| Home Support Forum The Big Myth At First Prostate Cancer Surgery Fails 95 Percent of the Time 2 Randomized Controlled Studies Holmberg's RCT Surgery Means Smaller Penis Australian CCC Prostate Surgery Spin Cognitive Dissonance and the Radical Prostatectomy Cure Stamey PSA is Over Catalona's Failure Rate PSA Less than 4 RP Failure Finasteride For Prostate Cancer PSA Screening and the Radical Prostatectomy Prostate Cancer Research Institute Prevention Trial Time Magazine Quote What I would do Tookad
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Sites - Genitourinary Prostatitis And BPH.org ProstateTalk .com Prostatitis Foundation Prostatitis .org Epididymitis Foundation .org Vasectomy Foundation .org Ejaculatory Duct Obstruction Foundation (ejaculatory .org) Vasectomy Reversal Foundation .org Chlamydia Foundation .org Acoustic Neuroma Foundation .org | Why Stamey et al. say the PSA era is OverHere I review the article: The prostate specific antigen era in the United States is over for prostate cancer: what happened in the last 20 years?It was a 20 year study. 1,317 consecutive radical prostatectomies were done between August 1983 and July 2003. Palpable nodules on digital rectal exam decreased from 91% per 17%. Mean age decreased from 64 to 59. PSA decreased from 25 to 8. Cancer index volume decreased from 5.3 to 2.4 ccs. By the end of the study serum PSA correlated only to prostate size, not to prostate cancer size, or Gleason grades. The study concludes that serum PSA is now misleading in the diagnosis of prostate cancer, and that PSA is better for diagnosing prostate enlargement. In the past relapse of prostate cancer was associated with cancer size and percent of Gleason grade 4/5 present. The authors say, "There is now no clinical relationship between serum PSA and the largest cancer in the prostate." There is now, "no correlation of serum PSA with any morphological variable except prostate weight." The authors say that prostate cancer "has an extraordinarily small death rate of 226 per 100,000 men older than 65 years." (0.226 percent). The authors reiterate " the relationship of serum PSA in the last 5 years rests exclusively with benign enlargement of the prostate." The authors say that lowering the threshold of PSA for recommending a biopsy is unwarranted. The authors ask, "In the meantime what are we to do in the face of such massive, unwarranted PSA screening." The authors finally conclude, "any excuse to biopsy the prostate has an excellent, age dependent chance of being positive." The Stamey paper is excellent science. The one major flaw in the study is that the men were not tested for prostatitis, and thus they cannot conclude the PSA is related to BPH, when in fact, it may be more related to prostatitis.
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