or 3 months if the PSA is very high-again your doctor will know).

3)      If the PSA goes up significantly, say from 4 to 6, again rely on the DRE.  However if the doubling time works out to be less than a year, more aggressive action is required and the spring biopsy is required.  Be sure to take the antibiotic the night before and the day of the biopsy to reduce the risk of infection. 

4)      Then there are various decisions to be made if prostate cancer is found in the biopsy.  If none is found continue to follow the PSA every 3 to 6 months for high PSA values.  If cancer is found, therapy choices will be based on your age, health, heart condition, and Gleason score.  In general if you are less than 60 and your doubling time is less than a year, you must take aggressive action.  Otherwise contact Henri (at Hair by Henri in Denison) for more options to discuss with your doctor, or attend one of our meetings to gather information.  Other options include following up on some the web sites listed on our web page.

Have a nice summer!   Jerry Bylander

Prostate Cancer Column Sent to the Herald Democrat (not printed)

Your misleading and potentially harmful article concerning prostate cancer therapies.

Mr. Heni Plunkett, Director, Dr. Jerry Bylander, Managing Director, and Dr.  Tom Nuckols, Director, USToo! Texoma Chapter

We of the USToo! Texoma Board take issue with your recent article, "Elderly may fare worse on drugs for prostate cancer", since it is misleading and harmful.  It will mislead many of us who have prostate cancer to and cause us to avoid life saving therapies.  The writeup indicated that therapies used in the treatment of prostate cancer, may not be effective and cost efficient.  First we note that the reported 20% of deaths of treated men (unspecified therapies) versus the 17% deaths of untreated men is not statistically different and cannot justify the conclusion that the treated group fared worse.  In fact, lumping the deaths from all prostate cancer causes is neither helpful nor safe.

Second, the data used to form this correlation was not analyzed by one of our  nations leading teaching medical universities. Also it was based on patient's records rather than on controlled studies.  And it lumped data from a reported six year period whereas the standard time for making positive conclusions is a ten year period.

Thirdly, there has always been a subset of men with prostate cancer, for whom it is prudent to do nothing for their situation.  The basis of this concept is that their individual cancer is indolent, and is most likely to be very slow growing.  Most likely the prostate cancer will not be the reason for these men's death.  However men diagnosed with aggressive prostate cancer systemic or  metastic, will surely see their demise directly from the prostate cancer without proper treatment. However to conclude that all categories of men with prostate cancer –treated or not - will have the same life expectancy is just plain wrong.  The truth is, that for decades, the facts that the administration of medicines in treating prostate cancer have proven to extend life and slow disease progression is accepted world wide. In fact the pioneering doctor who discovered the use of hormonal reduction in the setting of prostate cancer was awarded the Nobel Prize.

Prostate cancer is a highly individualistic disease and always should be treated as such.  Any correlation about prostate cancer that has a sweeping conclusion about therapy choice, surely can not be based on decades of extensive research studies and publications in refereed journals.

Therefore, we urge your readers to depend on their physician's recommendations and/or a second opinion where necessary, rather that upon the conclusions of an article that treats all failed first prostate cancer therapies as the same.


    

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Next Meeting

 


SPEAKER
:  Dr. Jerry Bylander, USToo! Managing Director

Date:  Tuesday, Sept 16, 2008
  Time:  6:30 pm - Social & Coffee  7:00 pm - Program
Location:
  Classroom 1,  Wilson N. Jones, 500 N. Highland, Sherman, Texas

TOPIC:  TBD - Stay Tuned to www.ustoo-texoma.org for Announcement

ABOUT THE SPEAKER:  TBD - Stay Tuned to www.ustoo-texoma.org for Announcement


ABOUT THE PROGRAM: 
  TBD
- Stay Tuned to www.ustoo-texoma.org for Announcement

 

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Last Meeting

 


SPEAKER
:  Dr. Michael Hilz, MD

Date:  Tuesday, May 13, 2008
  Time:  6:30 pm - Social & Coffee  7:00 pm - Program
Location:
  Classroom 1,  Wilson N. Jones, 500 N. Highland, Sherman, Texas

TOPIC:   Dr. Hilz was unable to attend due to a last minute personal  emergency.  Instead Jerry, Henry and Tom led an interesting discussion following their description of various incontinence solutions.

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Other Important Events

 


Your organization's meetings listed here.  Contact the Editor at jerryby@cableone.net .

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Editor's Notes

 


Material posted here is intended for educational purposes only and must not be considered a substitute for informed medical advice from your own physician.

 Jerry Bylander, Editor

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