Deeper Dive on PSA Screening
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Dr. Mike Evans is founder of the Health Design Lab at the Li Ka Shing Knowledge Institute, an Associate Professor of Family Medicine and Public Health at the University of Toronto, and a staff physician at St. Michael's Hospital.
Written and Narrated by Dr. Mike Evans
Executive Producer, Dr. Mike Evans
Illustrations by Liisa Sorsa
Produced, Directed, and Photographed by Nick De Pencier
Editor, David Schmidt
Story/Graphic Facilitator, Disa Kauk
Production Assistant, Chris Niesing
Director of Operations, Mike Heinrich
©2014 Michael Evans and Reframe Health Films Inc.
I’ve been told I was dying from prostate cancer for almost 30 years. These doctors NEVER asked one question about what I was doing.
Stress, overtraining, and going to a doctor have a effect on psa!
I had a good friend tell me 30+ years ago that he had prostate cancer. I asked him what he was going to do about it and he said nothing. I was actually pissed that he wasn't going to do anything. He lived another 25+ years after this and didn't die from prostate cancer. I learned from this. I understand that all cases are unique but I'm finding many videos from Dr's stating that don't go and jump under the knife unless you really have to.
So basically leave it alone
There's a dangerous slight of hand in this video which goes by very quickly. It says fifty men have side effects from their treatment (news flash: medical treatments cause side effects), but presumably they don't die an early and painful death from prostate cancer BECAUSE of their treatment (not mentioned). A bunch of other men worry about their high PSA number while waiting for further test results (news flash: life is hard sometimes and this is part of the deal for being born) which may or may not reveal aggressive prostate cancer. Five men die of prostate cancer (barely mentioned in the video) and we can guess these men lived a lot longer than they would have without screening and thus had opportunity to be a positive force in the lives of those they love. Consider these five combined with the fifty who have the opportunity to die of something else--and that's pretty good! "Zero or one man is helped by screening". What?? What about the ones who are treated and did or did not have side effects (usually manageable) And what about all the men who are not screened because of the current fad of not screening? They are not included on these 1000 men. Many of them, current studies are showing, arrive too late, with symptoms, and instead of a robotic surgery are subject to hormones, radiation, chemotherapy, more hormones and a seriously altered life path. I bought the train of thought served up in this video hook line and sinker and told myself I can't have PC because the screening is un-necessary. Guys, if your PSA is over a hundred it's pretty damn likely you have cancer. How do you find that high PSA? Screening! Mike drop...
You make good points. I have read that once your PSA is over 20, there is a good chance of actual prostate cancer. And as you said, if you hit 100 you surely do. The big controversy concerning PSA numbers is in the range of 4.0 to 10.0, and possibly a little lower or higher.
@@seascape35 I'd say 4 to ten is pretty high risk, and why take the chance?
Aggressive treatment doesn't extend life - PIVOT study. Treatment options for aggressive prostate cancer yield poor results - PIVOT study
None of the men would have been saved by PSA screening. But the revenue created by all the testing and treatment would be good for the health care industry?
I do not know how many, or what percentage, would be saved by PSA screening, but I am certain it is more than none. That is , some men ARE saved by PSA screenings. So, that's the problem: many shades of gray.
I interpret this video as suggesting, "So don't get screened. There's no point to it." Dr. Mike, am I missing your intended point?
Mike *can't* outright say whether or not you should get screened (at least assuming that you're asymptomatic). If you do get screened, there's a slight chance that you might significantly prolong your lifespan by detecting prostate cancer at an early phase. *A much more likely* outcome, however, is that you will worry unnecessarily about your health and get side-effects from unnecessary tests and/or treatment. The take home message from this video is that an asymptomatic individual might want to think twice (or even thrice) before getting the PSA test. If the test is taken and it shows a high PSA level, one shouldn't get too riled up just by the test result.
Mike won't tell you whether you as an individual should buy a lottery ticket either. The analogy [of course] is that you will almost certainly end up losing money but, if you're extremely lucky, might hit the jackpot. Some people think that it's worth buying lottery tickets whereas personally I prefer investing the money. But there's no absolute yes/no answer to whether people should buy lottery tickets or not.
Thoughtful note, Kalle. Thank you for investing the time!
Cheers, I'm happy if I managed to clarify the issue.
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