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c palmer

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May 3, 2013, 7:28:47 PM5/3/13
to
as you read what i have to say, you will have to skip to the end to see
what year this conversation took place...

i was talking with a well known surgeon who sits on a board that works
with the insurance industry.

what he told me is that there is a big strain on the health insurance
industry because people are living longer and that because people have
better screens and are able to caught an illness before it turns into a
life threatening situation.

he said that in time, what will happen is that health insurance will
get so expensive and the industry will tell people to start putting off
preventive tests as needless and it will slowly start to bring the
tables back in line for where we should be.

he agreed that better health care does lead to a longer life, but at
what cost? if the person can afford is one thing, but what happens if
they can't? who is going to foot the bill? that is the big question
that wasn't answered.

over the past few years, i've seen heated discussions about prostate
cancer testing as well as when should a woman get breast cancer testing.

we, at this newsgroup, over time, have seen and known men who developed
pca earlier in life and if they didn't have the pca testing and waited
for the symptoms to show up, would have been too late for any kind of
corrective treatment.

tonight, i see on the news that they say that panel of doctors have
decided that they recommend that a man should not be get a psa test
before the age of 55 and should only discuss getting a psa test with the
doctor from age 56 - 69 and no psa testing is recommend at age 70....

i just lost a good friend two months who died before the age 56. he
was dx'ed at age 51 with a psa of 67 and a gleason of 9. even with
aggressive treatments he still lived longer than he would have if he
would have just let the pca naturally progressed....

oh, the year i had the above conversation with this surgeon in the year
1989.....

~ curtis

*.*

unread,
May 4, 2013, 2:11:55 AM5/4/13
to
On Fri, 3 May 2013 18:28:47 -0500, PALME...@webtv.net (c palmer)
wrote:
The discussion I had with my doctor is that I will decline the DRE and
stick with monitoring my PSA. I read that the most sensitive finger
can only feel a prostate lump long after it has grown to large.

PSA on the other hand doesn't catch all forms of PCA. I look only at
the delta from my age of 40. If I see a significant delta change I
will consider options. So far so good. I hope to live to see more
definitive tests.

One game changer is lab on a chip. A 50 cent device capable of looking
at one or two protein (or other) markers for the cost of drawing a
drop of blood, lab costs and 50 cents to analyze. These devices remain
in the experimental stage but hopefully will soon drive down testing
costs dramatically.

Here is my 2 cents worth on modern health insurance: Despite annual
physicals none of them ever detected the inguinal hernia I developed,
the urine flow problem or any other ailment or physical condition I
developed. Sure listening to my lungs and heart is still a good idea.
All that palpitation crap is from the 1800's and rarely detects
anything. Ultrasound is far better and now comes in cheap, handheld
forms. So why do doctors push for annual exams? They get paid a higher
fee for them. It is a money maker. Think of all the saved doctor
visits if we really only saw the doctor when we were sick, except for
3-5 year checkups for heart, simple blood tests: CBC, fasting sugar,
etc. and ultrasound in office with handheld.


It is about time to throw away the 1800 crap in favor of science. No
more paying for "art of medicine" instead of paying for "science of
medicine." You don't need expensive doctors to listen to your heart,
order routine blood tests and use a handheld ultrasound unit.

Eventually they will get high Tesla MRI machines to catch prostate
cancer early on before a finger or PSA can.

Michael H Berkowitz

Steve Kramer

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May 4, 2013, 8:10:27 AM5/4/13
to
Hi, Michael

Any relation to Maynard?



PSA OCT 2000 @ 46
Biopsy NOV 2000 3+4=7, T2c
RRP DEC 2000 3+4=7), T3cN0M0, SVI, Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT MAY - JULY 2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron started JULY 2003 @ 48
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added JUL 2006 @ 51
Last PSA <0.05 Next draw AUG 2013 @ 58
Illegitimati non carborundum




"*.*" wrote in message news:mk89o81va9djiqp4v...@4ax.com...

I.P. Freely

unread,
May 4, 2013, 10:28:24 AM5/4/13
to
Michael, you sound like a bitter, cynical old man with limited, maybe
even little, faith in those gods in white coats.
I agree 99% with you.
My only exception might be the notion that doctors make money on annual
checkups, at least under Medicare or any other government insurance
plan. I haven't looked lately, but I'm guessing my civilian clinic gets
paid about $30-40 for an annual exam. That, or the medical factors you
accurately summarized, probably explains why my civilian doc doesn't
even give me an annual unless I ask for it ... which I don't. My present
local VA doc is conscientious, thorough, and responsive to my questions,
so their annual is good enough for me for routine concerns.

My criteria for seeking medical analysis are any unexplained symptom
that is perceptible for days to weeks, is painful for days, and/or is
alarming for moments. That has worked very well for many decades for me
... except for the VA idiot who ignored my PSA until my PC escaped my
prostate.

Funny hernia story: my brother got his draft notice for Viet Nam, passed
his screening physical, trained the guy who replaced him in his career,
put his engagement on hold, and went off to the induction center several
states away to go to war. Early in his induction physical he was told,
"Turn your head and cough", followed by, "Hmmm ... do that again.", then
by, "Sir, how'd you even walk in here? You have a very serious double
hernia. Get outta here; we can't use you. And get that thing fixed."

He cartwheeled back to Texas, got a better job, got married, and over 30
years later thought he perceived a twinge in his groin. Sure enough,
that hernia had become detectible, so he got it fixed in case it
actually began bothering him some day.

BTW ... dogs still detect some forms of cancer long before medical
science can. If Fido digs a 6 feet by 2 feet hole six feet deep and
nudges us into it, we'd better pay attention.

I.P.

*.* wrote:

> Here is my 2 cents worth on modern health insurance: ...

Gourd Dancer

unread,
May 4, 2013, 11:18:39 AM5/4/13
to
>tonight, i see on the news that they say that panel of doctors have
>decided that they recommend that a man should not be get a psa test
>before the age of 55 and should only discuss getting a psa test with the
>doctor from age 56 - 69 and no psa testing is recommend at age 70....

Interesting as not one of the sobs practices in urology nor has an
experience in treating prostate cancer...........

GD

"c palmer" wrote in message
news:25205-518...@storefull-3172.bay.webtv.net...

Alan Meyer

unread,
May 4, 2013, 1:25:14 PM5/4/13
to
On 05/04/2013 02:11 AM, *.* wrote:

> The discussion I had with my doctor is that I will decline the DRE and
> stick with monitoring my PSA. I read that the most sensitive finger
> can only feel a prostate lump long after it has grown to large.
>
> PSA on the other hand doesn't catch all forms of PCA. I look only at
> the delta from my age of 40. If I see a significant delta change I
> will consider options. So far so good. I hope to live to see more
> definitive tests.

For patients who have already been treated for prostate cancer, I think
that's a reasonable idea. I (who have already been treated) also
decline DRE's. Studies of thousands of post-treatment PCa patients have
shown that there is almost never a lump in the prostate region for these
patients without a prior rise in PSA.

For pre-treatment patients, the story may be a little different. As you
point out, there are unusual prostate cancers where the PSA does not
rise above the presumed "normal" point. For these patients, a DRE may
discover the cancer before it has spread. If done right, the DRE is an
extremely cheap and minimally invasive (though I admit it doesn't feel
like that) test that can detect a potentially terminal illness before it
becomes terminal.

However, having said that, I'll also say that your "most sensitive
finger" phrase is an important one. I would bet that most general
practice physicians, and unfortunately even some urologists (I went to
one), don't have the skills or the experience or both to recognize a
tumor on a prostate exam. There's not much point having a doctor feel
your prostate if he wouldn't know a tumor when he felt one.

> One game changer is lab on a chip. A 50 cent device capable of looking
> at one or two protein (or other) markers for the cost of drawing a
> drop of blood, lab costs and 50 cents to analyze. These devices remain
> in the experimental stage but hopefully will soon drive down testing
> costs dramatically.
>
> Here is my 2 cents worth on modern health insurance: Despite annual
> physicals none of them ever detected the inguinal hernia I developed,
> the urine flow problem or any other ailment or physical condition I
> developed. Sure listening to my lungs and heart is still a good idea.
> All that palpitation crap is from the 1800's and rarely detects
> anything. Ultrasound is far better and now comes in cheap, handheld
> forms. So why do doctors push for annual exams? They get paid a higher
> fee for them. It is a money maker. Think of all the saved doctor
> visits if we really only saw the doctor when we were sick, except for
> 3-5 year checkups for heart, simple blood tests: CBC, fasting sugar,
> etc. and ultrasound in office with handheld.
>
>
> It is about time to throw away the 1800 crap in favor of science. No
> more paying for "art of medicine" instead of paying for "science of
> medicine." You don't need expensive doctors to listen to your heart,
> order routine blood tests and use a handheld ultrasound unit.
>
> Eventually they will get high Tesla MRI machines to catch prostate
> cancer early on before a finger or PSA can.
>
> Michael H Berkowitz

I agree with all of that. A hundred years from now, our
great-great-grandchildren will have non-invasive instruments in the home
that will diagnose thousands of conditions that today are very hard to
diagnose.

Alan

P.S., As Steve Kramer asked, are you related to Maynard Berkowitz? He
was a very well respected participant in this newsgroup before he died
of PCa.

c palmer

unread,
May 4, 2013, 1:35:22 PM5/4/13
to
From: fugedd...@noway.nohow (I.P. Freely)

BTW ... dogs still detect some forms of cancer long before medical
science can. If Fido digs a 6 feet by 2 feet hole six feet deep and
nudges us into it, we'd better pay attention.
I.P.

===> this is just a thought from my sick bastard mind .....

can you imagine this new ad coming out on tv in your area.....???

---

"there are over 240,000 men a year who are dx'ed with prostate cancer.
we have the latest in non tactile technology and can offer it to you.
with the use of our special trained dog, "nipper'. with a sniff of
your crotch, he can detect prostate cancer. why bother with needless
blood tests and biopsies? just stop by our clinic to have 'nipper'
sniff you.

nipper's reputation is outstanding and comes from a long line of dog
sniffers. since dogs are known to have a prostate gland, that is one
of the main reasons that they sniff each other because they are watching
out for one another in a caring and loving way. women have called
men, 'dogs' for ages and now, they can share their love with you and
help protect you from prostate cancer.

nipper can also sniff butts too for colon cancer. so why not come on
down to our clinic, 'dewey, skrewem, and howl' and set up a time for
your next prostate and colon cancer screening.

note: cost of screening may vary, depending on how many 'scans' are
made by 'nipper'.

note disclaimer: dog sniffing may have some side effects. excessive
dog sniffing studies have shown that it can cause the humping of the leg
or the occasional urination of the test dog onto your leg or shoe.
check with your doctor to see if dog sniffing tests are right for you.

ChuckP

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May 4, 2013, 3:42:02 PM5/4/13
to
The report I read indicated that it was the ACU that proffered the advice.
The doctor heading the ACU committee was H. Balantine Carter, a urological
oncologist and surgeon with the Brady Institute at Johns Hopkins. He is also
a professor at JHU med school. I would say he has adequate credentials.

I find the the screening conclusions unsettling but if evidence based then I
can only raise my own anecdotal story against the discouraging words of the
committee. I would hope that many practicing uros will screen on request or
with other indications than age.

Chuck


"Gourd Dancer" <!!!noreply!!!@gmail.com> wrote in message
news:km38m1$vr$1...@dont-email.me...

Steve Kramer

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May 4, 2013, 5:39:13 PM5/4/13
to
Great to see you again Chuck!

Last we heard, your PSA was rising ever so slowly toward 2.0. How are you
doing now?



PSA OCT 2000 @ 46
Biopsy NOV 2000 3+4=7, T2c
RRP DEC 2000 3+4=7), T3cN0M0, SVI, Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT MAY - JULY 2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron started JULY 2003 @ 48
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added JUL 2006 @ 51
Last PSA <0.05 Next draw AUG 2013 @ 58
Illegitimati non carborundum




"ChuckP" wrote in message news:km3o42$11n$1...@dont-email.me...

ChuckP

unread,
May 4, 2013, 6:13:10 PM5/4/13
to
Feeling great Steve but now clearly recurrent. PSA is not 4.0 with a
doubling time of 8 months. New doc anticipates hormone treatment but not
yet ready to pull the trigger. He has a cut point of a dt of 6 months or
less. He is less concerned about the PSA number itself than velocity.

We will review in August.

Looking forward to a great summer at the Jersy shore.

Chuck

"Steve Kramer" <skr...@cinci.rr.com> wrote in message
news:km3uvo$bph$1...@dont-email.me...

jloomis

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May 4, 2013, 7:31:15 PM5/4/13
to
Funny how I was Dx'd when I was 49 in 1999 and found prostate cancer.
Not sure where I would be right now if I were not tested?
john

"c palmer" wrote in message
news:25205-518...@storefull-3172.bay.webtv.net...

Gourd Dancer

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May 4, 2013, 7:36:49 PM5/4/13
to
OK I just read the article in USA Today, dated May 3, 2013. I must tell you
that I am surprised. Just as surprised as Kenneth who at age 45 was
diagnosed with advanced prostate cancer and despite the best minds at MD
Anderson died ten years later.

GD

"ChuckP" wrote in message news:km3o42$11n$1...@dont-email.me...

Steve Kramer

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May 5, 2013, 9:47:59 AM5/5/13
to
Well, you will have held the bastard off for six years before having to
resort to ADT. No small feat. I wish for you a great summer.



PSA OCT 2000 @ 46
Biopsy NOV 2000 3+4=7, T2c
RRP DEC 2000 3+4=7), T3cN0M0, SVI, Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT MAY - JULY 2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron started JULY 2003 @ 48
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added JUL 2006 @ 51
Last PSA <0.05 Next draw AUG 2013 @ 58
Illegitimati non carborundum




"ChuckP" wrote in message news:km40vc$msq$1...@dont-email.me...

Steve Kramer

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May 5, 2013, 9:49:49 AM5/5/13
to
Same here. Dx'd at 46 in 2000. Except I know where I would be; Section 6,
Lot 1, Grave 2.



PSA OCT 2000 @ 46
Biopsy NOV 2000 3+4=7, T2c
RRP DEC 2000 3+4=7), T3cN0M0, SVI, Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT MAY - JULY 2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron started JULY 2003 @ 48
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added JUL 2006 @ 51
Last PSA <0.05 Next draw AUG 2013 @ 58
Illegitimati non carborundum




"jloomis" wrote in message news:km45o...@news4.newsguy.com...

jloomis

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May 5, 2013, 5:18:07 PM5/5/13
to
Yeah.....I understand.
And now I am hoping for good numbers after almost 14 years.........
I get my test in June......?
I am worried.....
john

"Steve Kramer" wrote in message news:km5nri$c9f$1...@dont-email.me...

Alan Meyer

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May 5, 2013, 5:22:53 PM5/5/13
to
On 05/04/2013 01:35 PM, c palmer wrote:
...
> check with your doctor to see if dog sniffing tests are right for you.

ROFL

(Rolling On the Floor Laughing)

Alan

Steve Kramer

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May 6, 2013, 9:38:41 PM5/6/13
to
Yeah. I forgot you're looking at the possibility of a 2.0.



PSA OCT 2000 @ 46
Biopsy NOV 2000 3+4=7, T2c
RRP DEC 2000 3+4=7), T3cN0M0, SVI, Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT MAY - JULY 2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron started JULY 2003 @ 48
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added JUL 2006 @ 51
Last PSA <0.05 Next draw AUG 2013 @ 58
Illegitimati non carborundum




"jloomis" wrote in message news:km6ia...@news4.newsguy.com...
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