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May 24, 2003
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This is only for real clinicians...{they tell me I start strange post}

PSA test may as well be equated with trickery..

1)American Cancer society recommends PSA for men over 50..
2)American Urological Society recommends PSA for men over 50
3)CDC saysthe test does not reduce risk of death or increase quality of life, nor does potential benefit outweigh the harm of screening and treatment.
4) the U.S. Preventive Task force advises against PSA in men 75 and older but agrees thee is no consensus for youNger men..

*The thing here is that in lets say a 62 year old patient is his prostate CA adenocarcinioma or is it the more agressive sarcoma??
In one year an aggressive prostate sarcoma may only give this patient 2 years to live and prostatecomy is out of the question!! Leaving only radiation or hormonal therapy.. Notice that even if this patient chose hormonal therapy in one year the cancer could become hormone refractory..Giving a very poor prognosis since the cancer is not localized and too advanced..

Moral of story:
Althought discounted on this forum...The practioner must communicate properly to the patient .. OFFER HIM A PSA AND DRE AT LEAST A FEW TIMES! Communicate in layman terms the pros and cons of the PSA and DRE..

Although the PSA doesnt increase the likelihood of survival or decrease morbidity and mortality.. Even if its controversial you must TALK to Patient about the PSA! The jury in this case would favor the patient since the doc didnt offer him the early choice of a PSA ..

Because malpractice is often based on misdiagnosis , failure to diagnose or in this case DELAY in DIAGNOSIS!

**Offer the patient the PSA/DRE and say it with conviction dont say it like a girl!!:xf:
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