An important article on cancer testing and treatment An important article on cancer testing and treatment - Page 2

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Thread: An important article on cancer testing and treatment

  1. #11
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    Quote Originally Posted by FatButWeak View Post
    Along these same lines - colonoscopies

    The Dangers Of Colonoscopies | Roar of Wolverine


    I think the answer is: don't smoke; dont be fat; dont have insulin insensitivity or diabetes. Were all going to need to eat more meat, too.
    All good advice, just make sure that meat is not cured with nitrites or smoked. People will still need colonoscopies. Mr Wolverine had a type of prep which is not in common use and had a complication of the prep and of the colonoscopy. It sounds like there was also a degree of mismanagement of his complications. As a result he is very passionate about colonoscopies, to the point of distorting some facts. He has generated an echo chamber which attracts people who have had adverse experiences.

  2. #12
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    [QUOTE=Mark Rippetoe;1761842],,,, that is interesting, QUOTE]
    I had(maybe still have) a higher than range #, 6 or 7ish, a few years ago,
    they wanted to shove a porcupine up my ass, and test.
    didn't quite make that appointment,
    we'll see what numbers do , when ever,
    oh, and bicycle riding, heavy exercise, squat, deads, sex, anal sex, all could boost that number.
    stupid number.

  3. #13
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    Quote Originally Posted by Gbraddock View Post
    Do you think it is reasonable to have a PSA checked annually for a male on TRT? Just curious if compelling reasons exist for PSA checks at all.
    I don't know enough to have an opinion on this. The connection between TRT and prostate cancer is unclear and debatable. This is a conversation to have with the doc prescribing your TRT.

    Quote Originally Posted by FatButWeak View Post
    Along these same lines - colonoscopies

    The Dangers Of Colonoscopies | Roar of Wolverine


    I think the answer is: don't smoke; dont be fat; dont have insulin insensitivity or diabetes. Were all going to need to eat more meat, too.
    Quote Originally Posted by Philbert View Post
    All good advice, just make sure that meat is not cured with nitrites or smoked. People will still need colonoscopies. Mr Wolverine had a type of prep which is not in common use and had a complication of the prep and of the colonoscopy. It sounds like there was also a degree of mismanagement of his complications. As a result he is very passionate about colonoscopies, to the point of distorting some facts. He has generated an echo chamber which attracts people who have had adverse experiences.
    I do not think he is accurate about the risks of colonoscopy. The sources he cites do not back up his numbers, and he gives a startling number ("0.5% injured or killed") from a study of colonoscopies done for diagnosis, not screening. IE, this study included people who were already ill, where the colonoscopy was done to stage or clarify a known or specifically suspected diagnosis. Screening colonoscopies are done on people in good health also, so the risks will skew much lower if you are talking about screening colonoscopies. A German study that looked at a little over 5K screening colonoscopies found about 0.13% risk of hospitalization (for bleeding or perforation) after colonoscopy, and no deaths attributable to colonoscopy.

    This is a good example of how bad we are at estimating risk: Mr. Wolverine's awful but very unusual experience has slanted his assessment of the risks. Likewise, people who feel their lives were saved by screening colonoscopies will have their view slanted the other way.

    When I was thinking about getting Lasix, I noticed that all the ophthalmologists I met were wearing glasses. I decided to avoid the cosmetic surgery. Maybe if you wonder about whether to get a colonoscopy, ask your doctor if they've had one.

    There are risks to everything, and risks to not doing everything too. Barbell training has nonzero risks, but we have all here decided the benefits outweigh the risks. You have to make the same choice for medical testing too: try not to be swayed by emotional stories and know what you're getting into. Easier said than done.

  4. #14
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    Quote Originally Posted by jfsully View Post
    I don't know enough to have an opinion on this. The connection between TRT and prostate cancer is unclear and debatable. This is a conversation to have with the doc prescribing your TRT.
    This assumes that the doctor knows anything about it. I remember asking my urologist about PSA and the meaning of the test, and he patiently explained to me that PSA was a marker for the presence of prostate cancer. I asked him what PSA -- the substance -- actually was, and he patiently explained that it was a marker for the presence of prostate cancer, and did I have any more questions.

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    Quote Originally Posted by Mark Rippetoe View Post
    This assumes that the doctor knows anything about it. I remember asking my urologist about PSA and the meaning of the test, and he patiently explained to me that PSA was a marker for the presence of prostate cancer. I asked him what PSA -- the substance -- actually was, and he patiently explained that it was a marker for the presence of prostate cancer, and did I have any more questions.
    Iíve been on TRT 8 yrs. I KNOW what my Dr thinks of it. Thatís why I do an annual PSA blood test. I do it to appease him mostly. Mine is well within range.
    Just curious of your take since you had an opinion on the subject in general. Not looking for medical advice.

  6. #16
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    Are you asking me, or JF? The original question was to him, I just jumped in.

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    Quote Originally Posted by Mark Rippetoe View Post
    Are you asking me, or JF? The original question was to him, I just jumped in.
    JF sorry. Accidentally replied to you.

    No Iím good either way. Just wondered what his opinion was on it. If he saw any compelling reasons to ever have the test done. Is easy and fairly cheap to add the test to labs so I run it annually. Dr wants to see it so I oblige to keep Rx refills coming.

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    Is PSA a stupid test; maybe.
    Should your doctor discuss with you whether or not to test your PSA score, yes.

    As I'm about to embark on a 28 day course of radiation treatments, after 2+ months on an androgen blocker. I have my own perspective on the article and how this has been presented.

    Background:
    1) 65 y/o, active and athletically inclined all my life
    2) Older brother has metastatic prostate cancer

    So I'm not a "typical" person who goes to see his PCP in this case.

    Three years ago I suspected problems. A trip to the urologist went in an unwanted direction when I allowed them to test my PSA as part of the work up. At my next appointment they did a more detailed assay, and came back with a "suggestion" that I undergo a biopsy due to the findings.

    I did not take action at that time for a number of reasons that were reasonable to me and unreasonable to them. Mark, I will agree with you that the taking of the PSA test caused great emotional turmoil. I did not want to know my condition at that particular point in time. All I wanted was to be able to pee again, comfortably. But they had to protect themselves legally, and insisted I come in for the biopsy.

    So against their recommendations, I declined the biopsy...and went to find another doctor. One who would listen to my concerns, help me understand the data, and collaboratively plot a course of action. I found such a doctor.

    My concerns centered around my training and my goals as a Masters lifter: I want to pull 500lbs in competition before I, potentially, lose my ability to be the best version of myself (again knowing what my brother was going through..which wasn't and isn't pretty).

    I was concerned that I would have an adverse outcome to the biopsy, putting paid to all the hard training I'd been undertaking. Additionally, should the results come back positive for prostate cancer, I was not ready to make decisions on treatment versus no treatment.

    My doctor/partner listened to all my concerns, walked me through a decision tree and we settled on taking no action through Spokane 2018. Training, hell, even just living a normal life was near impossible that year, what with every ache and pain causing me to think the worst Not to mention waking up in the middle of the night contemplating my own mortality. I did not have the meet I wanted in Spokane.

    Another PSA test in November of 2018 showed a rising PSA score. Collaboratively, we agreed to start researching cancer centers, and we settled on a center of excellence, my team of doctors being part of the panel that sets NCCN treatment guidelines. I was, and am comfortable that they would , and are treating me appropriately. Certainly not as a cash cow. The biopsy procedure was discussed with all parties involved and a plan developed to assuage my concerns/fears. The procedure was performed in March, with extra precautions taken to avoid post op infections. Unfortunately all thirteen samples came back positive for cancer. Based on the findings, we were able to plan on addressing this after Raw Natls in Chicago, and not have to take immediate action. Again, the team of doctors, along with my PCP were able to work with me to come to an appropriate plan of action.

    Training continued through out this process. In fact, the next 6-7 months were the best run of training I'd experienced to date. My doc's monitored my training all the way up to Raw Natls.
    I'm pleased to say that I achieved my goal of pulling 500lbs. Shortly after my return from Chicago, the treatment program we agreed on was initiated.

    I write all this in response to the Scientific American article. Yes, mine's a one off experience, but I'm concerned that the tenor of the article paints the medical profession in a unflattering light. To throw the article out there without presenting the other side of the argument is unfair.

    1) There are risks to treatments, just as there are risks to taking no action.
    2) Is it fair to paint all physicians who treat cancer patients as owing an allegiance to generating cash over providing their patients with the best care possible using the best treatments available?
    3) There's a lot of "grey" areas treating these diseases, and not a lot of certainty about things. People have to make informed decisions, based on the best information available.
    4) Certainly there is over testing, over diagnosis, and over treatment, but I believe the article borders on conspiracy theory at worst, and callous disregard for patient welfare at best.

    Perhaps you threw this out to the forum to generate a back and forth dialogue, where both side are explored. I'm afraid that people will take it as a argument to stay away from the medical establishment, reject sound practices without exploring the other side of the issue.

    Thanks for the opportunity to weigh in.

  9. #19
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    Quote Originally Posted by Browndog View Post
    Perhaps you threw this out to the forum to generate a back and forth dialogue, where both side are explored. I'm afraid that people will take it as a argument to stay away from the medical establishment, reject sound practices without exploring the other side of the issue.

    Thanks for the opportunity to weigh in.
    I threw it out there because you will not get this side of the issue from most doctors. In some cases, the medical establishment needs to be stayed away from, you guys need to know that you are free to think about these issues for yourselves, and you need to hear the other side to be able to do so.

  10. #20
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    Quote Originally Posted by Gbraddock View Post
    JF sorry. Accidentally replied to you.

    No Iím good either way. Just wondered what his opinion was on it. If he saw any compelling reasons to ever have the test done. Is easy and fairly cheap to add the test to labs so I run it annually. Dr wants to see it so I oblige to keep Rx refills coming.
    I honestly donít know about PSA and TRT. My shallow reading of the literature suggests there is a tenuous link at best between TRT and prostate cancer. Maybe there is an individual characteristic where TRT triggers prostate changes for some guys and not for others... if thatís the case, we donít know yet what that characteristic is, so we donít know who should be worried about it.

    If you are someone who worries a lot about cancer and wants to make sure youíre looking at all possible risks, and willing to take on the risk of getting a biopsy if your PSA spikes, then you should probably follow your PSA so you can sleep at night. If youíd rather avoid the risks of overtesting, and the specter of cancer uncertainty doesnít keep you up at night, you can probably skip it.

    But have your doctor do a DRE annually.

    And, as Browndog illustrated, get any symptoms checked out appropriately, whatever that means for you. The discussion we are having here is about cancer SCREENING, the testing of asymptomatic presumed healthy people.

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