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Sunday, 29 November, 2020

The Cow Dung Flung (part one of three)

Date: 01 April, 2010

By: Chief

Imageince I published the story "False Gods" a few weeks ago I have since found some rather illuminating information. What this all boils down to is the mainstream media has had this information for quite a while — but they are just coming to grips with how just serious it all is. And it is serious.

On to the illuminating information. They are, in no specific order the:

As you shall soon read, much to your chagrin, the pundits, advocates, lobbyists, medical industrial complex and other associated mouth pieces were and continue to be — wrong. These insane tests are:

God I do so enjoy being correct (I may make a mistake but I am never wrong).

The PSA test

Starting off with the vastly overblown PSA test is the latest from the American Cancer Society (ACS). Quoting a (AP story):

"[The] problem with the PSA test is that an elevated or fast-rising PSA reading can indicate the presence of cancer, but can also be caused by something minor, such as an infection or an enlarged prostate. A biopsy is needed to confirm cancer, and that can cause unnecessary pain and fear."

No joke Sherlock. Puh-lease, I would have never guessed. Sheesh.

Furthermore, the negatives or false positives, call 'em what you will, normally mean more and stronger treatment for something which may not even be present. Quoting CNN:

"While these tests can detect cancer, they also can produce false positive results that lead to unnecessary and uncomfortable biopsies and treatments that carry undesirable side effects such as impotence and urinary incontinence.

"On the other hand, tests that appear normal can overlook existing cancers."

Kind of a 'Damned if you do and damned if you don't situation'. Now there is a real useful test. Maroons.

At the same time some doctors are whining about the possibility of having to educate people — their patients, their customers, about the pitfalls of prostate PSA testing. Again quoting CNN who is quoting Dr. Herbert Lepor (chairman of urology at NYU Langone Medical Center in New York):

" 'How do you present this to a patient? You can't possibly spend an hour discussing this'. "

Additionally, Doctor Lepor also (quoting CNN):

"[B]elieves every man should be screened once for prostate cancer at 40, and annually after 50".

Let me see if I have this straight. The good Dr. Lepor doesn't think he could or possibly even should have to explain the pitfalls of the PSA test to a person — his patient, his customer. But he most certainly thinks that an annual exam is a good, nay, great idea.

I do believe it is time for Dr. Lepor to permanently lose his privilege to:

His 'holier than thou' attitude is strong enough to knock a buzzard off a gut wagon. He desperately needs to go and now is not soon enough to suit me.

Meanwhile Dr. Otis Brawley, Chief Medical Officer of the ACS, wrote an article about prostate cancer and the PSA test for CNN. Quoting Doc Brawley:

"With this update, a group of experts in urology, oncology, epidemiology and treatment outcomes and patients states clearly that a man needs to know the facts about prostate cancer screening and then needs to make a decision that is right for himself. It is not a statement against screening, but it is not a statement for screening either.

"One can reasonably ask, how did we get into this quandary? The answer is, we became unscientific. We began promoting and using the prostate-specific antigen test before it had been adequately evaluated. This is a common practice in American medicine and a major reason for its expense."

Thanks doc. And I mean that.

Doc's article is quite long, involved and most assuredly worth the time to read — several times. So do yourself a favor and read it. Then when your quack ... er ... doctor decides, without first getting your explicit permission, to do a PSA test — tell your doc, politely, to drop dead — slowly and painfully. He or she should understand those words.

The American Urological Association (AUA) has, as many medical associations have, what are called 'best practice guides' or something similar. When it comes to the PSA test this is what the AUA has to say (the link is to a .pdf file):

"Although an abnormal DRE or an elevated PSA measurement may suggest the presence of prostate cancer, cancer can only be confirmed by the pathologic examination of prostate tissue. The Prostate Cancer Prevention Trial had demonstrated that there is no safe PSA value below which a man may be reassured that he does not have biopsy-detectable prostate cancer.

"An alternative to the transrectal saturation biopsy approach is transperineal prostate biopsy, which is performed under local, regional, or general anesthesia using a brachytherapy grid and transrectal ultrasound guidance. Like transrectal saturation biopsy, this technique is reserved for patients with elevated and/or rising PSA values and prior negative transrectal prostate biopsies. Percent positivity with transperineal biopsy ranges from 37% to 43%.

"Based on a randomized trial of prostate cancer screening, there appears to be a modest reduction in prostate cancer mortality among those screened when compared to those that are not. In another screening study, there was no difference in prostate cancer mortality when comparing men that were and were not screened. However, there is a large amount of overdiagnosis and overtreatment associated with screening and at this point it is not possible to state that screening is associated with more benefit than harm.

"The recommendation to perform PSA testing annually among men who decide to be tested is also not evidence-based."

The above four paragraphs of medical gibberish mean precisely one thing — the much vaunted PSA test is as worthless as female appendages on a boar hog. Period.

Continue on to part two.

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